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Similar themes from vaping-related injuries emerge as death toll slowly rises

Anne Schuchat

The manner through which some patients who are affected by e-cigarette- or vaping-associated lung injury, or EVALI, obtained their vaping devices had a similar theme in different parts of country, a CDC official said.

The assessment came during a weekly teleconference call that the CDC and FDA host to bring the media and public up to date on its investigation into EVALI.

“Most patients in [Utah] had gotten THC-containing vaping products from informal sources or online, rather than from brick-and-mortar sources, stores or dispensaries,” Anne Schuchat, MD, CDC principal deputy director, said during the phone call. “The Utah data are fairly consistent with that pattern of products described in Illinois and Wisconsin.”

Among other information released during the call for the week ending Oct. 22 included:

• There are 1,604 confirmed or suspected cases of EVALI, up from 1,479 last week.
• There are 34 deaths, up from 33 last week.
• The patients who died range in age from 17 years to 75 years.
• The median age of the patients who died from EVALI is 45 years.
• The median age of those who survived EVALI is 23 years.
• Nearly 25% of EVALI fatalities are in patients aged younger than 35 years.
• 85% of the approximately 860 injured patients (of whom such data are available) reported using e-cigarette or vaping products that contained THC.
• Alaska remains the only state or U.S. territory not affected by EVALI.

“Although these new data continue to point to THC exposures as important, at this time, FDA and CDC have not identified a single specific compound, substance, product or brand that is causing these lung injuries. It may be that there is more than one cause,” Schuchat said.

She described some of the newer approaches the CDC and FDA are taking to find the cause of EVALI.

“We’ve been standardizing some acids to measure components of aerosol and pathology specimens,” Schuchat said, adding that tests for certain vaping-related fluids in blood, lungs and urine are also now being used.

Mitch Zeller

Nothing is being ruled out as a cause for EVALI at this point, Mitch Zeller, JD, FDA’s director of the Center for Tobacco Products added.

“We do not have a short list of compounds [that could be causing these injuries],” he said.

Schuchat added that visitors to CDC’s website may see statistics that indicate the EVALI is “tapering off,” “declining” and/or past its peak. But that is not necessarily the case, she said.

“There may be less intensive investigations of possible cases by the health departments, fewer cases from earlier in the year being reported or a lag of [authorities] reporting data to the CDC,” Shuchat said.

“It is also possible that our consumer warnings about the risk of using e-cigarette products or vaping products that contain THC are having an effect or that enforcement actions by local or federal authorities are impacting supply chains in some areas,” she added.

Stay tuned to Healio for continuing coverage of EVALI. – by Janel Miller

Disclosures: Schuchat and Zeller report no relevant financial disclosures.