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Vaping Illness Cases Identified in Buncombe County

. Computerized tomography images showing diffuse lung infiltrates in three patients with e-cigarette–associated severe lung disease — North Carolina, July–August 2019";s:3:

Health officials have confirmed two cases of vaping-related lung illness in Buncombe County.  Department of Health and Human Services spokesperson Stacey Wood told BPR News few details are known about the cases at this time and it is unclear if the two are among the five North Carolina cases highlighted  in a September  report by the Centers for Disease Control.  

According to the  September 13 Morbidity and Mortality Weekly report in July and August, five patients were identified at two NC hospitals with the similar symptoms, possibly due to e-cig use.  Patients were between 18 and 35 years old and all experienced several days of shortness of breath, nausea, vomiting and fever before they went to the hospital. Three required intensive care for respiratory distress syndrome.  All five survived and have been released from the hospital.

According to the  latest report from the CDC, more than 530 confirmed and probable cases have been identified in 38 states. The CDC has confirmed seven deaths, in six states  CDC officials say they are only counting cases that have been confirmed or are classified as highly probable because doctors have been able to rule out other causes of the lung illness.  More than 40 state health epartments have reported investigations of more than 700 possible cases.

More information from the Centers for Disease Control:

  • Seven deaths have been confirmed in California (2), Illinois, Indiana, Kansas, Minnesota, and Oregon.
  • CDC worked with states to create a case definition to classify confirmed and probable cases in a consistent way. State investigators determine if cases are confirmed or probable after examining the medical records of suspected cases and consulting with the clinical care team to exclude other possible causes of illness. Unlike nationally reportable conditions, these cases are requiring clinicians and public health professionals to interview patients to determine product use and individual behaviors.
  • CDC will report numbers of confirmed and probable cases once states have finalized their classification of cases.
  • States are in the process of classifying cases. We expect that states and clinicians may look back for older cases based on CDC’s case definition.
  • All patients have a reported history of e-cigarette product use, and no consistent evidence of an infectious cause has been discovered. Therefore, the suspected cause is a chemical exposure.
  • Based on initial data from certain states we know: Most patients have reported a history of using e-cigarette products containing THC. Many patients have reported using THC and nicotine. Some have reported the use of e-cigarette products containing only nicotine.
  • No consistent e-cigarette or vaping product, substance, or additive has been identified in all cases, nor has any one product or substance been conclusively linked to lung disease in patients.
  • Initial published reports from the investigation point to clinical similarities among cases. Patients reported a history of e-cigarette use and had similar symptoms and clinical findings. These align with the CDC health advisory released August 30, 2019.
  • These investigations are ongoing. CDC will provide updates when more information is available.

*The increase in cases from last week represents both new cases and recent reporting of previously-identified cases to CDC.

Helen Chickering is a host and reporter on Blue Ridge Public Radio. She joined the station in November 2014.