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November 4, 2019

As vaping-linked illnesses exceed 1,800, medical groups are calling for action

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    A coalition of medical groups are calling on Congress and the Trump administration to more closely regulate tobacco and e-cigarette companies as the number of vaping-linked illnesses exceed 1,800.

    Background: As cases of a vaping-linked illness surpass 1,800, CDC says it is unsure of cause

    CDC data updated Thursday shows the number of reported cases of a lung illness officials believe is linked to e-cigarette use and vaping, dubbed EVALI, reached 1,888 as of Oct. 29, with 37 confirmed deaths. Cases of the illness have been reported in 49 states, Washington, D.C., and one U.S. territory, with deaths confirmed in 24 states. Alaska is the only state with no reported cases of the illness.

    Based on CDC data released last month on 1,364 patients with known demographic information, the agency estimated that about 80% of patients in the reported cases are younger than 35, 40% are 18 to 24 years old, and 14% are younger than 18. About 70% of patients are male.

    Anne Schuchat—CDC's principal deputy director, who is overseeing the agency's investigation into the matter—last month said the number of reported cases is rising at a "brisk" pace and that cases typically involve "really serious injuries." She said, "[W]e don't know how well people will recover from them, whether lung damage may be permanent."

    Doctors report that patients' recoveries have varied, with some patients appearing to make full recoveries and others continuing to have trouble breathing. CDC earlier this month reported that some patients have relapsed and had to be hospitalized a second time, with readmissions occurring from as few as five days to as many as 55 days after initial discharge.

    CDC said it is unclear why those patients relapsed. However, Schuchat said it is possible that the lung illness made the patients more susceptible to other conditions. In addition, she said steroids used to treat the lung illness could "set [patients] up for increased infection risk."

    CDC also said officials still do not know what is causing the illness and associated lung injuries. The agency noted that a majority of patients with the illness have reported using products containing the compound tetrahydrocannabinol (THC), which is the high-inducing chemical found in marijuana. However, CDC noted that 10% of cases involve patients who reported using only nicotine vaping products.

    Schuchat has said the illness might have more than one cause, and the cause could vary throughout the United States. "The phenomenon we're seeing is going to have an explanation but it may not be tomorrow," Schuchat said earlier this month, adding, "It may take a few months to really understand the portion of illness that's due to some risky practice in the preparation of these materials or other causes."

    CDC recommends that people abstain from products that use THC. The agency previously had recommended that people abstain from all e-cigarette and vaping products, but CDC narrowed its recommendation earlier this month.

    Doctors seek tighter regulations on vaping products

    As the number of vaping-related illnesses continues to rise, a coalition of medical organizations are calling on Congress and the Trump administration to increase oversight of vaping products.

    The American Medical Association, the American Academy of Pediatrics, and the American College of Physicians asked Congress and the Trump administration to ban all flavored vaping products, including mint and menthol flavors, and to raise the national age to buy tobacco and e-cigarettes to 21.

    The groups also called for stricter regulations on tobacco companies' marketing practices and taxes on tobacco products.

    The provider groups noted that there is no clear understanding of the short- or long-term health effects of vaping, and that the devices increasingly pose a risk to children and teens.

    Sara Goza, president-elect of the American Academy of Pediatrics, said, "We need swift and decisive action." She added, "Every day we wait, more and more children will be put at risk"  (Hellman, The Hill, 10/31; Maddipatla/Sibi Joseph, Reuters, 10/31; Masson, Becker's Clinical Leadership & Infection Control, 10/31; Brady, Modern Healthcare, 10/30).

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