The U.S. Centers for Disease Control and Prevention released findings on Nov. 8 that strengthen the case against Vitamin E acetate as the main culprit in the national outbreak of vaping related illnesses.
The CDC looked at 29 samples of lung fluids sourced from patients who suffered from the illness. All 29 samples contained Vitamin E acetate.
"This is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries," the CDC report said. "These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs."
The wave of vaping-related deaths have killed 39 people, including two in Oregon. The CDC'S latest tallies show there are 2,051 probable cases.
It's unclear whether Oregon Gov. Kate Brown's proposed ban on flavored vaping products would address the CDC'S findings. Vitamin E acetate is largely suspected to be present in black market cartridges, but not in regulated products on store shelves.
The ban implemented by Brown targets flavor agents in vaping products, including artificial flavors and botanically-derived flavors from terpenes. The ban on tobacco products has been halted by the Oregon Court of Appeals; a lawsuit filed by a cannabis distribution company seeks a similar pause for the cannabis rules of the ban.
Of the 29 samples the CDC tested for additives, 82 percent of the samples contained THC—the psychoactive component of cannabis.
It's unclear how many of those 29 patients had used black-market vaping devices and cartridges, but the CDC maintains that all illicit cartridges should be avoided.
"The latest national and state findings suggest products containing THC, particularly from informal sources like friends, or family, or in-person or online dealers, are linked to most of the cases and play a major role in the outbreak," the report said.
That means health agencies are eliciting vastly different results from testing.
In October, the Mayo Clinic studied 17 lung tissue samples from patients that had suffered from vaping-related illness. It concluded that the injuries resembled chemical burns. The study found no evidence that Vitamin E acetate build-up had contributed to the injuries.
"While it is difficult to discount the potential role of aerosolized lipid accumulation in this injury, no cases showed coalescence of lipid into large droplets as occurs in exogenous lipoid pneumonia," said the Mayo Clinic report, first published in the New England Journal of Medicine.
Those inconsistencies could potentially be explained by what exactly is being tested. The Mayo Clinic tested the actual lung tissue; the CDC, in its published findings today, said lung fluid—and not the lung tissue itself—was tested.