Investigations continue into an outbreak of hospitalizations for lung damage nationwide, likely related to vaping products. The Wisconsin Department of Health Services (DHS) is currently tracking 69 probable cases of vaping-related lung disease, though a single cause remains elusive.
Dr. Jonathan Meiman, a DHS chief medical officer, told Wisconsin Examiner, “a big part of this investigation is determining what could be causing these illnesses.” Although many are pointing to counterfeit THC (Tetrahydrocannabinol) vape products as the source of the outbreak, some patients also reported only having used nicotine vapes.
“It varies a little state-by-state,” says Dr. Meiman. “In Wisconsin and Illinois, by and large, most people who have become ill have reported using THC alone, or in combination with nicotine vape products. So our goal is to try to determine what could be in those products that could be causing illness.”
New York state released some of the first clues in September, after counterfeit THC vapes tested positive for vitamin E. More recently, samples taken from California were found to have contained hydrogen cyanide. Both states have legalized cannabis markets, which advocates have argued create a level of regulatory protection against sub-par, black-market products.
Wisconsin’s own samples are still being analyzed by the Food and Drug Administration (FDA). “All of those products that we have received to date have been shipped off to FDA for further testing,” says Dr. Meiman. “We’re still waiting for results at this time.” In Wisconsin and other states, what we know about what patients have taken is left to self-reporting. “We couldn’t do it without people’s cooperation,” he tells Wisconsin Examiner, adding that self-reported data has its limitations.
Many states have been compiling patient data before submitting it to the Centers for Disease Control and Prevention (CDC). The CDC is currently tracking over 1,000 cases of lung illness across 48 states and the Virgin Islands. According to the agency’s website, the largest number of the patients, 26%, are between 25 and 34 years old. Over 80% of the patients nationally are under the age of 35, with 16% under the age of 18, 21% between 18 and 20, and 18% between 21 and 24 years old.
Dr. Meiman explained that some of the most detailed data has come from Wisconsin and Illinois. “We’re seeing this in very vulnerable groups,” says Meiman. “We’re seeing this in very young people, young adults and teenagers.”
“We haven’t been able to identify a particular product that we believe is responsible,” Dr. Meiman says, but points to a strong association with products the patients believed were THC. Marijuana is illegal in Wisconsin, Meiman adds: “people report getting it through informal sources.”
Cannabis advocates pushing for regulated, legalized markets in their home-states point to the rash of vaping-related illness as an argument for legalization. But making marijuana legal has not been a silver bullet.
In California, law enforcement seized $5 million worth of counterfeit THC oil intended for vape products. Tests found the oil contained 7,000 times the allowable levels of a pesticide which, when heated, turns into cyanide. Lab tests commissioned by the Associated Press found synthetic cannabinoid, linked to illness and deaths in 10 of 30 of brands of CBD sold both legitimately and on the black market.
The CDC has a page providing detailed information on patients from Illinois and Wisconsin. For Illinois, 13 out of 48 patients included in the analysis reported only using THC products, and nine reported exclusively using nicotine vapes. Wisconsin’s data, however, showed only two out of 38 patients reported only using nicotine, with 12 stating they’d only used THC products. Most patients appear to have used both products. In Wisconsin, 26 of the 38 patients included in the analysis reported using nicotine products, and 36 self-reported THC vape use.
A separate category has been dedicated to reported use of “Dank Vapes,” a brand of commonly counterfeited THC vapes. Numerous internet forums and websites have appeared since the outbreak, dedicated to differentiating fakes from more trusted products. Some of these products, labeled as “Dank Vapes” have been traced back to the Chinese black market. In Wisconsin, 24 of 38 patients included in a CDC analysis reported the use of Dank Vapes.
The Wisconsin Department of Health Services continues to monitor the situation. A page on the outbreak is updated every Thursday morning, as tests continue at the FDA. “This is an outbreak that we’re taking very seriously,” says Dr. Meiman.