Vaping-associated lung injuries can be attributed to vitamin E acetate, CDC says - The Verge | Canada News Media
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Vaping-associated lung injuries can be attributed to vitamin E acetate, CDC says – The Verge

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The outbreak of vaping-associated lung injuries this summer and fall can officially be attributed to vitamin E acetate in THC-containing vaping products, the Centers for Disease Control said today. The new confirmation of the link between the chemical and the injuries came after a new study found it in nearly all of the lung fluid samples from a new set of patients.

As of December 17, 2,506 people have been hospitalized with e-cigarette, or vaping, product use-associated lung injury (EVALI), according to the CDC. There have been 54 deaths. The injuries started increasing in June before peaking in September, new CDC data indicates, and the number of visits to emergency departments for vaping-associated injuries have been declining since.

“It is clear that the outbreak represented a new phenomenon,” said Anne Schuchat, principal deputy director of the CDC, during a press conference. “It’s not a recognition of a common syndrome that had evaded our attention.”

Vitamin E acetate was first identified as a key focus of a statewide investigation in New York in September. It was later described as a chemical of concern by the CDC in November, after it was found in every one of a set of 29 lung fluid samples tested by the agency. Investigators also found that most patients with EVALI reported using THC-containing vaping products before their injury. Product testing by the Food and Drug Administration has found many of those products are contaminated with the chemical. It hasn’t been found in nicotine-only vaping products.

In the new study, published today in the New England Journal of Medicine, clinicians collected lung fluid samples from 51 patients with either confirmed or probable EVALI. Vitamin E acetate was found in 48 of the samples — 94 percent. The majority of the patients also had THC in their lung fluid samples. Of the 11 patients who said they had not used THC products in the 90 days before their injury, nine had detectable levels of THC.

This set of patient samples was also compared to those from a group of 99 healthy people without EVALI, who were either e-cigarette smokers (with nicotine only), traditional cigarette smokers, or non-smokers. None of the samples from healthy people had vitamin E acetate, including those from the e-cigarette smokers.

The combination of this new data, along with previous reports and product analysis, allowed the CDC to conclude that the chemical was responsible for the outbreak. “The very large increase in cases is attributable to what was happening in this past year in the supply, with vitamin E acetate diluting or tainting THC products,” Schuchat said. In Minnesota, for example, THC-containing products from 2018 did not contain vitamin E acetate, but products from 2019 did.

Vitamin E acetate is a safe dietary supplement and ingredient in topical lotions and creams, but when it’s inhaled, it may interfere with proper lung function. Heating the chemical in a vaporizer can also cause it to break down into a compound called ketene, which can irritate the lungs. More studies are underway to figure out how vitamin E acetate might cause the type of damage seen in EVALI patients. “We don’t have to hold our breath for those results, but they’ll be helpful for us to go a little deeper in understanding the problem,” Schuchat said.

She stressed, though, that there may be more than one chemical causing these injuries. Not every patient with EVALI reported using THC-containing products, and not every tested product associated with an injury contained vitamin E acetate. “This does not mean there are not other substances in e-cigarettes or vaping products that have or are capable of causing lung injury,” she said.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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