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Published: January 23, 2020

E-CIG/VAPE PRODUCT LUNG INJURIES

CDC, has defined EVALI as e-cigarette, or vaping, product use-associated lung injury.  Vaping causes serious injury and even death.  Wyandot County Public Health would like to take this opportunity to share the following report, courtesy of Byron Morales, MD, FAAFP, Director of Population Health & Wellness at Wyandot Memorial Hospital in Upper Sandusky.

• As of January 14, 2020, there has been 2,668 cases of hospitalized EVALI reported by all 50 states, District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
• As of January 14, 2020, there has been 60 deaths confirmed in 27 states and the District of Columbia.
• Median age is 51 years (15-71 years)
• The states are: Alabama, California, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, and Virginia.
• More deaths are under investigation
• From 2,668 hospitalized EVALI patients, 66% were male with a median age of 24 (13-85)
o 15% < 18 yrs old
o 37% 18 yrs – 24 yrs
o 24% 25 yrs - 34 yrs
o 24% ≥ 35 yrs
As of January 17, 2020:
• ED visits related to e-cigarettes or vaping products continue to decline, after SHARPLY increasing in AUGUST 2019 and peaking in SEPTEMBER
• National and state data suggest THC and Nicotine-containing e-cigarettes particularly from informal sources like friends, family, or in person or online dealers, are linked to most EVALI cases and play a major role in the outbreak.
• THC (tetrahydrocannabinol) is the psychoactive mind-altering compound of marijuana that produces the “high.”
• 82% of hospitalized patients reported using THC-containing products, 33% reported exclusive use of THC-containing products
• CDC and FDA recommend that people NOT use THC-containing e-cigarettes or vaping products particularly from informal source.
• Vaping liquid also can contain Nicotine, CBD (cannabinoid) oil, and other substances, like flavorings and additives, not just THC.
• Vitamin E Acetate is STRONGLY linked to the EVALI outbreak
• Vit E Acetate has been found in product samples tested by FDA and state laboratories. It has also been found in patient’s lung fluid samples tested by the CDC.
• Vit E Acetate has not been found in lung of people that do not have EVALI.
• However, evidence is NOT sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC or non-THC products, in some of the reported EVALI cases.
• Vit E Acetate is used as an additive, most notably in THC-containing e-cigarettes or vaping products.
Byron Morales, MD, FAAFP
Director of Population Health & Wellness
Wyandot Memorial Hospital
Ohio Vaping Update (as of 1-16-2020):
• Number of cases: 95
• Age range: 15-65 years with a median age of 25 years
• Gender: 29 Females (31%) / 65 males (69%)
• Number of hospitalizations 87 (92%)- 0 in Wyandot County
• 0 deaths thus far
• Counties affected: Ashtabula, Belmont, Brown, Butler (2), Champaign, Clark, Clermont (3), Cuyahoga (14), Drake (2), Delaware, Fairfield, Franklin (12), Greene, Hamilton (3), Hancock, Jefferson, Lake (2), Lucas (5), Mahoning (2), Marion, Medina (3), Miami (2), Montgomery (7), Paulding, Perry, Portage (2), Preble, Richland (2), Ross, Seneca (2), Stark, Summit (7), Trumbull, Tuscarawas, Union (2), Warren (2), Wayne (2), and Wood
• 9 additional illness are under investigation

Wyandot County Public Health is nationally accredited through the Public Health Accreditation Board (PHAB). Established in 2007, PHAB is the non-profit organization that administers the national accreditation program, which aims to advance and transform public health practice by championing performance improvement, strong infrastructure, and innovation.