Vaping cartridges containing THC and referred to as "Dank Vapes", as well as some other illegal brands, are associated with severe lung disease that has recently emerged among people using vaping devices and electronic cigarettes to inhale THC or nicotine, or both health officials said Friday.
But they also said that Dank Vapes seems to be a label that THC sellers can slap on every product and is not a specific formulation or single product. THC is the psychoactive ingredient in marijuana.
"Dank Vapes appears to be the best known in the class of counterfeit brands, with general packaging that is readily available online and used by distributors to market THC-containing cartridges without apparently centralized manufacturing or distribution," said a report released Friday by Illinois and Wisconsin state health officials and federal Centers for Disease Control and Prevention.
But officials said that they do not know whether disappearing diseases or deaths in other parts of the country are also related to these brands.
In Illinois and Wisconsin, among patients reporting nicotine vaping, Jules was the dominant brand.
C.D.C. held a briefing on Friday to discuss some of the findings in health investigations of vaping diseases that have been reported in 46 countries, including 805 cases and 13 deaths. Oregon reported a second death Thursday; state health officials said the man was hospitalized with respiratory symptoms after vaping cannabis products.
p. Ann Shuchat, CDC's deputy director, called lung disease "serious and life-threatening." She described the vaping product market as dynamic and said there was a large array of products, ingredients, packaging and supply chains and consumers had no way of knowing exactly what is in the liquids they drink.
Many patients in the United States have reported using THC products, the agency said. Some patients say they only modified nicotine, but Wisconsin researchers find that some patients who claim to have actually used THC.
Of 771 patients nationwide, 91 percent were hospitalized; 69 percent are men and just over 60 percent are between 18 and 34 years old. From the deaths of C.D.C. says that nearly 60 percent are men and the average age is 50.
Both C.D.C. and the Food and Drug Administration are investigating outbreaks of vaping disease, in an attempt to identify not only the products used but also some of the substances that have been inhaled.
F.D.A. commissioner, Dr. Ned Sharples, told a congressional committee Wednesday that the agency tested the vaping fluid provided by people who became ill.
"We received about 300 samples," he said. "We have tested about 150. I would say that about 70 percent are THC products. The rest are nicotine products or something. A significant portion of THC products, possibly half of them, are contaminated with vitamin E acetate. "
Vitamin E acetate is an oil for the skin and is 'no work' because it is a product that people inhale," said Dr. Sharples. , adding that the product is being added to thin or "slice" the THC before it is sold.
But other ingredients or contaminants can also contribute to the disease, health experts say.
Patients became weak and short of breath. Many need additional oxygen and treatment in intensive care units. In some patients, the damage to the lungs was so severe that they were placed on ventilators. In several cases, lung function was so poor that ventilators were not sufficient and patients also needed to be connected to machines that pump oxygen directly into the bloodstream.
Most of the patients have recovered enough to go home after days or weeks in the hospital, but doctors say it's too early to say whether they will suffer permanent damage to their lungs.
Given the unanswered questions about the exact cause of the disease, many health experts say people just don't have to cheat. Those who continue to do so should avoid THC and not buy vaping liquids on the street or add ingredients to commercial products, C.D.C. said. It emphasizes that non-smokers should not start using electronic cigarettes and young people and pregnant women should never use them.
The disease package this summer has prompted several states and legislators to call for more restrictions on e-cigarettes and law enforcement agencies to crack down on illegal vape shops and illegal sales of vaping products. Michigan, Rhode Island and New York imposed bans on flavored e-cigarettes, while Massachusetts imposed a four-month ban on all vaping products. The state of Washington is also considering banning flavored e-cigarettes.
Katie Thomas participated in the reporting.