Science Lion Byte: Vaping Illness Outbreak Update – Jan. 31, 2020

***Science Lion Media will pause coverage on the vaping outbreak as the public health issue has plateaued and appears to be reaching a resolution. Thank you for heeding the advice of health professionals and communicators to protect yourselves and others from unnecessary harm***

Please refer to our previous publication for a comprehensive background of the vaping illness outbreak in the United States.

Here is a summary of the latest vaping-related lung illness information released by the CDC, as of January 21, 2019 at 1pm EST:

  • The CDC, as of December 4, 2019, has elected to only report hospitalized EVALI cases and related-deaths, regardless of hospitalization status. Non-hospitalized cases have been removed from previously reported case counts.                     
  • The number of e-cigarette, or vaping, product use associated lung injury (EVALI) cases has been reported to reach 2,711 nationwide. With California, Illinois, and Texas leading the nation in confirmed EVALI cases.
  • EVALI cases have now been reported in all 50 states of the United States, after Alaska’s Department of Health and Social Services reported their first case of vaping-related lung injury on December 3, 2019. The District of Columbia (D.C.), Puerto Rico, and U.S. Virgin Islands have reported cases, as well.
  • There have now been 60 confirmed deaths related to EVALI, with Texas reporting the youngest EVALI-related death of a 15 year-old.
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As of the most recent data collected from January 14, 2019, EVALI patient statistics are as follows:

  • Regarding hospitalization status, 95% of EVALI patients have been hospitalized; 5% have not.
  • 66% of patients are reported to be male.
  • The median age of patients is 24 years old, with an age range between 13 and 85 years old.
  • The median age of the deceased patients is 51 years old, with an age range between 15 and 75 years old.
  • Breakdown of patients by age group:
    15% of patients were under 18 years old
    37% were 18 to 24 years old
    24% were 25 to 34 years old
    24% were 35 years or older

 

 

The most complete information of patient product use, 3 months prior to symptom onset, reflects the following:

  • 82% reported using THC-containing products; 33% reported exclusive use of THC-containing products.
  • 57% reported using nicotine-containing products; 14% reported exclusive use of nicotine-containing products.
  • Younger EVALI patients (13-17 years of age) were significantly more likely to acquire THC-containing vape products only from informal sources (94%), versus 62% of older patients, 45 years of age and older.
  • Regarding nicotine-containing vape products, 42% of younger EVALI patients (13-17 years of age) acquired these products only from informal sources, versus 12% of older patients, 45 years of age and older.

Overall, 152 different THC-containing product brands were reported by EVALI patients, and of those products reported, *Dank Vapes was the most commonly reported product brand used by patients nationwide, although there are regional differences. This supports the premise that THC-containing products are heavily contributing to the EVALI outbreak, and that no one brand is solely responsible. Overall, these unregulated and off-branded products, in addition to their unconventional use, are suspected of undergirding the spread of this lung illness outbreak.

* Dank Vapes is a class of largely counterfeit THC-containing products of unknown origin.

 

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On January 2, 2020, the FDA implemented a partial ban on vaping in the US, focused on ceasing the manufacture of unauthorized flavors which may appeal to under-age individuals. Additionally, President Trump has signed into law an amendment which nationally raises the smoking age from 18 to 21 years old.

Looking beyond the United States, President Rodrigo Duterte of the Philippines has officially issued a ban on e-cigarettes, after the country reported its first confirmed EVALI case in a 16 year-old girl, on November 15, 2019.

The Philippines join roughly 30 other countries that have moved to issue a ban on e-cigarette products, including Brazil, India and Singapore. Indonesia is now strongly considering following suit of the Philippines by possibly issuing their own vaping ban to preempt the surfacing of EVALI cases in its country.

Canada is also experiencing an uptick in vaping cases with its 17th official EVALI case reported in the country, as of January 21, 2020.

 

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CDC Reports First U.S. Case of Human-to-Human Transmission of 2019 Novel (Wuhan) Coronavirus

On January 19, 2020, an initial reported outbreak of the 2019 Novel Coronavirus manifested in the city of Wuhan, the capital of the Hubei province of China. Unfortunately, upwards of ten thousand cases of infection have been reported, with the death toll eclipsing 200, as of January 30, 2020.

As fears began to swell regarding the potential global implications of the virus, on the afternoon of January 30, the director of the World Health Organization officially declared a global emergency for the spreading Coronavirus, which had now begun leaking through national borders, worldwide, as travelers returned from the Chinese outbreak epicenter.

Although the first case of Coronavirus infection in the United States occurred on January 21 in the state of Washington, around 12:30pm ET on January 30, the CDC reported the first United States case of human-to-human transmission of the virus in Chicago, Illinois. As of that day, there have been 6 confirmed cases of infection and 92 unconfirmed, as they await the results of their screening.

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Although, there is heightened anxiety at this time surrounding the potential implications of the spreading virus, there is no need for panic. Rather, take the precautions that you would normally apply to protecting yourself from the spread of germs, and keep your immune system in optimum shape by eating nutritious foods, while limiting (the best you can) exposure to stressful environmental conditions.

For more details about this first case of transmission and the most recent commentary on the virus, click the CDC link below. Stay tuned for the latest information from Science Lion Media, as we monitor the progression of the global Coronavirus outbreak.

https://www.cdc.gov/media/releases/2020/p0130-coronavirus-spread.html

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Sodium Intake and Your Health: A Tale of Two Standards

When it comes to making food pleasurable to the taste buds, adding salt to a cuisine definitely helps make that a reality. Salt has been known not just as a food additive for flavor enhancement, but for thousands of years, it has also been used as a preservative to extend the shelf-life of food.

However, as with many things in western society, the use of salt has become excessive. Simultaneously, the prevalence of obesity has also been on the rise along with the associated negative health consequences, such as, diabetes, renal (kidney) disease, and cardiovascular disease. For all of these outcomes, in one way or another, the common denominator is hypertension (high blood pressure), so controlling this risk-factor is paramount in maintaining good long-term health.

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Clinicians advise that for good cardiovascular health, we maintain a resting blood pressure reading of 120/80 or less. So what does that readout actually mean? The top number, 120, represents the pressure that blood vessels are subjected to when the heart pumps, and the bottom number, 80, represents the pressure on the blood vessels when the heart is at rest.

Important blood pressure levels to consider
Hypertension: 140/90 and above
Prehypertension: 121-139/81-89
Normal: 120/80 and below

A primary factor that influences blood pressure is sodium, and the most common form of sodium consumption is salt. Although there is a common misconception that the two substances are synonymous, on a molecular level, salt in the form of NaCl (sodium chloride) is 40 percent sodium and 60 percent chloride, so salt is not purely sodium.

Without getting too detailed with the molecular chemistry of NaCl (sodium chloride), this is a simplified representation of the salt molecule at an atomic level.

Taking this into consideration, it is clear that tracking sodium intake is prudent to the regulation of blood pressure. Specific populations are more susceptible to the impacts of excessive sodium intake, such as adult populations over 50 years old, individuals with a history of cardiovascular complications, and individuals of African descent.

To help the general population gauge how much sodium they should be consuming, the USDA has established guidelines for daily sodium intake, with 2300mg being the upper limit for the general population, and 1500mg for more salt-sensitive groups.

However, just because there are guidelines in place, does not mean that we actually abide by them. Unfortunately, it is estimated that about 90 percent of Americans are ingesting too much sodium, and according to the CDC, the average American consumes more than 3400mg of sodium per day! It’s no wonder that with the over-indulgence of this element, cardiovascular-related disorders and diseases are the leading cause of death, not just in the United States, but also in the world!

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So how are we consuming so much sodium? I mean, we’re talking thousands of milligrams per day, so is it that hard to stay within the suggested limits? The figure below, courtesy of the CDC, may give you an idea of how quickly your sodium intake can add up.

Breads, canned goods, processed foods, fast foods, and packaged snack foods contain some of the highest levels of sodium that can be potentially introduced into our diets, so avoiding these where possible is strongly advised when striving to follow a low-sodium regimen.

Now, if we go back to the sodium intake guidelines we notice that in the context of ethnic groups, only African-descended people are advised to shoot for the lower sodium limit, which begs the question, “Why?”

There is no one over-arching smoking gun, but one link that has been made pertains to the angiotensin converting enzyme (ACE) gene, which manifests itself in multiple variants/forms. This ACE gene is responsible for inducing the release of a hormone called angiotensin, which regulates the level of constriction of the blood vessels and, by proxy, regulates blood pressure.

Some of these ACE variants which exist in people of African-descent are more sensitive to sodium, and exposure to certain levels of this element can result in an over-constriction of the blood vessels, leading to an elevated systolic blood pressure.

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However, with this in mind, African-descended people who may be nutrition facts-conscious and track their sodium consumption may need to be wary of another revelation: The nutrition facts label assumes that your daily limit of sodium is capped at the general population’s recommendation of 2300mg.

Oops.

So instead of going by the percent of daily value, people of African descent and other susceptible groups need to pay attention to the number of milligrams of sodium, and align it with their 1500mg limit.

Some of these group-specific nuances have a history of being overlooked or ignored, as we have highlighted in previous publications regarding dairy consumption, or even calcium and vitamin D daily recommendations.

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As is typical with science, opposite findings have been revealed when tipping the scale to the other extreme of very little sodium consumption. There are also instances where lower sodium intake may not show benefits to cardiovascular health, and some of these findings are presumptively gathered and disseminated as a devil’s advocate rebuttal to the promotion of a diet lower in sodium.

However, what is often overlooked is that the studies supporting this rebuttal are composed of majority or entirely Caucasian participants; this means that we don’t really know if these claims hold the same weight for African descendants, Hispanics, Asians, or any other non-Caucasian groups (remember those ethnic group nuances we mentioned earlier?). According to the American Heart Association (AHA), 500mg of sodium is the minimum requirement for physiological health (healthy bodily function). In this day and age, barring an extreme circumstance, it is pretty difficult to not eclipse that threshold.

Claims of a low sodium diet not being beneficial may only be relegated to individuals with a history of congestive heart failure, or in very extreme instances of voluntary (diet) or involuntary (starvation) sodium restriction. These claims should not be irresponsibly dispersed as this may mislead and misinform the readers. Any study findings that have shown a lack of benefit from lower sodium intake (within physiologically relevant levels, such as 1000mg-2000mg) have been relegated to almost exclusively Caucasian participants.

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So, besides the typical recommendations of avoiding sodium-laden foods or suppressing the urge to add excess salt when cooking (and at the dinner table), are there any other ways to help individuals of African descent reduce sodium intake? Definitely!

  • Consume more potassium-rich foods. Potassium and sodium are fierce competitors for some of the same targets, so the blood pressure-raising effects of sodium can be offset by the presence of this element. Bananas, orange juice, sweet potatoes, and spinach are excellent sources of potassium, for example.
  • Consider using a proportion of potassium chloride with traditional sodium chloride salt. Some food companies have done this, like Smartfoods, with their bagged popcorn.
  • Transition to a more contemporary salt alternative, such as SODA-LO with their salt microspheres. Simply put, it is your traditional sodium chloride salt, but with a twist; it’s engineered as hollow spheres instead of dense flakes or granules, so the density of salt (and concentration of sodium) is up to 50% less! This Tate & Lyle’s ingredient has garnered recognition for its innovative goal of helping reduce our sodium intake, while apparently retaining that same magnificent salty taste (*wink wink*). Hopefully, this product can be approved for adoption worldwide, if it hasn’t already.
  • Make sure to consult your primary care physician or personal dietician for guidance in implementing the aforementioned suggestions, as well as other alternatives I haven’t mentioned here.

With the daily grind of work, family, and recreation, it can be challenging to plan and execute your goals of reducing sodium intake. Meal planning and cooking take time, I get it. But believe me, it’s worth the effort. Not only will your body thank you for it, but so will your loved ones; not just for sticking around, but for maintaining a higher quality of life while you’re still here.

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Science Lion Byte: Vaping Illness Outbreak Update – Jan. 9, 2020

Please refer to our previous publication for a comprehensive background of the vaping illness outbreak in the United States.

Here is a summary of the latest vaping-related lung illness data released by the CDC, as of January 9, 2019 at 1pm EST:

  • The CDC, as of December 4, 2019, has elected to only report hospitalized EVALI cases and related-deaths, regardless of hospitalization status. Non-hospitalized cases have been removed from previously reported case counts.                     
  • The number of e-cigarette, or vaping, product use associated lung injury (EVALI) cases has been reported to reach 2,602 nationwide. With California, Illinois, and Texas leading the nation in confirmed EVALI cases.
  • EVALI cases have now been reported in all 50 states of the United States, after Alaska’s Department of Health and Social Services reported their first case of vaping-related lung injury on December 3, 2019. The District of Columbia (D.C.), Puerto Rico, and U.S. Virgin Islands have reported cases, as well.
  • There have now been 57 confirmed deaths related to EVALI. Among states reporting the most EVALI-related deaths are Illinois (5), Indiana (5), and California (4), with Texas reporting the youngest EVALI-related death of a 15 year-old, today.
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As of the most recent data collected from December 3, 2019, EVALI patient statistics are as follows:

  • Regarding hospitalization status, 95% of EVALI patients have been hospitalized; 5% have not.
  • 67% of patients are reported to be male.
  • Breakdown of patients by age group:
    16% of patients were under 18 years old
    38% were 18 to 24 years old
    24% were 25 to 34 years old
    23% were 35 years or older

 

 

The most complete information of patient product use, 3 months prior to symptom onset, reflects the following:

  • 80% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
  • 54% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
  • 40% reported both THC- and nicotine-containing product use.
  • 5% reported no THC- or nicotine-containing product use.

Overall, 152 different THC-containing product brands were reported by EVALI patients, and of those products reported, *Dank Vapes was the most commonly reported product brand used by patients nationwide, although there are regional differences. This supports the premise that THC-containing products are heavily contributing to the EVALI outbreak, and that no one brand is solely responsible. Overall, these unregulated and off-branded products, in addition to their unconventional use, are suspected of undergirding the spread of this lung illness outbreak.

* Dank Vapes is a class of largely counterfeit THC-containing products of unknown origin.

 

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On January 2, 2020, the FDA implemented a partial ban on vaping in the US, focused on ceasing the manufacture of unauthorized flavors which may appeal to under-age individuals. Additionally, President Trump has signed into law an amendment which nationally raises the smoking age from 18 to 21 years old.

Looking beyond the United States, President Rodrigo Duterte of the Philippines has officially issued a ban on e-cigarettes, after the country reported its first confirmed EVALI case in a 16 year-old girl, on November 15, 2019.

The Philippines join roughly 30 other countries that have moved to issue a ban on e-cigarette products, including Brazil, India and Singapore. Indonesia is now strongly considering following suit of the Philippines by possibly issuing their own vaping ban to preempt the surfacing of EVALI cases in its country.

Canada is also experiencing an uptick in vaping cases with its 15th official EVALI case reported in the country, as of January 2, 2020.

Take care and stay tuned for the next Science Lion Byte!

 

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Science Lion Byte: Vaping Illness Outbreak Update – Dec. 13, 2019

Please refer to our previous publication for a comprehensive background of the vaping illness outbreak in the United States.

Here is a summary of the latest vaping-related lung illness data released by the CDC, as of December 12, 2019 at 1pm EST:

  • As of December 4, 2019, CDC will only report hospitalized EVALI cases and EVALI deaths regardless of hospitalization status.                     
  • The number of e-cigarette, or vaping, product use associated lung injury (EVALI) cases has been reported to reach 2,409 nationwide, rising from 2,291 last week. California, Illinois, and Texas lead the nation in confirmed EVALI cases.
  • EVALI cases have now been reported in all 50 states of the United States, after Alaska’s Department of Health and Social Services reported their first case of vaping-related lung injury on December 3, 2019. The District of Columbia (D.C.), Puerto Rico, and U.S. Virgin Islands have reported cases, as well.
  • There have now been 52 confirmed deaths related to EVALI, rising from 48 last week. States reporting the most EVALI-related deaths are Illinois (5), Indiana (5), and California (4).
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As of December 3, 2019, EVALI patient statistics are as follows:

  • Regarding hospitalization status, 95% of EVALI patients have been hospitalized; 5% have not.
  • 67% of patients are reported to be male.
  • Breakdown of patients by age group:
    16% of patients were under 18 years old
    38% were 18 to 24 years old
    24% were 25 to 34 years old
    23% were 35 years or older

 

 

The most complete information of patient product use, 3 months prior to symptom onset, reflects the following:

  • 82% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
  • 62% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
  • 48% reported both THC- and nicotine-containing product use.
  • 4% reported no THC- or nicotine-containing product use.

Overall, 152 different THC-containing product brands were reported by EVALI patients, and of those products reported, *Dank Vapes was the most commonly reported product brand used by patients nationwide, although there are regional differences. This supports the premise that THC-containing products are heavily contributing to the EVALI outbreak, and that no one brand is solely responsible.

* Dank Vapes is a class of largely counterfeit THC-containing products of unknown origin.

 

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Looking beyond the United States, President Rodrigo Duterte of the Philippines has officially issued a ban on e-cigarettes, after the country reported its first confirmed EVALI case in a 16 year-old girl, on November 15, 2019.

The Philippines join roughly 30 other countries that have moved to issue a ban on e-cigarette products, including Brazil, India and Singapore. Indonesia is now strongly considering following suit of the Philippines by possibly issuing their own vaping ban to preempt the surfacing of EVALI cases in its country. President Trump of the United States is still contemplating an executive order to ban e-cigarettes; in particular, flavored e-cigarette products. In the meantime, a vaping bill which is currently being mulled over in congress, would strengthen restrictions against tobacco sales to youths and ban e-cigarette flavorings; this bill will be voted on early next year.

Canada is also experiencing an uptick in vaping cases with its 14th official EVALI case reported in the country, as of December 10, 2019.

Take care and stay tuned for the next Science Lion Byte!

 

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Science Lion Byte: Vaping Illness Outbreak Update – Dec. 6, 2019

Please refer to our previous publication for a comprehensive background of the vaping illness outbreak in the United States.

Here is a summary of the latest vaping-related lung illness data released by the CDC, as of December 5, 2019 at 1pm EST:

  • As of December 4, 2019, CDC will only report hospitalized EVALI cases and EVALI deaths regardless of hospitalization status. As a result, the CDC removed 175 non-hospitalized cases from previously reported national cases.                                                                   
  • The number of e-cigarette, or vaping, product use associated lung injury (EVALI) cases has been reported to reach 2,291 nationwide, rising from 2,116 last week. California, Illinois, and Texas lead the nation in confirmed EVALI cases.
  • EVALI cases have now been reported in all 50 states of the United States, after Alaska’s Department of Health and Social Services reported their first case of vaping-related lung injury on December 3, 2019. The District of Columbia (D.C.), Puerto Rico, and U.S. Virgin Islands have reported cases, as well.
  • There have now been 48 confirmed deaths related to EVALI, rising from 47 last week. States reporting the most EVALI-related deaths are Illinois (5), California (4), and Indiana (4).
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As of the most recent data set, EVALI patient statistics are as follows:

  • Regarding hospitalization status, 95% of EVALI patients have been hospitalized; 5% have not.
  • 68% of patients are reported to be male.
  • Breakdown of patients by age group:
    15% of patients were under 18 years old
    38% were 18 to 24 years old
    24% were 25 to 34 years old
    23% were 35 years or older

 

 

The most complete information of patient product use, 3 months prior to symptom onset, reflects the following:

  • 83% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
  • 61% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
  • 48% reported both THC- and nicotine-containing product use.
  • 4% reported no THC- or nicotine-containing product use.

 

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Looking beyond the United States, President Rodrigo Duterte of the Philippines has officially issued a ban on e-cigarettes, after the country reported its first confirmed EVALI case in a 16 year-old girl, on November 15, 2019.

The Philippines join roughly 30 other countries that have moved to issue a ban on e-cigarette products, including Brazil, India and Singapore. Indonesia is now strongly considering following suit of the Philippines by possibly issuing their own vaping ban to preempt the surfacing of EVALI cases in its country. President Trump of the United States is still contemplating an executive order to ban e-cigarettes; in particular, flavored e-cigarette products.

Canada has also reported that they now have 13 official EVALI cases in its country with fears of more cases popping up in the future.

Take care and stay tuned for the next Science Lion Byte!

 

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Science Lion Byte: Vaping Illness Outbreak Update – Nov. 21, 2019

Please refer to our previous publication for a comprehensive background of the vaping illness outbreak in the United States.

Here is a summary of the latest vaping-related lung illness data released by the CDC, as of November 21, 2019 at 1pm EST:

  • The number of e-cigarette, or vaping, product use associated lung injury (EVALI) cases has been reported to reach 2,290 nationwide, rising from 2,172 last week. California, Illinois, and Texas lead the nation in confirmed EVALI cases.
  • EVALI cases have now been reported in all of the United States, with the exception of Alaska. The District of Columbia (D.C.), Puerto Rico, and U.S. Virgin Islands have reported cases, as well.
  • There have now been 47 confirmed deaths related to EVALI, rising from 42 last week. States reporting the most EVALI-related deaths are Illinois (5), California (4), and Indiana (4).
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As of the most recent data set, EVALI patient statistics are as follows:

  • Regarding hospitalization status, 95% of EVALI patients have been hospitalized; 5% have not.
  • 68% of patients are reported to be male.
  • Breakdown of patients by age group:
    15% of patients were under 18 years old
    38% were 18 to 24 years old
    24% were 25 to 34 years old
    23% were 35 years or older

The most complete information of patient product use, 3 months prior to symptom onset, reflects the following:

  • 83% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
  • 61% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
  • 48% reported both THC- and nicotine-containing product use.
  • 4% reported no THC- or nicotine-containing product use.

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Looking beyond the United States, President Rodrigo Duterte of the Philippines plans to issue an official ban on e-cigarettes, after the country reported its first confirmed EVALI case in a 16 year-old girl, on November 15, 2019.

The Philippines would join roughly 30 other countries that have moved to issue a ban on e-cigarette products, including Brazil, India and Singapore. President Trump of the United States is still contemplating an executive order to ban e-cigarettes; in particular, flavored e-cigarette products.

Due to the Thanksgiving holiday, the CDC will not report new numbers next week, but expect an update around December 5.

Take care and stay tuned for the next Science Lion Byte!

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Smoking or Vaping, There’s No Escaping – UPDATED

Traditional smoking of cigarettes has become less appealing to the public over time, and there is still a significant segment of society that partakes in this activity. Some willingly view this activity as an outlet for stress relief, while others have acknowledged their addiction and are open to quitting their habit with an implemented program. As the dangers of smoking have become more exposed over time, a variety of quitting mechanisms have arisen from gum, to skin patches, to other forms of pharmaceutical interventions. Unfortunately, with the use of these options, there has only been a 10% success rate in quitting smoking.

In 2003 the first commercially available E-cig was created by Hon Lik in China, and in 2006 the E-cig was introduced to the U.S. market. Today, the most influential player in the E-cig market is Juul, a startup which after launching in 2015 captured 70% of the E-cig market within 3 years. The intention was to provide a “healthy cigarette” and as opposed to attaching itself to the stigma of smoking, E-cig usage was popularly dubbed “vaping”. 

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Instead of burning the nicotine-containing substance or other alternative, that main ingredient is suspended in a complex liquid which is heated to an aerosol for inhalation. Much contention has arisen over the effect heating may have on the ingredients, and whether enough reproducible research has been conducted on the health impacts of vaping. Over the course of marketing the product, a perception developed that this product could be used as a bridge to lead smokers to a non-smoking lifestyle, if desired. Unfortunately, controversy has struck, as a mysterious lung disorder initially described as “vaping associated pulmonary illness” (VAPI), and now reclassified as “E-cigarette, or vaping, product use associated lung injury” (EVALI) began impacting hundreds of vaping clients requiring them to be hospitalized, with over 3 dozen individuals dying from the symptoms, as of this post. Below is a list of states with some of the most EVALI-related cases, including some statistics from the current EVALI epidemic, as it has evolved over time:

CALIFORNIA

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  • In our previous issue, according to the CDC, as of September 24, 2019, there had been 805 confirmed and suspected vaping-related cases in the U.S. and U.S. territories. By November 13*, they saw that number jump to 2,172 cases. Pertaining to deaths related to vaping, as of October 2, there had been 17 deaths reported. As of this publication, that number has more than doubled to 42, with 4 of those deaths occurring in California. This state is among the top 3 states reporting vaping-related cases.
  • Regarding what is physiologically leading to this outcome, research has shone the spotlight on what appears to be an infiltration of certain immune cell types that typically don’t represent the quiescent lung environment, seemingly caused by vaping. 

ILLINOIS

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  • In addition to having one of the highest number of reported cases amongst reporting states for lung illness related to vaping, Illinois has 4 vaping-related deaths reported to the CDC. To determine if these cases are legitimately related to vaping, teams including state investigators, clinicians, and public health officials are organized to align their findings with a validated case definition. If possible, interviews are also conducted with the patient to establish confirmation of the case.
  • Based on the cases investigated so far, all patients were reported to have been vaping leading up to their hospitalization status. Additionally, most patients used THC-containing products or a combination of nicotine-containing and THC-containing products; one subset of patients only used nicotine-containing vaping products. No consistent evidence of infection has been associated with these cases.
  • CDC officials have recently revealed that vitamin E acetate may be an ingredient included in THC-containing E-cigs and vaping products, to serve as a thickening agent. Although vitamin E is safe to use as a cosmetic or dietary supplement, previous research suggests vitamin E acetate may interfere with normal lung function, when inhaled.
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INDIANA

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  • Indiana, a state with a high number of EVALI cases, shares the highest number of reported EVALI-related deaths which have risen to 4, as of this posting. Texas rounds out the top 3 reporting states for vaping-related cases, although it reported it’s first and only related-death in early October.
  • As of the latest statistics, 79% of total patients were under the age of 35 years old; 65% of patients were between the ages of 18 and 34. Roughly 70% of EVALI cases involved male patients, as of October 15, 2019. Alarmingly, 14% of patients were under 18 years old, as this product is prohibited for sale to minors. This implies that further enforcement of the law is needed.
  • The first reported double lung transplant surgery related to vaping was successfully conducted on a 17-year old boy from Michigan. Health officials declined to provide information on what the teen had vaped or how long he had been vaping. Regardless, the extent to which this vaping crisis has evolved and reared its ugly head continues to baffle and concern health care officials nationwide.

MINNESOTA

  • Minnesota is a moderately high reporting state as it pertains to lung illness cases; this includes 3 EVALI-related deaths being reported from this state, as of this posting.
  • Investigators are diligently working to uncover what may be the primary culprit in manifesting this mysterious lung illness, as this is still unknown. However, contrary to some E-cigarettes being marketed to contain zero percent nicotine, they have been found to contain the substance. The aerosolized liquids used in these vaping vectors typically contain:
  • Nicotine
  • Ultra-fine particles
  • Flavorings (such as diacetyl, which has been linked to serious lung disease)
  • Volatile organic compounds
  • Cancer-causing chemicals
  • Heavy metals such as nickel, tin, and lead

Although many countries have long banned the import of E-cigarette products, more bans are now cascading down from the U.S. federal government and sweeping across the country. There is simply too much controversy around not only the marketing practices of E-cig manufacturers, but also the safety of the vape fillers themselves when heated and inhaled.

A similar dark cloud of uncertainty hovers over the hookah community, too, as similar arguments have been made regarding the safety of the activity. It is best advised to avoid E-cig use until more substantiated reviews and studies are conducted, regarding the concerns therein. And of course, it is best to avoid the habit of smoking altogether. Check back for the latest news and updates on the U.S. vaping outbreak, as we revise our coverage on a regular basis.

*This content has been updated, as of November 14, 2019, to provide you with the most current coverage of the EVALI outbreak in the U.S.

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CDC Unveils Alarming U.S. Trend in STD Statistics

Summertime is finally simmering down, and I don’t know about you but it is such a relief to move on to the beautiful autumn season and enjoy the outdoors. However, “cuffing-season” is upon us! For those of you who aren’t hip to the term, cuffing-season refers to the time of year when the weather gets colder and almost as a biological response, single minglers seek out a suitable partner to claim as their netflix-and-chill companion or even as a bed-warming buddy – look we’re trying to keep it ‘PG’-rated here (PG = pretty geeky, ha!).

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Naturally, these pairings tend to lead toward some form of sexual activity, and unless you’re intending on having a baby with this person, or worse, are careless about exposing yourself to the risk of contracting a sexually transmitted disease, it’s best to have protection on deck before proceeding with your bedroom affairs. The latest CDC figures that came out regarding STD surveillance for 2018, show it would be smart to both protect yourself and choose your partner wisely. Here are some key startling statistics from that report:

A record 2,457,118 STD cases were reported in the United States during 2018. Mind you, these are only reported numbers so accounting for unreported cases, figures could be almost double what’s shown in these documents.

  • Young women between the ages of 15 and 24 account for 44% of reported chlamydia cases and face the most severe consequences of going undiagnosed, as infertility can result.
  • Congenital Syphilis cases among newborns jumped by 40% compared to the year before. Symptoms of which can result in severe health complications such as blindness, deafness, other debilitating developmental disorders, and even death.
  • Syphilis progresses through different stages of infection with primary and secondary infections being the most infectious stages – men accounted for 86% of cases in these highly infectious stages.
  • As of 2018, gonorrhea cases among men have nearly doubled over the past 5 years.
  • Gay and bisexual men appear to be impacted disproportionately by syphilis and gonorrhea, highlighting a need for more precautionary measures within those groups.
  • For all three diseases, blacks far out-pace all other races or ethnicities, when it comes to reported cases.

All of these outcomes are quite troubling, and considering that the U.S. was experiencing record low STD infection rates around the year 2000 for all three major diseases, we need to figure out what has gone wrong to reverse course so drastically. While trying to pinpoint the smoking gun behind this public health concern, blame has been tossed around to different organizations like a hot potato, but all explanations lead to a common funding issue. 

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The CDC has advocated for more funding and attention at the state and local levels of government, as this alleged neglect has reignited the resurgence of these diseases. The CDC and the AHF (Aids Healthcare Foundation) which are bound to the hip as it pertains to carrying out public health initiatives related to STDs, have also shed light on the dire need of federal government assistance to keep up with STD prevention funding needs. 

In that same vein, the AHF has also had some choice words for the CDC, regarding its perceived lack of effort in pursuing more funding for their preventative care programs. The potato gets chucked again when the CDC remarks that the public health infrastructure needs overhauling and to accommodate the populations in greatest need.

However, there is evidence that antibiotic-resistant strains of Gonorrhea have been arising (3.6% of gonorrhea cases in 2016), and as our treatments have pressured the bacteria to mutate and evolve, we are now down to our last remaining form of treatment that still works for non-resistant strains. 

Another consideration is that STDs may not be necessarily getting passed around at a more rapid rate, but instead greater detection from more clinical check-ins have attributed to the uptick in cases. It is very concerning for instance that females between the ages of 15 and 24 are so severely hampered by chlamydia cases versus males of the same age group. 

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One could infer that there is a sub-population of males lurking around, knowingly or unknowingly infected, and they pass along their disease burden to these women who have unprotected sex with them (primary transmission is through direct contact of the genitals). There are certainly some unanswered questions regarding this disparity, and others, but the short podcast interviews mentioned at the bottom of this article may help provide some clarity; check them out!

As this nationwide public health issue continues to seemingly spread like wildfire, please consider writing your local and state legislators to advocate for increased funding for STD prevention programs. Must I remind you that before you know it election time will be here too, so if this subject matters to you (which it should), be sure to make it a policy issue that leaders are obligated to address, and hold them accountable! We don’t want to wait until this is completely out of control, and we’re dealing with a raging health crisis. 

With all this in mind, you don’t need me to tell you that it’s getting a little crazy out there in the streets, so make sure to slow down and choose wisely during this cuffing-season. Oh, and of course, always use protection if and when that steamy moment arises. 

Feel free to peruse the full 2018 surveillance report here, to stay up to date on all the detailed data, commentary, and trends regarding STD infection.

Interviews

Listen here to NPR’s Atlanta station WABE 90.9 FM which spoke with Dr. Gail Bolan, director of the CDC’s Division of STD Prevention, and Dr. Walkitria Smith, Family Medicine Associate Program Director at the Morehouse School of Medicine, about the results of the 2018 STD surveillance data along with proposed solutions to help reverse the alarming trends.  


Also check out another great discussion and recap on the 2018 surveillance data here, with CDC epidemiologist Dr. Elizabeth Torrone, courtesy of Boston’s NPR Station.

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The Brain Eating Amoeba, Know Thine Enemy

The Brain-Eater Naegleria fowleri (nay-gleer-ee-uh) is a type of free-living amoeba,that infects the central nervous system and “eats” the brain tissue. There have been 142 cases of recorded infection with 4 survivors , 2 of which received no permanent brain damage. The U.S. possesses 3 of 8 Naegleria f. strains, however as far as scientists can tell, there isn’t any difference in virulence between strains…meaning they are all equally deadly. 

Naegleria f. is present worldwide in soil and both natural man-made freshwater habitats, thriving in warmer temperatures as high as 115 degrees fahrenheit! Some of these amoeba reservoirs include fountains, swimming pools, spas, cooling circuits, and tap water sources. Well before you start freaking out, let’s take a look at some data to provide a more clear perspective!

From 1962 to 2017 there have been approximately 142 incidences of infection with the brain-eater, Naegleria fowleri.According to the Center for Disease Control, there have been 60 cases from 1962-1989 and 82 cases from 1990 to 2017. What has changed in the past 26 years to make the incidence of a brain-eating amoeba more frequent? There are two schools of thought:

  1. The increases in disease incidence could be scaling with a population increase. Since 1990 the population of the U.S. has grown by an estimated 75.53 million individuals, for a population of 325.15 million in 2017  based on the U.S. Census Bureau statistics. 
  1. The Brain-Eater Naegleria f., is able to thrive in high temperature water. The temperature of the U.S. continental surface has been steadily increasing since 1990. These increasing temperatures could be allowing Naelgleria to thrive and reproduce faster. The primary states of incidence, Florida and Texas (both of which have 30+ incidences) are naturally hot climates with numerous bodies of freshwater. This has made both of these sites primary incubators for infection and Naegleria f. persistence.

A  question that arises when learning of a brain-eating amoeba-does this happen where I live? The CDC has developed the chart below to answer this crucial question. Number of Case-reports of Primary Amebic Meningoencephalitis by State (1962-2018)

Naegleria f. Infection typically leads to inflammation, swelling, and hemorrhaging of the brain. Symptoms include headache, fever, nausea, vomiting, stiff neck, confusion, short attention spans, loss of balance, seizures, and hallucinations; all of which can manifest themselves anywhere from 1 to 9 days post infection. 

Okay, okay so onto the big questions of what the treatment options are after infection, along with the prospects of surviving this amoeba encounter. Immediate admission to your local hospital as soon as you suspect Naegleria f. infection is your best bet, with a combination therapy of lowering body temperature and administration of antimicrobials. Unfortunately, the mortality rate of this disease is roughly 97%, with late diagnosis serving as a predominant culprit.  

Naegleria f. infection is not transmissible between humans so there currently isn’t a fear of an outbreak of amebas eating our brains. However, a few suggestions on how to limit the possibility of infection altogether include: avoiding swimming in warm fresh water, using nose clips when diving into warm fresh water, abstaining from disturbing the sediment of shallow bodies of warm water. Remember, if you think you or someone you know has been infected, please seek medical help immediately!

Joint Article-B.Ford, J. Hamilton

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