Officials in San Diego County are continuing to investigate reports of a mysterious vaping-related respiratory illness after confirming 12 local cases.
The lung disease linked to electronic smoking devices has surged across the country in recent months, sickening hundreds in more than 30 states and killing at least six. San Diego health officials are working with state and federal agencies to help pinpoint the cause of the illness.
Dr. Eric McDonald, who leads the county’s Epidemiology and Immunization Services Branch, said the state is testing vaping products used by two of the San Diego patients. He said the process can take a while to yield results.
"They're looking for what I would call the usual suspects — things that are known to cause problems — and then if they don't find that, then they have to look deeper and look for things that perhaps have never been detected before," McDonald said.
The county recently obtained a sample from a third patient that it will submit for testing. San Diego officials are also asking patients a set of standard questions developed by the Centers for Diseases Control and Prevention.
"We do that personal interview, we're doing the collecting of specimens if necessary. And then we send all that up the chain," McDonald said.
Locally, the county is looking for similarities across the 12 verified cases to share with health care providers. So far, all of those patients vaped cannabis products, and 10 said they purchased their items from an online or unlicensed vendor. The county doesn't know from where the other two patients purchased their vaping products because they aren't participating in follow-up interviews, McDonald said.
Most of the at least 65 patients possibly sickened with the disease in California also said they bought their vape products from unregulated entities, according to the state health department website.
Vitamin E Found In Products Linked To Illnesses
Testing in Utah and New York uncovered Vitamin E in some of the products that caused people to get sick. It’s a common dietary supplement and topical agent but there isn’t much research on the effects when inhaled. However, the additive wasn't present in all the tested samples, and the Food and Drug Administration has said it can't confirm Vitamin E is the culprit.
The agency would not provide details about which brands they used but said consumers should search online to confirm they are purchasing cannabis vaping products from licensed vendors, which are regulated by the Bureau of Cannabis Control. The health department said people should throw away products from unlicensed retailers.
A person who had severe respiratory illness and died in Oregon reportedly used a cannabis vaping device that was purchased from a dispensary. A death in Minnesota, where marijuana is approved for medical use but not recreational, was linked to "illicit THC products." That person was over 65 years old and had a history of lung disease.
Information about the products suspected in the other deaths was not made available by the other state health departments.
Yet the CDC reports not all of the 380 possible cases of the respiratory illnesses are linked to only cannabis products and suggested people refrain from using all vaping products.
"While many of the patients, but not all, reported recent use of THC-containing products, some reported using both THC- and nicotine-containing products. A smaller group reported using nicotine only," the federal health agency said in a statement last week. "No evidence of infectious diseases has been identified in these patients, therefore lung illnesses are likely associated with a chemical exposure."
The federal agency's warning does not further breakdown how many patients allegedly used THC-containing products from a licensed facility in a state that legalized marijuana compared to an unregulated or black market source. The substance is illegal at the federal level.
Until the cause is identified, the CDC has said on its website people should "consider not using e-cigarette products." The American Vaping Association pushed back against the agency and said it should focus on THC separately from nicotine products.
The group pointed to a Sept. 6 advisory from the Food and Drug Administration that specifically cautioned against using THC oil.
“We agree with the FDA — if you don’t want to die or end up in a hospital, stop vaping illegal THC oils immediately," Vaping Association President Gregory Conley said in a statement Monday.
The Sept. 6 FDA advisory also stated consumers should "avoid buying vaping products of any kind on the street."
Symptoms of vaping-related illnesses include cough, shortness of breath, chest pain, nausea, vomiting, diarrhea and fever. Officials encourage people who experience these symptoms and have vaped within the last 90 days to seek medical attention.
