Maryland health agencies investigating cases of severe lung illness linked to vaping

Maryland health officials reported Wednesday that five residents developed a severe lung illness after using e-cigarettes, adding to an increasing number of cases across the country.

More state and federal health officials are warning about the potential dangers of e-cigarettes as the vaping industry grapples with lawsuits, counterfeit products and growing reports of adverse health effects.

Maryland and Virginia reported cases of severe lung illness linked to e-cigarette use this week, contributing to about 200 possible cases nationwide. No cases of lung illness associated with vaping have been reported so far in the District of Columbia, according to D.C. health officials.

“There is so much we don’t know about the contents of these products. The best way to keep yourself safe is to not use e-cigarettes or vapes,” said Dawn Berkowitz, director for the Maryland Department of Health Center for Tobacco Prevention and Control.

The Virginia Department of Health said it has confirmed three of eight potential cases of respiratory illness currently under investigation.

The health department is urging parents to talk to their children about the dangers of vaping.

“While all forms of tobacco use cause disease and death, recently a new danger has been linked to ’vaping’ or ’dabbing’ (vaping marijuana oils, extracts or concentrates). Since June 28, 2019, many states have been investigating cases of patients hospitalized with severe lung illness associated with those activities — primarily among teens and young adults,” the agency said.

The Centers for Disease Control and Prevention reported late last week 193 possible cases of severe lung illness linked to vaping in 22 states, including the first death of a person in Illinois.

Utah’s health department confirmed 21 cases as of Monday, with additional cases under investigation. It first reported five cases related to vaping on Aug. 19.

Patients with vaping-related respiratory illnesses experienced shortness of breath, coughing and chest pain before hospitalization. Some reported gastrointestinal illness such as vomiting and diarrhea accompanied with fatigue. In more severe cases, patients needed to be hooked up to mechanical ventilators due to breathing difficulties.

All patients said they had vaped in the weeks and months leading up to their hospitalizations, with some reporting using products containing THC, the psychoactive ingredient in marijuana.

Former Food and Drug Administration Commissioner Scott Gottlieb told CNBC this week that these lung illnesses are probably linked to counterfeit flavored products that are compatible with commonly used devices, including Juul.

Juul, a leading e-cigarette company, stopped distributing mango, fruit, creme and cucumber flavored products to traditional retail stores in November.

Federal officials said they do not yet know the cause behind the vape-related lung illnesses.

“We find ourselves in the early stages of these investigations, trying to piece together the facts,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, noting that many cases involved the presence of ingredients like THC. “We need to get to the bottom of every single case.”

He said the agency has received some product samples that they are analyzing to see whether they contain nicotine, THC or other ingredients.

Gregory Conley, president of the American Vaping Association, said there is no evidence that links counterfeit nicotine vaping products to the illnesses, but there is a significant number of health departments pointing to street-bought THC cartridges as the cause.

Juul said it is monitoring these reports, commenting on how these cases of lung illness reaffirm the need to keep all tobacco and nicotine products away from youth.

“We also must ensure illegal products, such as counterfeit, copycat, and those that deliver controlled substances, stay out of the market,” the company said.

The uptick in cases comes as these e-cigarette products face more scrutiny for its role in the youth vaping “epidemic” and its possible health effects on users.

Some states are suing e-cigarette companies, blaming them for the youth vaping “epidemic.” North Carolina filed a lawsuit against eight e-cigarette companies for their alleged aggressive marketing that targeted children and lack of appropriate age verification when selling their products, according to a Tuesday announcement from state Attorney General Josh Stein.

Earlier this month, the FDA said it received 127 reports of e-cigarette users having seizures or other neurological symptoms. The agency is also looking into adding some ingredients found in e-cigarettes to a list of potentially harmful ingredients found in tobacco and nicotine products.

A national survey published Wednesday found that about one-third of middle school and high school students said they were exposed secondhand to vaping aerosols last year, a 30% increase from the previous three years, according to Andy Tan of the Dana-Farber Cancer Institute.

D.C. Health said parents and teachers should be aware that some e-cigarette devices look like USB flash drives — not cigarettes — enabling students to vape in schools often unnoticed.

Last year, 3.6 million middle and high school students across the country used e-cigarettes, up by 1.5 million from the previous year, according to the FDA.