A woman in Kansas is the sixth person to die in the U.S. from the severe respiratory illness being linked to vaping, health officials in the state confirmed Tuesday.
The woman was over 50 with a history of health problems. However, doctors say it's clear vaping was the cause of her rapid deterioration.
"She had some underlying medical illnesses, but nothing that would have foretold the fact that within a week after starting using e-cigarettes for the first time, she developed full-blown acute respiratory distress syndrome and died," Dr. Lee Norman, secretary of the Kansas Department of Health and Environment, told NBC News.
Acute respiratory distress syndrome, or ARDS, occurs when the lungs fill with fluid.
Though many patients across the nation have been in their late teens, 20s or 30s, Norman said the Kansas death is a warning that older adults may be at particular risk.
"It's a reminder that older people with pre-existing illnesses are probably going to have worse clinical outcomes if they do develop problems with vaping," Norman said.
The Kansas woman had been one of six cases of vaping-related illness either confirmed or under investigation in that state, a number that Norman predicted will grow.
The other five vaping-related deaths were previously reported in Illinois, Indiana, Oregon, Minnesota and California.
State health departments were aware of at least 483 confirmed or suspected cases in 39 states plus the U.S. Virgin Islands by Tuesday afternoon, a jump from the 450 cases reported by the Centers for Disease Control and Prevention last week.
The rapid and worrisome increase has now prompted a Congressional hearing on the matter, scheduled for later this month.
Patients tend to arrive at the hospital short of breath and coughing. Many have also had fevers, general fatigue and gastrointestinal problems. It is not unusual for patients to be put into intensive care units, and on ventilators. All reported vaping nicotine, THC or a combination of the two in the days and weeks before falling ill.
The CDC has recommended people stay away from vaping devices while investigators work to pinpoint exactly what’s behind the illnesses.
The number of cases has risen in parallel with concern and awareness among doctors, major medical groups and parents who are now sounding the alarm on vaping.
"Parents seem to be driving new cases because they’re bringing their kids to doctors," said Dr. Humberto Choi, a pulmonologist and critical care specialist at the Cleveland Clinic. Choi has treated several of the vaping-related illnesses.
He and colleagues have not been able to pinpoint any one product behind the illnesses because patients report using a wide variety of e-liquids and devices.
"We haven’t seen any common pattern, but they’d all been vaping at the time they got sick," Choi told NBC News.
Larger investigations also have not yielded answers.
The Food and Drug Administration has tested 120 product samples, and so far has been unable to identify any one brand, ingredient or substance that could explain the illnesses.
In a statement to NBC News Tuesday, an FDA spokesperson wrote that finding answers to the vaping-related illnesses is a "top priority."
"We are all working tirelessly to get as much information as possible about any products or substances used. We are leaving no stone unturned in following any potential leads," the statement said.
Electronic cigarettes have been sold in the U.S. since 2006 largely without oversight, recently exploding in popularity, especially among young people. In 2018, the FDA estimated that 3.6 million kids under 17 use e-cigarettes. Nearly 11 million adults use e-cigarettes, according to a study published last year.
The FDA gained authority to regulate e-cigarettes in 2016. But the agency has struggled with how to control the booming industry.
On Monday, the FDA sent a stern warning letter to e-cigarette company Juul for illegally marketing its products as safer alternatives to smoking. The letter also cited congressional testimony that Juul representatives went into high schools targeting teens under the guise of anti-tobacco education.
A Juul spokesman said the company is reviewing the FDA comments and "will fully cooperate." There is no indication Juul products are behind the hundreds of vaping illnesses being diagnosed nationwide.
E-cigarette companies have been given years to gather and submit evidence their products are safe and effective ways to quit smoking traditional tobacco.
A federal judge has set a May 2020 deadline for companies to do so.
God only knows what all is in there.
Americans continue to inhale myriad mixtures of chemicals, nicotine, cannabis, oils and flavorings at a rapid pace. Some doctors liken them to a science experiment.
"God only knows what all is in there," Norman said. "There should be a moratorium on the sale of these products until we know more."
"We’ve allowed industry to addict a new generation of people. That has had enormous public health impact," said Dr. Rose Marie Robertson, deputy chief science and medical officer for the American Heart Association.
She, along with a growing number of local health departments, as well as the American Medical Association, urged the public to stay away from e-cigarettes.
The American Lung Association also released a statement warning the public that e-cigarettes could cause irreversible lung damage.
"No one should use e-cigarettes or any other tobacco product," Harold Wimmer, national president of the American Lung Association, wrote in the statement. "This message is even more urgent today following the increasing reports of vaping-related illnesses and deaths nationwide."
Also Tuesday, billionaire philanthropist Michael Bloomberg announced his organization will spent $160 million over the next three years aimed at banning flavored e-cigarettes he said are enticing to kids.
"If you have a product that looks like it might be damaging people’s health and killing them, the logical thing to do is to stop distributing the product," Bloomberg told NBC News.
Bloomberg will partner with the Campaign for Tobacco-Free Kids to launch awareness campaigns and work towards stopping e-cigarette companies from targeting kids.
"We know that kids using these products are far more likely to go on to smoke cigarettes," Matthew Myers, president of the Campaign for Tobacco-Free Kids said.
"I have never seen more moms, dads and kids deeply concerned about this epidemic," he said. "We’ll give them a voice."