Health officials confirm Utah’s first vaping-related death

(Tony Dejak | AP file photo) A woman uses an electronic cigarette in Mayfield Heights, Ohio in this Friday, Oct. 4, 2019 photo. Only two years ago e-cigarettes were viewed as holding great potential for public health, offering a way to wean smokers off traditional cigarettes. But now Juul and other vaping companies face an escalating backlash that threatens to sweep their products off the market.

A Salt Lake County resident under age of 30 has died after vaping THC, marking the state’s first death from the vaping-related lung injuries that have killed at least 18 other people nationwide.

The person died at home without being hospitalized, according to the Utah Department of Health. While officials are not identifying the person or releasing further details, they want Utahns to be aware of the fatal risk.

“We wanted to include that information so people understand the seriousness of seeking medical help if they do vape THC products and they do experience symptoms,” said Tom Hudachko, spokesman for the state health department.

For most Utah patients, symptoms began with gastrointestinal problems — nausea, vomiting and diarrhea — and progressed to respiratory symptoms, such as shortness of breath and wheezing, Hudachko said.

[Read more: Utah cases of vaping-related illness rise again]

But the combination and onset of symptoms have not been consistent from patient to patient, said physician Sean Callahan, who has been treating patients and studying vaping-related illness at University of Utah Hospital. Some patients have had mild symptoms for days or weeks before their condition worsened, Callahan said. One patient did go from mild to severe symptoms within a day, he said.

The symptoms themselves are not always the same, Callahan added. A patient recently checked into the hospital with no respiratory symptoms but after vomiting for a solid half-hour.

“We don’t think of GI [gastrointestinal] symptoms as related to something you’re inhaling,” Callahan said. “So that’s something to keep in mind: If someone has GI symptoms and they’re currently vaping, one should wonder, are the two related?”

Hudachko wouldn’t discuss the possible reasons the Salt Lake County adult did not seek medical care, or any information investigators gleaned about the person’s symptoms before the death.

Different severities of symptoms have prompted Callahan’s patients to seek care, he said. Some come in only when their shortness of breath “is getting so extreme they can’t take it anymore,” he said. Others have come in with milder symptoms because they saw media coverage of vaping-related illnesses and became more vigilant.

At this point, Callahan said, if those vaping develop gastrointestinal or respiratory symptoms, they should visit a doctor even if the symptoms don’t seem severe.

“If a bunch of ‘worried-well’ people come in," he said, “that’s not the end of the world.”

That’s especially true for anyone who is vaping THC products, Hudachko said. “Absolutely, without hesitation, get yourself to the hospital.”

An autopsy on the Salt Lake County adult, including a toxicology screen, ruled out other causes of death, such as infectious diseases or poisoning, Hudachko said. The toxicology screen confirmed the use of THC, he added, and vape cartridges containing THC were found at the person’s home.

“This death is a sad reminder of the severity of these unexplained illnesses,” state epidemiologist Angela Dunn said in a news release Wednesday. “Based on what we know about this outbreak and what may be contributing to it, our best advice to the public is to stop vaping products that contain THC.”

As of this week, the state has confirmed 76 cases of vaping-related lung injuries, and another 14 potential cases are under investigation. More than 90 percent of those patients were hospitalized, many in intensive care units. Ninety-four percent of Utah patients reported vaping THC products, which are illegal in the state.

As of Oct. 1, the U.S. Centers for Disease Control and Prevention had confirmed 1,080 cases of vaping-related illness nationwide, including 18 deaths. Utah appears to have had an exceptionally high rate of the mysterious illness, and some state officials have proposed banning flavored e-cigarettes — though CDC officials have concluded that THC products appear to be playing a significant role in the outbreak.

But, Callahan said, people who vape nicotine should not consider themselves in the clear. “It’s not 100% associated with THC,” he said. “There are some people who are getting this with nicotine products.”

Callahan also noted that vape products have not existed long enough for anyone to know the long-term effects of vaping nicotine. “We have people dying right now," he said, “and we still don’t know what their lungs are going to look like in 30 years.”

The Utah Department of Health has drafted emergency rules limiting the sale of flavored e-cigarette products to tobacco specialty shops and requiring those shops to post warnings about the risks of vaping THC products. State officials had planned to enact the rules this week but delayed implementation to Oct. 21 to give general retailers, like grocery and convenience stores, more time to clear their inventories of flavored products. General retailers will still be allowed to sell unflavored e-cigarette products.

For more information on the outbreak, visit https://health.utah.gov/lung-disease-investigation.