Alaska has yet to see a case of vaping-associated pulmonary illness, even as the 49 other states and Washington, D.C., have reported a combined 1,888 cases.

“We’re the only state that hasn’t had any yet,” said Cheley Grigsby, manager for the state Tobacco Prevention and Control Program.

The Centers for Disease Control and Prevention is providing updates every Thursday on the lung injury outbreak.

There have been 37 confirmed deaths in 24 states and Washington, D.C., as of the Oct. 31 update, available at bit.ly/325NkM3.

“This complex investigation spans almost all states, involves over a thousand patients, and a wide variety of brands and substances and e-cigarette, or vaping, products.

“Case counts continue to increase and new cases are being reported, which makes it more difficult to determine the cause or causes of this outbreak,” according to the website.

With the uncertainty about what is causing the illness, Grigsby said there is no way to say what the difference is between Alaska and the states reporting vaping-associated pulmonary illness.

However, because THC has been present in most of the samples to date, the Department of Health and Social Services Section of Epidemiology is recommending not using THC e-cigarettes or vaping products, and avoiding THC altogether.

“What we’re saying is that people should not use e-cigarettes or vaporized products that contain THC,” said Eliza Muse, marijuana education program manager, adding that if people choose to do so anyway, they definitely should not receive those products from informal sources.

“So you don’t want to be getting something from friends or family members or illicit dealers. You definitely want to rely on the marketplace if you’re going to do it at all, understanding that there is a risk associated,” Grigsby said.

Muse added that they are also advising people not  to modify any of their cartridges in ways not intended by the manufacturer.

The relatively new marketplace for e-cigarettes and vapes presents challenges, as well.

“So in traditional cigarettes there’s over 7,500 cancer causing toxins. We know the history with cigarette use and how unhealthy it is. With e-cigarettes, they’re fairly new and they’re still being studied,” Grigsby said.

Muse said the vape industry is “essentially unregulated” federally and in the state, with the only restriction being the age of purchase.

This lack of regulation means no standards exist to determine the levels of nicotine contained in vaping products, Grigsby said.

What is regulated, Grigsby and Muse noted, is the marijuana industry. All vaporized products approved by the Marijuana Control Board are subject to regulation, including child-resistant packaging, an age minimum of 21 to purchase the product and testing.

On Oct. 18, Alaska Health and Social Services posted to its Facebook page that the Alcohol and Marijuana Control Office is reviewing all vaping products approved by the Marijuana Control Board to identify those that contain additives.

“If a product is identified to contain additives, it will be brought to the board’s attention for review. If you have any questions about an approved product in a marijuana retail store, please visit the AMCO website at commerce.alaska.gov/web/amco or call (907) 269-0350,” the post states.

AMCO Director Erika McConnell confirmed the office is reviewing all approved vaping products and will provide the information to the board at its next meeting.

“At the last meeting, I informed the board (and read into the record) information from the CDC about the vaping-related illnesses. The board did not direct me to take any action in September. At the November meeting, I will share with the board (and the public) a list of approved products that contain nonmarijuana additives. There are no approved products with Vitamin E Acetate in them.” McConnell wrote in response to a News-Miner email.

While it has not been confirmed by Federal Drug Administration tests, Vitamin E acetate is one substance speculated to be what could be causing the illness.

The Department of Health and Social Services is following CDC guidance and has issued a public health alert, requesting health services providers report possible cases of the illness to the Alaska Section of Epidemiology.

“So we’re working with health care providers right now on some public education, some materials for them to be on the lookout for,” Muse said.

Symptoms include cough, shortness of breath and fatigue, which can worsen over a period of days, according to the health alert. Other symptoms, which have been reported at fever, chest pain, weight loss, nausea and diarrhea.

A copy of the alert, along with a list of symptoms, is available at bit.ly/36F8Qee.

Contact staff writer Kyrie Long at 459-7510. Follow her on Twitter at twitter.com/FDNMlocal.