Reports of a mysterious vaping lung illness are continuing to pop up across the US. While many question marks still hang over this freak outbreak, some answers are finally emerging. Here’s everything we know so far.
The first cases were reported in Illinois and Wisconsin back in April 2019. As of September 27, there have been 805 reported cases of lung injury associated with vaping from 46 states and one US territory, according to the latest CDC statistics. There was also one case in Canada, although the patient appears to have recovered.
Twelve deaths have been confirmed on the CDC's website, although some media outlets are reporting that the death toll has risen to 13.
An overwhelming majority of cases are young men – 72 percent are male and 67 percent are 18 to 34 years olds. This trend is not fully understood, however, it’s noteworthy that vaping is especially popular among young men. All patients have a reported history of e-cigarette product use, many using both THC and nicotine and some just using nicotine.
Symptoms include a cough, wheezing, shortness of breath, chest pain, and nausea. Fever, fatigue, and weight loss have also been reported. Patients with the disease typically have an elevated white blood cell count, indicating that their immune system is fired up.
What’s causing the illness?
No one is totally sure.
A study in The New England Journal of Medicine (NEJM) published on September 6, 2019, closely studied 53 of the cases and found that 84 percent of them had vaped with flavored liquid containing THC, the psychoactive component of cannabis. Notably, nearly 60 percent of 41 patients interviewed had also vaped using THC products labeled as “Dank Vapes.”
This “company” is a bit of an enigma. No one is quite sure if Dank Vapes is an actual company or just a brand name used by multiple operators. Either way, it appears that some unlicensed sellers are filling cartridges, complete with the colorful Dank Vapes branding, with their own illicit vape liquids.
Some of their THC-infused vape liquids also appear to have been cut with a thickening agent, vitamin E acetate. While it's unclear how this supplement affects human health when it's inhaled, the US Food And Drug Administration is pointing to vitamin E acetate as a prime suspect.
The NEJM study also found that many of the patients had lipid-laden macrophages in their lungs. This could be a sign of lipoid pneumonia, a noninfectious condition that occurs when fatty, oily particles enter the lungs, although – once again – it’s not certain.
“I don’t think we yet know the clinical significance of the lipid-laden macrophages and we don’t know if the lipids that have been detected within the cells are endogenous or exogenous, meaning did they come in through the body or were they already present in lung tissues,” Dr Dana Meaney Delman, incident manager at the CDC, said at a media briefing on September 6.
“It’s too early to know if the lipid-laden macrophages will be a range of pathologic illnesses.”
Regardless, it's safe to say that this appears to be a problem with a contaminated vaping liquid, as opposed to a fundamental issue with e-cigarettes and vapes that has gone undetected until now.
“E-cigarettes have been around for over a decade now and are used by millions of people, with no such cases occurring. The outbreak is similar to methanol poisonings that kill people every now and then when contaminated alcohol is sold,” Professor Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary University of London, commented on the outbreak.
Should you quit vaping immediately?
Unless you recently bought some THC vape liquid from a shady online peddler – in which case, you should avoid consuming it – there is not enough evidence to assess the full scope of the risks. However, most authorities are taking a “better safe than sorry” approach by suggesting people halt vaping until more concrete evidence comes to light.
The CDC recommends people “consider refraining” from using e-cigarettes or vaping products until we know more. Even President Trump gave his two cents on the issue and suggested he’s looking to ban the sale of most flavored e-cigarette liquids. Some states, such as Massachusetts, have already put a temporary ban on the sale of all vaping products.
Additionally, if you started vaping as a means to quit cigarettes then it’s worth remembering that experts still believe that vaping is the “lesser of two evils” compared to tobacco smoking.
“We must also remember that for nearly every person who vapes, the alternative to vaping is smoking. While vaping does produce some toxins, those are at significantly lower levels than seen in cigarette smoke,” said Professor Paul Aveyard, professor of behavioral medicine at the University of Oxford, commenting on the NEJM study.
“These cases are worrying and need investigating, but advice from all official bodies in the UK is that it is always preferable to vape than to smoke. Today’s reports should not change that advice.”