U.S. federal health officials are finally confident enough to single out a primary culprit for the wave of acute lung illnesses linked to vaping: an additive called vitamin E acetate often found in unregulated THC products.
On December 20, the U.S. Centres for Disease Control and Prevention (CDC) updated their investigation into the condition known as EVALI, short for “e-cigarette or vaping product use-associated lung injury.” As of December 17, 2,506 people have been hospitalized with EVALI across all 50 states, while 54 have died. Two-thirds of victims have been under the age of 35, though the median age of those who died has been 52. People have reported respiratory symptoms like shortness of breath and chest pain as well as digestive problems like nausea and vomiting.
For months, dating back to the first reported cases this summer, CDC health officials have been reluctant to assign blame to any particular cause. But the ongoing testing of patients’ lung fluid samples has apparently convince them.
According to findings published last week in the New England Journal of Medicine, nearly 95 per cent of the 51 patients tested so far have had vitamin E acetate—a oily form of the vitamin used as a thickening agent in many products, including skin creams—in their lungs, compared to none in a matched control group. A similar percentage also tested positive or reported using cannabis or THC vaping products. No other likely toxic chemicals were found in these patients.
The results were enough for CDC chief Anne Schuchat to state that the “the vast majority of patients” during this outbreak have been sickened by vitamin E acetate. She delivered the verdict at a CDC press conference held Friday.
On the optimistic side of things, the outbreak seems to be slowing down. The influx of weekly new cases reached its peak in September and has been steadily declining since, with just two hospitalizations reported during the first week of December.
Other agencies, including the Food and Drug Administration and the Drug Enforcement Administration, have also taken steps to reduce the distribution of illegal vaping products. On Friday, both agencies announced that they had shut down 44 websites advertising these products, though some seemed to operate as a scam, not actually delivering goods. While cases haven’t been linked to a single product or distributor, a slight majority have been connected to products branded as “Dank vapes.”
Good news aside, some victims have had trouble recovering. Dozens of patients have been readmitted to the hospital following their initial episode, the CDC said Friday, and some have died soon after. These patients were more likely to have risk factors like being older and having pre-existing lung disease.
Despite zeroing in on vitamin E, though, health officials aren’t ruling out that there could be other causes. They continue to advise people to avoid using any vaping and e-cigarette products.
“I want to stress that this does not mean there are not other substances in e-cigarette products that are capable of causing lung injury,” Schuchat said during the press conference, pointing to the small minority of cases that have been not linked to THC or vitamin E.