An analysis by the CDC found that emergency room visits related to vaping spiked suddenly, indicating a shift in vaping habits around that time. The report, which showed a dramatic increase in such visits starting in June and reaching a peak in September, was published alongside three other studies into the ongoing EVALI crisis this past Friday.

Most of the affected individuals had used THC-laden vaping products acquired from informal sources such as street vendors or acquaintances.

Moreover, substantial evidence is now linking vitamin E acetate to the outbreak. Dr. Anne Schuchat, the CDC's principal deputy director, confirmed in a press briefing that this substance is a key suspect in the EVALI cases. The CDC's investigation involved analyzing lung fluid samples from 51 patients with EVALI, 48 of which tested positive for vitamin E acetate. In comparison, lung fluid from 99 healthy individuals showed no presence of this substance.

Vitamin E acetate's thick, sticky consistency resembles that of pure THC oil, leading officials to believe it was used to dilute THC products, contributing to the health issues observed.

The mechanisms by which vitamin E acetate could damage the lungs are still being studied, but several hypotheses have been proposed. Schuchat mentioned that fine particles from the oil might interfere with a critical lung lining essential for normal respiratory function. Moreover, when subjected to high heat, vitamin E acetate may decompose into a harmful byproduct known as ketene, which has the potential to harm lung tissue.

However, Schuchat emphasized that these findings don't rule out the possibility of other harmful substances in e-cigarettes or vaping products contributing to lung injuries. "It's important to acknowledge that a small yet consistent number of EVALI cases have not involved THC vaping products," she noted.

Schuchat also pointed out that the proliferation of bootleg vaping products isn't tied to a single manufacturer or dealer. Instead, the issue may have been exacerbated by online guides promoting the use of vitamin E acetate in homemade vaping concoctions. "There seems to be an influence from social media in promoting these practices," she added.

On the same day, the FDA and DEA revealed the shutdown of 44 websites as part of "Operation Vapor Lock," which involved tracing the origins of illegal THC vape products. This operation, which included talking to EVALI patients and their families, identified these websites. However, no direct connections between the products sold on these sites and EVALI cases have been confirmed yet. Some of these websites were scams, taking payments without delivering any products.

Dr. Stephen Hahn, the newly appointed FDA commissioner, stressed the illegality of online advertisements for illicit THC vape cartridges. "Seizing these websites allows us to turn our attention to other online and physical locations where illegal and potentially harmful vaping products are being sold," he stated on the FDA's website.

Lung illness complications

The CDC's recent findings also highlight complications involving EVALI patients who were initially discharged but then required re-hospitalization due to further health issues. These individuals were typically over the age of 50 and had pre-existing chronic conditions like cardiovascular disease, diabetes, sleep apnea, and additional respiratory ailments.

Physicians are now recommended to conduct follow-up assessments with patients within 48 hours of their discharge from the hospital.

"Clinicians must ensure they coordinate with EVALI patients to provide necessary follow-up care within two days," stated CDC Director Dr. Robert Redfield in a press release. "Prompt medical follow-up can be crucial in saving lives."

Individuals who use vaping products are urged to be vigilant for symptoms of EVALI, which include severe tiredness, weight loss, coughing, difficulty breathing, fever, vomiting, and diarrhea.