Federal analyses of some vape products used by victims of a vaping-related lung illness revealed that vitamin E acetate, an oily substance that can cause severe damage to the lungs, was found in every case tested.

The results are a “breakthrough,” said Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention, as the agency reported for the first time that officials have identified a possible toxic chemical of concern in biological samples extracted from patients.

“These findings provide direct evidence of vitamin E acetate as the primary site of injury among EVALI patients,” the agency reported on Friday, using an acronym for the name health officials have given for the severe lung illness, “E-cigarette, or vaping product use associated lung injury.”

As of Nov. 5, 2,051 people have fallen ill with EVALI, and 39 have died, the CDC reported Thursday. Two Oregonians have died in the epidemic, and 17 have fallen ill. At least one of Oregon’s victims is under 18, the Oregon Health Authority confirmed this week. Health officials said two weeks ago that the epidemic could be receding because of increased awareness and public health messaging.

The CDC reported Friday that it did chemical tests on lung fluids from 29 patients from 10 states who had been treated for the vaping-related lung illness. Federal investigators made a prioritized list of chemicals to test for, which included vitamin E acetate — a chemical identified early in the epidemic as a possible culprit — and MCT oil, plant oils, petroleum distillates and other chemicals and compounds.

Each of the 29 samples had vitamin E acetate, the CDC reported.

The chemical could be being added to vaping products to thicken THC vape oil, the agency reported. Part of the reason it is hazardous is the high temperature necessary to turn it into a vapor. The Washington Post has reported that vitamin E could cool down enough to turn into oil droplets before it is absorbed into vapers’ lungs, accumulating to the point that the material could elicit a violent immune system reaction.

The focus of the inquiry continues to be on products containing THC, the intoxicating chemical in marijuana. Of the 23 patients who told officials what products they had used, 20 said they vaped THC. The focus is, in particular, on THC products bought illicitly. There’s a possibility that tainted vape products entered the legal marijuana production pipeline in states where THC products are legal, Schuchat said.

At least six Oregon victims used only THC and at least five reported they had used only nicotine. Federal officials said they continue to investigate nicotine products because, though a minority, some patients have credibly said that’s all they used before falling ill.

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