Illnesses and deaths linked to vaping continue to increase around the United States, now totaling 1,080 cases and 19 deaths, health officials said on Thursday.
The Centers for Disease Control and Prevention said that cases had occurred in 48 states and the United States Virgin Islands. This week, Nebraska, Alabama, Delaware, Connecticut, Virginia and New Jersey reported deaths, which brought the total to 19 in 16 states.
The new case count reflects an increase of 275 in just the past week. About half of the 275 were hospitalized in the past two weeks, and the rest were older cases whose link to vaping was just recognized, Dr Anne Schuchat, principal deputy director of the CDC, said during a news briefing.
She described the outbreak as "continuing at a brisk pace," emphasized that the illnesses were serious and life-threatening and called the proportion of patients hospitalized and in intensive care "just terrible."
"We know that additional deaths are under investigation," Schuchat said.
About 70% of the patients were male, 80% under 35 years old and 16% younger than 18, she said. Among the patients who died, the median age was about 50, and the proportion of women was higher than in the overall group of patients.
Outbreak of illnesses
In response to the outbreak of illnesses as well as the increasing rate of teenage vaping, several states have ordered bans on flavored e-cigarettes. The Trump administration has said that it would draft a ban on flavored e-cigarettes, too.
But on Thursday, a New York appeals court ordered a temporary stay of a statewide flavor ban that was to take effect on Friday. Vaping groups had filed suit against the ban, contending that it would hurt retailers and adults who use the products. The vaping industry is also battling a more extensive ban of all vaping products in Massachusetts.
Dr Howard Zucker, the New York state health commissioner, called the outbreak a "public health emergency," adding: "It is undeniable that the vaping industry is using flavored e-cigarettes to get young people hooked on potentially dangerous and deadly products. While the court's ruling temporarily delays our scheduled enforcement of this ban, it will not deter us from using every tool at our disposal to address this crisis."
Symptoms of the illness
Symptoms of the illness include coughing and breathing trouble that can become severe enough to require that patients be attached to ventilators. Some also have nausea, vomiting and fever. Many have vaped THC, the psychoactive ingredient in marijuana; some have vaped both THC products and nicotine. Some say they have vaped only nicotine.
It is not yet possible to tell whether the illness comes on quickly or is the cumulative effect of longtime vaping.
The exact cause of the illness is still not known, although CDC officials have been referring to "chemical exposure." The culprit could be one or more ingredients in the vaping fluids, or a toxin released from the materials used to make vaping devices, which contain heated coils that vaporize fluids or other substances. Many of the ingredients in the products are unknown.
"I wish we had more answers regarding the specific harmful products or components that are causing these illnesses," Schuchat said.
She added: "I think we have the feeling right now that there may be a lot of different nasty things in e-cigarettes or vaping products, and they may cause different harms in the lungs."
In some cases, the injury to the lung tissue looks like a chemical burn, the same kind of damage that occurs from industrial accidents where chemicals spill and people inhale poisonous fumes, experts in lung pathology from the Mayo Clinic reported on Wednesday. Their findings were based on studying samples of lung tissue from 17 patients, ages 19 to 67, who became ill after vaping. Most reported vaping THC.
Medical investigators are scrambling to find the cause of the illnesses, a task made more difficult by the booming market in vaping products, some legal and many not, from sources unknown. Some are concocted at home by users themselves. All the products are a stew of chemicals, often including flavorings, oils and solvents that may react with one another when heated, to produce still more molecules that have yet to be identified.
The Food and Drug Administration is testing vaping products, and has obtained more than 440 samples from 18 states, Judy McMeekin, the agency's deputy associate commissioner for regulatory affairs said at the briefing on Thursday.
So far, she said, no single product or substance has been identified as the source of the trouble. She said that the agency was particularly concerned about black-market sources, but that it was too soon to rule out other products.
During the briefing, Schuchat was asked if THC vaping products could be considered safe if purchased from dispensaries in states that license them.
She replied: "With all the data I've been seeing, I don't know what safe is now."