Number of Vaping-Related Lung Disease Cases Doubles As Clues Point to 'Chemical Exposure'

A vape pen next to marijuana.
(Image credit: Shutterstock)

UPDATE: On Sept. 12, the Centers for Disease Control and Prevention (CDC) announced that there are currently 380 confirmed and probable cases of lung disease tied to vaping in 36 states. This revised case count is lower than what the agency announced last week because the new number includes only confirmed and probable cases that meet the CDC's current case definition, or the specific criteria officials use to classify a vaping-related illness. The previous case count included "possible" cases that did not necessarily meet this definition. Live Science published this article (below) on Sept. 6.

The number of Americans sickened by mysterious, vaping-related lung illnesses continues to soar as health officials unravel clues to what could be causing these illnesses.

Today (Sept. 6), the Centers for Disease Control and Prevention (CDC) announced that it is aware of 450 possible cases of severe lung illnesses tied to vaping that are under investigation in 33 states. (That's more than double the number of cases under investigation as of last week.)

Among these cases, three deaths have been confirmed in connection with these illnesses — one each in Illinois, Oregon and Indiana — and a fourth death is under investigation.

Overall, many of the patients are teens or young adults who were previously healthy. All patients reported using e-cigarettes, and many reported using the devices to vape marijuana before they got sick.

Related: 4 Myths About E-Cigarettes

So far, the cause of the illnesses is unknown; no single vaping device, product or substance has been tied to all of the cases, said Dr. Dana Meaney-Delman, the manager of the CDC's investigation into the lung illnesses.

Officials believe "chemical exposure" is likely behind these illnesses, but much more information is needed to determine which substances are involved, Meaney-Delman said at a news conference today. "[We're] working hard to understand why people are getting sick."

Yesterday, it was reported that a substance known as "vitamin E acetate" — an oil derived from vitamin E — had been found in 10 out of 18 marijuana product samples taken from patients for testing by the Food and Drug Administration (FDA). The agency is now analyzing more than 120 samples from around the country for a broad range of chemicals, said Dr. Ned Sharpless, acting FDA commissioner.

But simply identifying a compound in samples doesn't mean that it caused the illnesses, officials stressed. "Identifying any compounds present in the samples will be one piece of the puzzle but won't necessarily answer questions about causality," Sharpless said in a statement.

Today's announcement coincided with the release of several new reports on vaping-related illnesses. The reports include a detailed description of some of the cases, as well as a "case definition," or the specific criteria officials use to classify  a vaping-related illness. This will help "define the clinical picture of what we are dealing with" and help doctors identify patients more quickly, Meaney-Delman said.

One report, published today in The New England Journal of Medicine, describes a cluster of 53 patients from Wisconsin and Illinois who developed serious respiratory symptoms after vaping. Most of these patients were young — the median age was 19 — male and generally healthy prior to their illness. Patients reported symptoms such as shortness of breath, cough and chest pain, and some reported nausea, vomiting, fever and weight loss. All of the patients had vaped within the prior three months, and 84% reported vaping marijuana products.

Interestingly, the report seems to suggest that these vaping-related lung illnesses are indeed a new phenomenon, and not something that simply went undetected in the past. The rate of monthly emergency room visits for severe lung illness in young adults was twice as high in June through August 2019 than in the same months in 2018, the study found.

Another report, published Sept. 6 in the CDC journal Morbidity and Mortality Weekly Report, describes five young patients in North Carolina who had similar symptoms after vaping. All of the patients were diagnosed with lipoid pneumonia, a rare condition in which fats or oils enter the lungs and lead to pneumonia, or inflammation of the lungs. Doctors couldn't determine whether the lipids came from outside the body — from an inhaled substance — or from inside the body, due to altered fat metabolism, the CDC said.

The CDC recommends that people consider not using e-cigarettes while the investigation is ongoing. And regardless of this investigation, e-cigarettes should not be used by youth, young adults, pregnant women or adults who currently don't use tobacco products, the CDC said. What's more, people should not buy e-cigarette products off the street and should not modify the products or add substances that aren't intended for vaping by the manufacturer, the agency said.

 Originally published on Live Science. 

Rachael Rettner

Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.