Five confirmed deaths and nearly 500 cases of lung illness are now potentially linked to e-cigarette products, according to U.S. public health officials investigating the national outbreak tied to “vaping.”
The U.S. Centers for Disease Control and Prevention (CDC) said in its latest update that these severe lung diseases are being investigated in 33 states, including Florida. Most cases are associated with “e-cigarette product use, or vaping, primarily among adolescents and young adults,” the CDC says.
E-cigarettes  are devices that deliver an aerosol to the user by heating a liquid that usually contains nicotine, flavorings, and other chemicals, the CDC says. E-cigarettes can also be used to deliver marijuana or other substances, the agency adds.
“We are working around the clock to find out what is making people sick,” Ileana Arias, the CDC’s acting deputy director of non-infectious diseases, told reporters Friday. “The focus of the investigation is narrowing, but we are still faced with complicated questions in this outbreak.”
Five deaths have been confirmed in California, Illinois, Indiana, Minnesota, and Oregon, the CDC says.
Patients have reported symptoms such as: cough, shortness of breath, or chest pain, nausea, vomiting, or diarrhea. They have also reported fatigue, fever, or weight loss. Some patients grew so ill they needed a ventilator to help them breathe. Most improved with treatments, the CDC said.
The American Lung Association (ALA) this week joined public health officials across the U.S. in urging people who vape to stop. “E-cigarettes are not safe and can cause irreversible lung damage and lung disease,” the ALA said. “No one should use e-cigarettes or any other tobacco product. This message is even more urgent today following the increasing reports of vaping-related illnesses and deaths nationwide.”
The CDC emphasized that there was no evidence of an infectious disease behind the illnesses. However, more information was needed to determine whether the illnesses were caused by e-cigarette use.
“It’s very important to understand that electronic cigarettes also damage the lungs,” says pulmonologist Javier Pérez-Fernández , M.D., the critical care director at Baptist Hospital of Miami . “They contain many substances that are toxic to the lungs and substances that are toxic to the brain.”
The CDC is working with state health departments. State officials are examining the medical records of suspected cases and consulting with respective clinical care teams to exclude other possible causes. The CDC says these cases are requiring clinicians and public health officials to interview patients to determine product use and individual behaviors.
The U.S. Food and Drug Administration (FDA) said it is working closely with the CDC, and state and local public health partners, to investigate the vaping cases. The FDA is providing consumers  with some information to help protect themselves.
Physicians and public health officials over the past several months have raised concerns about the popularity of vaping among young people. Vaping by children and teens surged 75 percent in 2018, compared to 2017, according to a policy statement  issued earlier this year by the American Academy of Pediatrics (AAP).
“The damage is very worrisome most of all for youngsters, teens, and schoolkids,” says Dr. Pérez-Fernández. “They are the ones who are starting to smoke these electronic cigarettes, and the damage is much greater because their organs are still developing and it’s much more harmful to them than to the rest of the population.”
The fact that e-cigarettes are a gateway to traditional cigarette use, which often leads to nicotine addiction, is also a top concern for youth health, the AAP iterates. There are still many uncertainties as to the level of long-term harm to e-cig users caused by the toxic chemicals contained in vaping devices, says physicians and public health experts.
The statement is among the latest issued to spur stricter regulation and warn the public about the dangers of vaping among young people. The toxic substances found in e-cigarettes can have harmful effects on the developing adolescent brain up until age 25, according to previous papers published by the AAP.
E-cigarettes, or vaping devices like Juul, lets users inhale nicotine vapor without burning tobacco like traditional smokers do with cigarettes and cigars. However, most e-cigs contain nicotine – the addictive drug in regular cigarettes.
“The damage to the lungs is real,” says Dr. Pérez-Fernández. “These are chemical substances that vaporize when these types of cigarettes are lit. There are there are substances that can cause intrinsic and direct damages and substances that will cause indirect damage in the long run. “