SALT LAKE CITY — A man in Salt Lake County is the first to die in Utah of a lung injury linked to vaping, state health officials said Wednesday.
The deceased, who was under the age of 30, had vaped the marijuana compound THC and not been hospitalized, according to the Utah Department of Health. His name and the date of his death have not yet been released.
“It is a real, real tragedy in our outbreak investigation here in Utah,” said state epidemiologist Angela Dunn. “We also have evidence that this person vaped THC cartridges prior to death and that he had THC in his blood at the time of his death.”
The vast majority of those found to have vaping-related illness in Utah obtained THC on the street or from other unlawful sources, Dunn said.
And symptoms of the disease may not be obvious. In many cases, vomiting, nausea or diarrhea progress within a week to breathing problems like a cough, shortness of breath or chest pain, according to the health department.
“We want to encourage anybody who has symptoms after vaping to seek care,” Dunn said said.
She and her colleagues have reported 76 other cases of vaping-related lung disease in Utah as they investigate another 14 potential cases. More than 90% were hospitalized and many were treated in intensive care units. Ninety-four percent of those people reported they had vaped THC products.
Like around the nation, lab results from the cartridges in Utah revealed significant amounts of vitamin E acetate, Dunn said. That means dealers are likely cutting the products with vitamin E, though Dunn said health officials don’t yet know the significance of the substance in the injuries.
Dunn and her colleagues are not investigating any other deaths at the moment, she said, though she doesn’t expect the rate of vaping-related illness to slow down in the near future. They learn of a new case nearly every day.
“Really the only way to stop this outbreak is for people to stop vaping THC,” she said.
Yet much surrounding the disease remains a mystery.
At the University of Utah, doctors announced last month they had found that each of 10 patients with a severe, vaping-related lung illness had one thing in common: Immune system cells deep down in their lungs were laden with oily droplets.
“We think that’s a marker of somebody vaping oil-based substances. The fact that it’s getting all the way down into the air sacs is pretty remarkable,” said Dixie Harris, a pulmonologist with Intermountain Healthcare.
In August, during video chats with patients in remote parts of the state, Harris noticed many of those reporting breathing problems happened to be e-cigarette users.
“This has been going on over two months and we still don’t have one obvious cause,” Harris said Wednesday. “There’s many, many different toxins that are from vaping that can get into the lungs. But what specifically is causing this, if this is one specific agent, or one thing, we have not identified.”
In medical research published last week, doctors analyzed biopsies of patients and found chemical inflammation deep in the lungs, where tissues began to peel off like skin that has been severely burned. The effect is similar to that of inhaling cleaning agents, Harris said.
“These patients feel absolutely terrible,” she added. “In fact, I was just talking to a patient today. He said he felt like he was going to die. He felt horrible everywhere. He ached, he couldn’t breathe, he was vomiting.”
Harris said she and her colleagues don’t know why patients feel so queasy, since most of the problems are in the lungs. Cultures don’t grow any bacteria, virus or fungus, so they know it’s not an infection.
Their CT scans reveal a haziness that looks like a blizzard — what Harris believes to be the toxic reaction, inflammation and swelling.
“I think the question is, in this day and age, is it still safe to vape? And in my opinion, the answer is no,” Harris said.
To help limit the outbreak in Utah, a four-month emergency administrative rule is set take effect Oct. 21, requiring stores selling vape products to post notices of potential lung injuries related to electronic cigarette use. The rule also restricts the sale of flavored e-cigarette products to tobacco specialty stores.
Federal officials have said they intend to prohibit the sale of flavored vape products, though a ban has not yet taken effect.
In Utah, a legislative working group is crafting proposals to curb youth vaping in the state. Other states, including Michigan, New York and Rhode Island have banned certain vape products.
One Utah lawmaker, Rep. Paul Ray, has told the Deseret News he plans to bring forward one bill that would ban flavors in the Beehive State and another that would raise taxes on vaping products.