Vaping illnesses rise in NY as investigation turns to cannabis products – Times Union

ALBANY — State health officials are investigating the role that a substance called vitamin E acetate may have played in the rising number of vaping-related illnesses being reported statewide and nationally this summer.

As of Friday, 27 cases of severe respiratory illness associated with e-cigarette use have been reported in New York since June, the state Health Department said. That’s up from 11 cases announced just two weeks ago. Four of them have been in the Capital Region.

The news comes as federal health agencies are investigating a spate of more than 200 possible cases of vaping-related illness reported nationwide since June. The illness is severe: A person in Illinois died last week after being hospitalized, and others have needed supplemental oxygen or assisted ventilation.

The development has alarmed public health officials, who don’t yet know what is causing the illness and worry that contaminated or adulterated product may have recently entered the market.

On Friday, the national Centers for Disease Control and Prevention and the U.S. Food and Drug Administration issued a joint statement urging anyone who is concerned about the potential health risks to stop using e-cigarette products immediately. They also cautioned against buying products on the street or modifying them by adding substances not intended by the manufacturer.

“We are working closely with state and local health officials to investigate these incidents as quickly as possible, and we are committed to taking appropriate actions as a clearer picture of the facts emerges,” the agencies said.

Cannabis connection

As of Tuesday, 215 possible cases have been reported from 25 states, and additional reports of pulmonary illness are under investigation.

While all patients reported using e-cigarette products prior to their symptoms appearing, no one product or device has been identified as a common link in the cases yet, the agencies said.

However, many of the patients have reported vaping products containing tetrahydrocannabinol, or THC — the ingredient in marijuana that gets people high. Others, however, say they used nicotine products only. Laboratory testing is underway to determine the exact contents of the vape products.

“At this time, the specific substances within the e-cigarette products that cause illness are not known and could involve a variety of substances,” the agencies said.

The vast majority of cases under investigation in New York involve people who reported vaping cannabis-based products, said state Health Department spokeswoman Jill Montag.

“However, we are also investigating cases in which people report using both cannabis and nicotine products,” she said.

Testing by the state’s Wadsworth Center has identified high levels of vitamin E acetate — an ingredient typically found in skin care products and dietary supplements — in nearly all of the cannabis samples provided by patients. The samples came from different brands and different parts of the state, Montag said.

“This vitamin E acetate is never found in NYS Medical Marijuana Program-authorized vape samples and is now the focus of the investigation of potential causes of vaping-associated respiratory illnesses,” she said.

Wadsworth will continue to test all product samples it receives as the investigation continues, Montag said.

Ongoing investigation

Although little is known about the long-term effects of e-cigarette use — which is particularly popular among teens, young adults and former smokers — the sudden onset of severe respiratory illnesses this summer has some experts doubtful that legal e-cigarette products are to blame.

In an interview with the New York Times, former FDA commissioner Scott Gottlieb guessed that the investigations will lead health officials to illegal products.

“It’s not like the major manufacturers have suddenly changed their ingredients,” he said. “It’s probably something new that has been introduced into the market by an illegal manufacturer, either a new flavor or a new way to emulsify THC that is causing these injuries.”

Investigators are looking into the brands and types of vaping products used, as well as where they were obtained and how they were used. They are also analyzing devices for specific ingredients and substances associated with e-cigarette use, along with possible contaminants.

The FDA has received about 80 samples for laboratory testing so far, and is analyzing the contents for nicotine, THC and other cannabinoids, and other chemicals and ingredients.

The CDC has also released a standardized case definition and interview questionnaire to clinicians in hopes of standardizing information collected at the state level.

So far, patients have reported a gradual start of symptoms, including breathing difficulty, shortness of breath and/or chest pain before hospitalization. Some cases reported mild to moderate gastrointestinal illness including vomiting and diarrhea, or other symptoms such as fever or fatigue.

Until more information is available, medical professionals cannot even be sure that the symptoms stem from a common cause.

“Even though cases appear similar, it is not clear if these cases have a common cause or if they are different diseases with similar presentations,” the CDC and FDA said, “which is why our ongoing investigation is critical.”

Health officials are urging e-cigarette users to monitor themselves for the symptoms listed above and to promptly seek medical attention if health concerns arise.