The Centers for Disease Control updated its website today. The organization said that recent CDC laboratory testing of bronchoalveolar lavage (BAL) fluid samples from 29 patients with EVALI submitted to CDC from 10 states found vitamin E acetate in all of the BAL fluid samples. Vitamin E acetate is used as an additive in the production of e-cigarette, or vaping, products. This is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries.
As of November 5, 2,051 cases of e-cigarette, or vaping, product use associated lung injury have been reported to CDC from 49 states (all except Alaska), the District of Columbia, and 1 U.S. territory. There have been 39 deaths in 24 states and the District of Columbia.
CDC continues to recommend that people should not use e-cigarette, or vaping, products that contain THC, particularly from informal sources like friends, or family, or in-person or online dealers. We will continue to provide updates as more data become available.
The website posted these new findings:
New Laboratory Findings:
- Analyses of bronchoalveolar lavage (BAL) fluid samples (or samples of fluid collected from the lungs) of patients with e-cigarette, or vaping, product use associated lung injury identified vitamin E acetate, an additive in some THC-containing products.
- Recent CDC laboratory test results of BAL samples from 29 patients submitted to CDC from 10 states identified vitamin E acetate in all BAL fluid samples. THC was identified in 82% of the samples and nicotine was identified in 62% of the samples.
- CDC tested for a range of other chemicals that might be found in e-cigarette, or vaping, products, including plant oils, petroleum distillates like mineral oil, MCT oil, and terpenes (which are compounds found in or added to THC products). None of these potential chemicals of concern were detected in the BAL fluid samples tested.
- This is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries. These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs.
- These findings complement the ongoing work of FDAexternal icon and some state public health laboratories to characterize e-liquid exposures and inform the ongoing multistate outbreak.
The CDC admitted that no one compound or ingredient has emerged as the cause of these illnesses to date, and it may be that there is more than one cause of this outbreak. Many different substances and product sources are still under investigation.