At least five people have died in the US after vaping, officials said on Friday, in an outbreak that has sickened hundreds with severe pulmonary disease and left several teens in induced comas.
No single substance has been found to be present in all the laboratory samples being examined, federal officials said, but added that investigators in New York are now focusing on black market cannabis e-cigarette products containing vitamin E oil.
Local health authorities in California and Minnesota announced the vaping-related deaths of two individuals, both older and in relatively poor health, at least one of whom had used products containing tetrahydrocannabinol, the principal psychoactive compound in cannabis.
There are now more than 450 possible cases of pulmonary illness associated with vaping, more than double the figure reported last week, said Ileana Arias, acting deputy director for noninfectious diseases at the US Centers for Disease Control and Prevention.
North Carolina-based pulmonologist Daniel Fox said that patients he had examined had a noninfectious condition known as lipoid pneumonia, which can occur “when either oils or lipid-containing substances enter the lungs.”
The New York State Department of Health said that laboratory test results showed very high levels of vitamin E oil in cannabis cartridges used by all 34 people in the state who had fallen ill after using e-cigarettes, adding that as a result it was focusing its investigation in that direction.
Vitamin E acetate is a commonly available nutritional supplement taken orally or applied to the skin, but is harmful when inhaled.
US Food and Drug Administration Acting Administrator Ned Sharpless said that his agency was aware of the reports, “but no one substance, including vitamin E acetate, has been identified in all of the samples tested” at a national level.
Many patients reported vaping cannabis, but some said that they had only inhaled nicotine products.
The first death was reported in Illinois late last month.
Oregon this week announced that the death of a patient in July was also being linked to vaping.
Authorities in Indiana have said that a death occurred there as well, although they have not provided details.
Patients have reported symptoms including breathing difficulty and chest pain before they were hospitalized and placed on ventilators.
Medics said that many people had been initially misdiagnosed as having bronchitis or a viral illness until their symptoms escalated, at times to very extreme levels.
The parents of Kevin Boclair, a 19-year-old from Philadelphia, told reporters that their son had been placed in a medically induced coma three weeks ago and might require a lung transplant if he recovers.
“I even know, as a nurse, he could die,” said his mother, Deborah Boclair. “So we are hoping it gets better, and I just want his friends to know and all these kids out there — I could tell the parents: ‘Tell your kids don’t do this.’”
Sean Callahan, a doctor who successfully treated 20-year-old Alexander Mitchell from Provo, Utah, told reporters: “I’ve never seen anything like this before.”
“You know, when I’ve had people this sick who need this sort of life support, it’s a really advanced case of like a flu, pneumonia or patients who have weakened immune systems from cancer and chemotherapy,” Callahan said.
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