Vape Illness Update: 3 Deaths, 450 Cases, Countless Questions

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Zeller added that the public is encouraged to report any “unexpected tobacco or e-cigarette-related health or product issues” to the FDA via the agencies online safety-reporting portal,

No single source for the outbreak has been identified, federal officials say.

Federal health officials on Friday said no single source has been identified for the outbreak of respiratory illnesses linked to vaping, although New York state health officials reported that vitamin E acetate found in cannabis vaping products may have caused at least some cases.

As of Friday, CDC officials on a call with reporters said the latest count showed 450 suspected cases of vaping-related illness in 33 states, including three deaths and one other suspected death.

On Wednesday, Oregon health officials reported a second death believed to be related to vaping. The middle-age patient died of severe pulmonary illness in July. On the Friday press call, the CDC confirmed a patient’s death in Indiana on Friday, bringing the confirmed fatality count to three.

The vitamin E link was first reported Thursday by the New York State Department of Health in a press statement. State health officials confirmed that high levels of vitamin E acetate were found in “nearly all cannabis-containing samples analyzed” as part of the investigation into vaping-related illnesses. The compound was found in several samples of the tetrahydrocannabinol (THC) vaping products used by people who became ill.

At least one vitamin E acetate-containing vape product has been linked to each of the 34 reported cases of severe pulmonary illness reported as of Thursday in New York State.

But a letter published Friday in the New England Journal of Medicine — one of several that the journal rushed into print to coincide with the CDC release — appeared to cast doubt on vitamin E acetate as a cause of illness.

Researchers at the University of Utah, describing six cases in that state, wrote, “A notable and consistent feature of the cases we report is the presence of lipid-laden macrophages seen with oil red O staining in BAL [bronchoalveolar lavage] samples that are not attributable to aspiration of exogenous lipoid material.” Vitamin E acetate is a lipid compound.

And in the Friday press call, CDC and FDA officials emphasized that no chemical cause of the unexplained, vaping-related illnesses has been confirmed by federal health officials investigating the outbreak.

“I want to stress that more information is needed to determine which specific products or substances are involved,” said Dana Meaney-Delman, MD, of the CDC.

She added that continued investigation is needed “to better understand if a true relationship exists between any specific product or substance and the illnesses we are observing in patients.”

Mitch Zeller, director off the FDA Center for Tobacco Products, said the outbreak investigation remains in the “critical fact-gathering stage.”

“More information is needed to better understand whether there is a relationship between any specific product and any specific substances in those products, and the reported illnesses,” he said.

The FDA has received more than 120 samples of vaping products used by people who have become ill and they are in various states of review, an FDA spokesperson told MedPage Today.

Zeller said the samples are being analyzed for the presence of a broad range of chemicals including nicotine, THC, other cannabinoids, cutting agents, additives, pesticides, opioids, poisons, and toxins.

“The samples we are continuing to evaluate show a mix of results, and no one substance or compound, including vitamin E acetate, has been identified in all of the samples tested,” he said.

Online Safety-Reporting Portal

Zeller added that the public is encouraged to report any “unexpected tobacco or e-cigarette-related health or product issues” to the FDA via the agencies online safety-reporting portal,


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