Patients back in hospital after ‘EVALI’ vaping illness

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WASHINGTON, Oct 12, 2019 (BSS/AFP) – Some patients who have been discharged
from hospital after recovering from lung injury associated with vaping have
had to be readmitted, US officials said Friday as they named the mysterious
illness that has killed 26.

Authorities issued new clinical guidance and are now referring to the
condition as “e-cigarette or vaping product use associated lung injury” or
“EVALI.”

Around 1,300 people have fallen ill since March, almost all hospitalized,
with the rate of new cases showing no signs of slowing despite a series of
dire public health warnings.

A 17-year-old this week became the youngest person to die from the illness,
and 80 percent of cases are among individuals under 35.

Anne Schuchat, a senior official with the Centers for Disease Control and
Prevention (CDC), told reporters: “We’re aware of a handful of individuals
who have been readmitted for clinical care after discharge for lung injury.
We need to understand these accounts better.”

She added the number was “less than five” and the time between discharge
and readmission ranged from five to 55 days.

It is not yet clear what was responsible, with theories including a
resumption of vaping, that the injury had left patients more susceptible to
infectious disease, that steroid treatment had made them vulnerable to
infection, or steroid treatment was halted too quickly.

The CDC recommended every patient return for outpatient follow-up within
seven days.

Schuchat told reporters nationwide research suggested products containing
THC, particularly those obtained off the street or from unknown sources, were
linked to most of the cases and play a major role in the outbreak.

Tetrahydrocannabinol (THC) is the main psychoactive component of cannabis
and more than three-quarters of patients reported using it either exclusively
or with nicotine products.

Ned Sharpless, the acting head of the Food and Drug Administration (FDA),
reported that among samples tested of THC containing products, 47 percent
contained Vitamin E acetate which is used as a cutting agent and is harmful
when vaporized and inhaled.

But authorities cannot definitively exclude nicotine products, since 13
percent of all patients reported nicotine use only.

A CDC spokeswoman later told AFP that because the information was self-
reported, it was potentially unreliable.

“Specifically, patients might not always know what substances they use or
might be hesitant to reveal use of substances that are not legal in their
state.”

For now, investigators suspect that some portion of the cases are due to a
risky practice linked to the preparation of THC, but cannot say for certain
whether other cases have other causes innate to the vaping process.