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CDC Warns Against Use of Black Market E-Cigarettes

— More than 200 illnesses linked to vaping have been reported

MedpageToday

Following growing numbers of reports of respiratory illness -- totaling 215 at last count -- and one death thought to be linked to vaping, the to avoid purchasing black market cannabis or nicotine products sold on the street and to stop modifying the products at home.

The agency activated its , used to relay information on "urgent public health incidents," for only the fifth time this year to issue the warning.

Although the exact cause of the illnesses is not known, many patients have reported vaping cannabis e-cigarettes bought on the street and practices such as dripping -- dropping nicotine or tetrahydrocannabinol (THC) liquid directly onto the hot coils of an e-cigarette to further concentrate the compound -- or dabbing, which involves super-heating cannabis using a solvent to form a highly concentrated resin or "dab."

The CDC is also warning pregnant women, young adults, and children who do not currently use tobacco products to avoid all e-cigarettes, including commercially available nicotine vaping products.

In Wisconsin, where 16 individuals have been hospitalized, Milwaukee's health department , irrespective of the liquids consumed.

All of the 215 patients tracked by the CDC reported using e-cigarette products in the days or weeks before developing respiratory and/or gastrointestinal symptoms.

While not all of the illnesses were severe, many patients have required assisted ventilation and oxygenation, and several were intubated. One patient in Illinois with a recent history of e-cigarette use was hospitalized on July 29 with severe pulmonary disease and died on August 20.

Senior government officials also weighed in on the spate of cases, hoping to assure the public that they are taking the problem seriously.

, U.S. Health and Human Services (HHS) secretary Alex Azar vowed to use "every tool we have to get to the bottom of this deeply concerning outbreak of illnesses in Americans who use e-cigarettes."

And in a , FDA Commissioner Ned Sharpless, MD, and CDC Director Robert R. Redfield, MD, updated efforts to identify the source of the illnesses, confirming that FDA investigators are in the process of analyzing around 80 samples of e-cigarette products used by people who became ill.

"More information is needed to better understand whether there's a relationship between any specific products or substances and the reported illnesses," the joint statement read. "At this time, there does not appear to be one product involved in all of the cases, although THC and cannabinoids use has been reported in many cases."

On Friday, federal health officials also called on clinicians "to report cases of severe pulmonary disease of unclear etiology and a history of e-cigarette product use within the past 90 days" to state or local health departments.

State public health officials were also asked to notify CDC about possible cases of vaping-related illness by sending an email to VapingAssocIllness@cdc.gov.