Investigators are homing in on a potential chemical culprit behind the mysterious spate of vaping-related illnesses and deaths. Here's what officials knew and when.

AP Photo/Steve HelberA customer blows a cloud of smoke from a vape pipe at a local shop in Richmond, Va.

The mysterious spate of vaping-related illnesses and deaths continues to grow.

The Centres for Disease Control and Prevention said that 2,051 people in the US have been struck with lung illnesses tied to vaping THC or using e-cigarettes, in 49 states and one territory. The illnesses have claimed 39 lives, and doctors and other health experts fear there could be more on the way.

Investigators are homing in on vitamin E acetate, an ingredient found in canola, soy, and corn oil, as one of the primary compounds linked with the injuries, they said during a Friday call with reporters.

“For the first time, we have detected a potential toxin of concern: vitamin E acetate,” CDC Principal Deputy Director Anne Schuchat said on a call with reporters Friday.

When Vitamin E acetate enters an individual’s lungs, it can prevent them from working properly.

“Vitamin E acetate is enormously sticky,” Jim Pirkle, from the CDC’s environmental health lab, said on the call. “You can think of it to be just like honey. And so when it goes into the lung, it does hang around.”

Still, investigators advised caution. They have not firmly established that the vitamin E oil is causing the illnesses – only that the two are related.

The lung injuries are now being called EVALI, or e-cigarette or vaping-related lung injury.

According to the CDC, people with EVALI who said they’d used THC vapes were 9 times more likely to have gotten the vapes from informal sources, compared to licensed dispensaries.

A recent study found that out of 12 illicit vape cartridges tested, nine contained dangerously high levels of vitamin E acetate. On top of that, all of the illegal vapes contained pesticides, including myclobutanil, which can break down into poisonous hydrogen cyanide when inhaled, Business Insider reported.

“The data so far that have been carefully looked through point to a much greater risk associated with the THC-containing products that are acquired from informal sources as opposed to licensed dispensaries,” said Dr. Schuchat.

“The majority of what we’re seeing now points to informal sources,” said Dr. Schuchat. The CDC still recommends to not use any THC-containing vape product, particularly ones bought off the street.

The FDA launched a criminal probe into the matter in September, and warned against using any THC-containing vapes, whether bought in retail shops or from illicit sellers.

In a call with reporters in October, Dr. Schuchat said that the “epidemic curve,” or the number of new illnesses reported is “levelling off or declining.”

In September, the Trump administration announced it will push for a ban on all flavored e-cigarettes, including mint and menthol flavours.

The administration has separately recommended that people not use e-cigarettes.

Here’s what officials knew when. We’ll update this as more information comes to light:

August 17:

Associated PressJoshua Ni, 24, and Fritz Ramirez, 23, vape in San Francisco.

CDC officials say they are actively investigating almost 94 cases of vape-related illnesses in 14 states. That number would grow to 200 cases in 22 states.

Officials haven’t yet determined the specific causes of the illness, but it is thought that oils and chemicals used to emulsify THC, CBD, and nicotine in illicit vapes is to blame.

August 23:

Associated Press

The first vape-related death is reported in Illinois.

The person, who has remained unnamed, was hospitalized with severe breathing difficulties, according to officials. He was reportedly using e-cigarettes to consume nicotine.

September 3:

Oregon’s Health Authority says it is investigating the death of an individual with a severe respiratory illness following the use of an e-cigarette.

While officials have not yet determined the root cause of the middle-aged person’s illness, he had reportedly fallen ill after vaporizing marijuana oil purchased at a legal cannabis dispensary, reports The Associated Press.

September 4:

Mario Anzuoni/ReutersBrandy Tseu uses an e-cigarette in Los Angeles.

Dr. Scott Gottlieb, the former FDA commissioner, writes an editorial in The Washington Post urging federal officials to take action in investigating the causes of these illnesses and deaths.

“Bright lines must be drawn between less-harmful ingredients and those that cause undue risk. That would arm regulators with the information to crack down on illegal and dangerous vape juices. It’s also time to end the political ambivalence that allows THC and CBD to evade oversight,” Gottlieb wrote.

September 6:

Ben Gilbert/Business Insider

Indiana health officials confirm a third vape-related death. Shortly afterward, officials in Minnesota confirm a fourth, and then a fifth in California.

Like the other deaths, officials have yet to determine a root cause. However, the 65-year old Minnesota man had a history of lung disease. He fell ill after vaping an “illicit” THC product,The New York Times reports.

September 6:

Wikimedia CommonsNational Cancer Institute director Dr. Norman Sharpless.

Acting FDA Chief Ned Sharpless says “Our investigation into the concerning reports of respiratory illness and deaths associated w/ vaping is a top priority for FDA and our federal, state, local health partners. We’re working tirelessly to gather and analyse information about these incidents,” on Twitter.

Sen. Minority Whip Dick Durbin pushed Sharpless to act quicker in a letter addressed to Sharpless on Friday.

September 10:

Brendan McDermid / ReutersA woman vaping.

Officials from the Kansas Department of Health announce the sixth vape-related death of a man “over the age of 50.”

“If you or a loved one is vaping, please stop. The recent deaths across our country, combined with hundreds of reported lung injury cases continue to intensify,” Secretary for the Kansas Department of Health and Environment Dr. Lee Norman said in a statement.

September 11:

Erin Scott/Reuters

The Trump Administration announces it’s pushing for a ban on all flavored e-cigarettes in the US, including mint and menthol flavours.

“The Trump Administration is making it clear that we intend to clear the market of flavored e-cigarettes to reverse the deeply concerning epidemic of youth e-cigarette use that is impacting children, families, schools and communities,” Health and Human Services Secretary Alex Azar said in a statement.

September 12:

Reuters / Brendan McDermid

The CDC released new numbers on the outbreak, with 380 confirmed and probable cases of illness in 26 states since June. Six people have died, the agency said.

The new illness numbers are slightly lower than previous figures because they include only cases that investigators have confirmed or come close to confirming.

September 15:

ReutersNew York Gov. Andrew Cuomo.

New York Gov. Andrew Cuomo announced a ban on all flavored e-cigarettes, except tobacco and menthol.

“These are obviously targeted to young people and highly effective at targeting young people,” the Democratic governor said at a press conference in Manhattan.

New York is the second state behind Michigan to issue a ban.

September 19:

ReutersA man uses a vape as he walks on Broadway in New York City.

The FDA announces it is conducting a criminal probe into the spate of vape-related illnesses and deaths, as the toll stands at 530 individuals with lung disease and 8 deaths.

September 24:

REUTERS/Brian SnyderMassachusetts Governor Charlie Baker.

Massachusetts Gov. Charlie Baker announced a 4-month ban on all vaping products, including both flavored and unflavored e-cigarettes containing nicotine and vapes containing THC sold in legal dispensaries.

“I’m declaring this public health emergency because medical and disease control experts have been tracking a rapidly increasing number of vaping-related illnesses that in some cases have led to death,” said Baker at a press conference.

Michigan has also moved to ban the sale of vape products within its borders as well, and other states, including Maine and New York, are weighing similar bans.

Baker’s decision has come under scrutiny from both public health officials and the state’s cannabis control board.

September 25:

Juul/YouTubeFormer Juul CEO Kevin Burns.

Juul CEO Kevin Burns stepped down from his position amid concerns over vape-related illnesses. It’s not clear if Juul’s devices are tied to the illnesses.

The company also said it would be “suspending all broadcast, print and digital product advertising in the US,” in a release.

Altria executive KC Crosthwaite took over as the e-cigarette company’s CEO, effective immediately. Altria owns a major stake in Juul.

September 26:

REUTERS/Adnan AbisiA man uses a vape device in this illustration picture.

The CDC said there have been 805 cases of lung injury reported from 46 states and one territory.

The illnesses have claimed 12 lives, and doctors and other health experts fear there could be more on the way.

October 4:

Associated PressIn this Saturday, June 8, 2019 file photo, two women smoke cannabis vape pens at a party in Los Angeles.

The FDA warned consumers not to use any THC-containing vapes, whether purchased on the street or in retail stores, amid a lung disease outbreak.

“[T]he agency believes it is prudent to stop using vaping products that contain THC or that have had any substances added to them, including those purchased from retail establishments. Simply put, inhaling harmful contaminants in the lungs could put a patient’s health at risk and should be avoided,” the FDA said in a statement from acting director Norman Sharpless.

November 8


The CDC homes in on vitamin E acetate, an ingredient found in canola, soy, and corn oil, as one of the primary compounds linked with the injuries, officials said during a Friday call with reporters.

According to the CDC, people with EVALI who said they’d used THC vapes were 9 times more likely to have gotten the vapes from informal sources, compared to licensed dispensaries.

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