RiverStone Health and the Department of Public Health and Human Services (DPHHS) have identified the first confirmed case of severe pulmonary disease associated with vaping in connection with the ongoing national investigation.
The confirmed case is a Yellowstone County resident in their 30s with a history of vaping nicotine and THC. This individual was hospitalized in August, and is now home recovering.
Eight deaths associated with severe pulmonary illness have occurred. As of September 17, 2019, there were 530 confirmed and probable cases of lung disease associated with e-cigarette product use, or vaping, reported by 38 states and the U.S. Virgin Islands. Two thirds (67%) of cases in this investigation are people 18 to 34 years old, and 16% are younger than 18 years old.
Montana's first confirmed case adds to the growing number of cases in this national investigation.
"This is deeply concerning, especially given the rapid increase in young people using e-cigarettes," said Governor Steve Bullock. "Montana is supporting the national investigation to determine what is making people sick, while also looking at options on how we can take action without waiting on Washington."
State Medical Officer Dr. Greg Holzman said DPHHS is working directly with local health officials on the investigation and is urging state residents to take into account the current situation both in Montana and in other states and respond accordingly. "I urge Montanans to refrain from using e-cigarettes, considering the existing unknown health consequences," Holzman said. "If you're having difficulties quitting these highly addictive nicotine products contact your healthcare provider or the Montana Tobacco Quit Line."
The CDC reports that products used could include a number of substances, including THC, CBD, nicotine, flavorings, and other chemicals.
John Felton, President/CEO of RiverStone Health and Yellowstone County's health officer, thanked the individual associated with the first confirmed case for providing valuable information about their illness. "In order to solve what is causing these illnesses, it's imperative that people impacted cooperate with the investigation so that accurate information can be gathered," he said. "These investigative efforts are happening around the country, and we appreciate those in Montana who are assisting."
Regardless of the ongoing investigation, health officials state that e-cigarette products should never be used by youth, young adults, pregnant women, or adults who do not currently use tobacco products.
DPHHS states that adding to the concern is the high rate of e-cigarette use among youth. In Montana, e-cigarettes are now the most commonly used tobacco product among high school students. The 2019 Montana Youth Risk Behavior Survey showed nearly a third (30%) of Montana high school students currently use e-cigarettes and more than half (58%) have tried them.
CDC states that all patients reported using e-cigarette products in the weeks and months prior to becoming ill. To date, no single substance, e-cigarette product, or additive has been consistently associated with the illness.
Symptoms include coughing, shortness of breath, chest pain, and fatigue. Nausea, vomiting, and diarrhea are also common. Symptoms worsen over a period of days or weeks and do not appear to be caused by a pulmonary infection. Anyone who vapes and is experiencing respiratory issues should promptly consult their provider. Healthcare providers treating patients with respiratory illness with no apparent infectious cause and who have a history of e-cigarette use are asked to notify their local health department.
Current recommendations for the public include:
• Until more information is known, CDC and DPHHS are advising people not to use any type of e-cigarette product.
• Anyone who uses e-cigarette products and is experiencing respiratory issues should promptly consult their provider. If it is a medical emergency call 9-1-1 or the Poison Control Center (1-800-222-1222).
• Anyone who uses e-cigarette products should not buy them off the street and should not modify these products or add any substances that are not intended by the manufacturer.
• Current tobacco users, including e-cigarette users, trying to quit should use evidence-based strategies, which include counseling, FDA-approved medications, and calling the Montana Tobacco Quit Line at 1-800-QUIT-NOW (1-800-784-8669).
• Youth (anyone under the age of 18) who need help quitting tobacco, including e-cigarettes, can text "Start my Quit" to 1-855-891-9989 or visit mylifemyquit.com.
• Anyone experiencing unexpected health or product issues related to tobacco or e-cigarettes should submit this information via FDA's online Safety Reporting Portal.
More information about the investigation is available on the DPHHS website at dphhs.mt.gov.
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