Investigators Find Clue to Mysterious Vaping Injuries

Vitamin E oil was detected in all 29 samples taken from vaping patients tested by the Centers for Disease Control and Prevention, the federal agency said Friday, a tantalizing clue in the investigation into the cause of mysterious lung injuries.

Researchers found the oil in fluid taken from the lungs of patients with illnesses related to vaping from 10 different states, the CDC said. No other suspicious substances were detected aside from vitamin E oil, also known as vitamin E acetate.

A CDC official described the finding as a breakthrough, since it links a concerning substance found in the vaping products to biological samples from the patients.

“For the first time, we have detected a potential toxin of concern” in patient samples,

Anne Schuchat,

the principal deputy director at the CDC, said on a call with reporters. “These findings provide direct evidence of vitamin E acetate at the primary site of the injury within the lung.”

Vaping related illnesses are on the rise, and it appears to be related to a black market of THC vapes. WSJ’s Daniela Hernandez sat down with doctors and experts to understand what’s happening with the outbreak.

Yet, the results aren’t enough to be labeled a cause, according to Dr. Schuchat, who said more studies will need to be conducted to determine whether vitamin E oil was behind the vaping injuries.

Health officials also say there might be more than one cause of the illnesses and they will continue to work to better understand the outbreak.

Vitamin E acetate is commonly found in food, dietary supplements and skin creams, according to health authorities. The thick oil is also sometimes added to vaping products containing the psychoactive ingredient THC, especially illicit products, to increase the heft.

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Adding the oil can increase profits, because each product won’t need to have as much THC. The substance is safe to ingest but potentially dangerous to inhale, the CDC said.

New York state health officials highlighted vitamin E acetate as a substance of concern in early September, when they found high concentrations in THC products submitted by lung illness patients. Investigators from at least one other state, Utah, have also noted finding the substance in THC-containing products. THC is the psychoactive ingredient in cannabis.

So far, the evidence points to a connection primarily with THC oils, Dr. Schuchat said, and federal and state officials haven’t reported finding vitamin E acetate in any of the tested nicotine products linked to the patients.

Juul Labs Inc., the market-leading e-cigarette maker, said its vaping products don’t contain THC or vitamin E acetate.

Separately, President Trump said he supports raising the minimum purchase age for e-cigarettes nationwide to 21 from 18. To curb teenage vaping, Mr. Trump said his administration will next week release details on a plan to remove from the U.S. market the sweet and fruity e-cigarette flavors that are popular with young people.

“We’re going to be coming out with a very important position on vaping,” Mr. Trump told reporters outside the White House. “We have to take care of our kids, most importantly. So we’re going to have an age limit of 21 or so…. We have a lot of people to look at, including jobs, frankly, because it’s become a pretty big industry. But we’re going to take care of that.”

The White House is still working out the details of a policy to pursue legislation raising the minimum purchase age for e-cigarettes, according to a person familiar with the matter.

It could include traditional cigarettes and other tobacco products, the person said.

Altria Group Inc.

and Reynolds American Inc., the two biggest U.S. cigarette manufacturers, both support an increase of the minimum age to 21, as does Juul, a startup that has been blamed by health officials for a surge in underage vaping. On Thursday, Juul said that it was voluntarily stopping the sale of its mint-flavored e-cigarette refill pods, which government data indicates are popular among teenagers.

Altria, which has a 35% stake in Juul, rose 0.91% on the New York Stock Exchange on Friday.

Dozens of people have died and thousands have been sickened with confirmed and probable cases of pulmonary illnesses related to vaping. To determine the substances at fault, doctors squirted a fluid into a patient’s lungs through the mouth or nose and then collected the fluid, which was later analyzed by the CDC.

Researchers testing the lung samples checked for plant oils, mineral oils and other chemicals used to flavor vaping products, the CDC said. The testing found nicotine in 16 samples, and THC in 23 samples, including three from patients who had said they hadn’t used products containing THC. Not all of the 29 fluid samples could be tested for all of the substances, and inhaled substances might not always show up in the lung fluid, officials said.

Also on Friday, the Illinois health department and the CDC released findings about vaping patients drawn from surveys of vapers of all products who were injured and THC vapers who weren’t. The injured patients vaped THC more often than those who weren’t sickened and were more likely to use products containing THC exclusively, said Jennifer Layden, the chief medical officer and state epidemiologist at the Illinois Department of Public Health.

Patients were also eight times more likely to report using Dank Vapes, an illicit THC brand without a single manufacturer, and were nine times more likely to obtain products from informal sources, compared with THC vapers who didn’t get sick, she said.

There are 2,051 cases of the vaping-related illnesses spread across 49 states, the District of Columbia and the U.S. Virgin Islands, according to the latest CDC numbers released Thursday.

The CDC has confirmed 39 fatalities. Massachusetts reported an additional death Wednesday, a man in his 50s who has been reported vaping both THC and nicotine, bringing the total deaths confirmed by state and federal health officials to 40, with more under investigation.

The CDC warns that people shouldn’t vape THC-containing products. The agency also recommends people stay away from illicit products and from modifying products they have purchased legally. It says people should consider stopping vaping altogether while the investigation is ongoing.

Corrections & Amplifications
Anne Schuchat is with the Centers for Disease Control and Prevention. An earlier version of this article incorrectly misspelled her surname Shuchat. (Nov. 8, 2019)

Write to Jennifer Maloney at jennifer.maloney@wsj.com

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