FARGO — State health officials, public health agencies and hospitals have been working closely to identify vaping-related lung illnesses while trying to find possible common denominators in the growing outbreak.

It’s proven to be a challenge, said Tracy Miller, state epidemiologist at the North Dakota Department of Health. “In every single case, there has not been the exact same situation,” Miller said.

Like other states have been doing since the outbreak began, North Dakota health officials are trying to connect the dots.

“It’s been a whirlwind,” said Neil Charvat, director of the state’s Tobacco Prevention and Control Program.

The U.S. Centers for Disease Control and Prevention said of more than 1,000 vaping-related lung injury cases nationwide thus far, most patients reported using products containing THC, many purchased off the street. THC is the active ingredient in marijuana that makes users feel high.

Miller said the state will not yet provide a breakdown of cases it's identified involving THC because the numbers are small, and the cases are still under investigation. However, she said some patients reported using nicotine vaping products only.

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Charvat said since states are still gathering data, he thinks some erroneous conclusions are being reached about THC. “I’m not saying THC is not the problem, but there’s a lot of insinuation (about it),” he said.

According to the CDC, of the 1,000-plus vaping-related lung illnesses nationwide, 18 deaths have been confirmed in 15 states, including Minnesota, and more deaths are under investigation. Symptoms can include cough, shortness of breath, chest or abdominal pain, vomiting, diarrhea, fatigue, and fever.

North Dakota reports nine confirmed or probable cases and three suspected cases occurring in Cass, Burleigh, Morton, and Williams counties. South Dakota also reports nine cases. Minnesota has 63 confirmed or probable cases and 39 that are under review.

News of vaping illnesses began spreading in early August when more than a dozen people were hospitalized in Wisconsin and Illinois with severe breathing problems after vaping.

At the time, Melissa Markegard, tobacco prevention coordinator at Fargo Cass Public Health, said she wasn’t surprised, given the vaping epidemic.

Then in early September, North Dakota officials issued an alert regarding the state’s first case of vaping-related lung illness and asked health care workers to be on the lookout for more cases.

North Dakota joined other states, including Minnesota, in establishing websites where medical providers can report vaping-related lung illnesses and residents can self-report cases.


The North Dakota website, like the CDC website, is updated weekly. Dr. Douglas Griffin, chief medical officer at Sanford Health in Fargo, said the website is “basically a hotline” to which hospitals and clinicians can directly report cases. He said Sanford has treated vaping-related illnesses, but he couldn’t give a number.

Miller said the state can also distribute vaping information through the North Dakota Health Alert Network that encompasses state and local public health agencies, health care providers, hospitals and emergency management officials.

Griffin cautioned against vaping, given the number of deaths that have occurred. For those using it as a way to wean off cigarettes, he suggests they visit with their physician about other methods to stop smoking.