The CDC didn't help matters by issuing guidance to avoid "all vaping products", even as it became clear that the vast majority (or perhaps even all) of the illness cases were related to THC vape cartridges bought off the street and not through legitimate retailers.
E-cigarettes and other vaping devices heat a liquid into an inhalable vapor.
So far, there have been 2,051 cases of vaping associated illnesses, reported in every state, except for Alaska, as of November 5.
"These results are unacceptable and that is why we must reset the vapor category in the USA and earn the trust of society by working cooperatively with regulators, Attorneys General, public health officials and other stakeholders to combat underage use", K.C. Crosthwaite, CEO of Juul, said in a statement. The samples, she said, "provided evidence of vitamin E acetate at the primary site of injury in the lungs". Numerous injured also reported using counterfeit or black-market products containing THC, notably those marketed as "Dank Vapes".
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"The CDC's reporting supports what New York State's Wadsworth Center Lab has found in vape products tested since early September and reinforces the importance of the role that Vitamin E acetate may play in the current outbreak of vaping related illnesses", New York Gov. Andrew Cuomo said in a statement on Friday.
Anne Schuchat, the CDC's principal deputy director, said tests have been conducted for a wide variety of substances, including plant oils and petroleum distillates.
The latest samples were collected through a process in which fluid is pushed into the lungs and then collected for analysis. The CDC said the lack of THC in five of those samples does not definitively indicate the patients didn't use the drug, because THC can be hard to detect in samples taken from lungs.
Although the substance was detected in all 29 of the lung samples, which came from patients in several different states, more testing is needed to establish a causal link between exposure and injury, Schuchet said, adding that "many substances are still under investigation".
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Almost 85 percent of lung injury patients in the nationwide outbreak have reported using products containing THC. Nicotine was detected in 16 of 26 patients.
While the findings released Friday are seen as a significant development, the CDC warns that there could still be additional factors at play.
82% of the samples included THC; 62% included nicotine. But Schuchat also says it's too soon to say if it's safe to use products even from licensed dispensaries: "I don't think we know enough yet to completely take the dispensaries out of the question". Vitamin E acetate has been highlighted as a huge concern by proponents of vaping for months, and once people began falling ill it seemed like the most likely culprit.
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