Pathologists examining the mysterious lung illness that has sickened more than 800 people across the country say toxic chemical burns may be the culprit, according to images and an analysis published in the New England Journal of Medicine on Wednesday.
The results come after the authors of the study examined lung biopsy samples from 17 patients who had been diagnosed with the vaping-related illness. Pathologists believe that the illness "represents a form of airway-centered chemical pneumonitis from one or more inhaled toxic substances."
Images of lung tissue published by researchers showed severe chemical injuries after the patients had vaped unknown substances. The top right image shows a cutaway of a person's airway with the pink circular structure representing the airway wall. Healthy airways have nothing in the middle of that structure, which allows air to flow easily. However, researchers said the lung tissues they examined showed that the patients had widespread inflammation and injuries which inhibited the flow of air.
"What appears to be going on in the lung itself is a direct toxic chemical injury, like a chemical fume injury or a poisonous gas injury," Dr. Brandon Larsen, an author of the study and a surgical pathologist at the Mayo Clinic in Scottsdale, Arizona, told NBC News. "It looks like the kind of injury that we normally see when a person is exposed to a spilled drum of toxic chemicals at their workplace."
So far, 805 cases of the vaping-illness have been confirmed by the Centers for Disease Control and Prevention, with twelve people having died from complications arising from the disease. Most of the patients studied by the Mayo Clinic were men, between the ages of 19 and 67. Nearly three-quarters of those had vaped marijuana or cannabis oil. So far, public health investigators haven't been able to determine any one ingredient or substance that's been linked to all the lung injury cases.
In response to the rash of cases across the country, the CDC is urging people to immediately stop vaping e-cigarettes or vaping products that contain THC.
"Some patients have reported that their symptoms developed over a few days, while others have reported that their symptoms developed over several weeks," the CDC said on its website. "A pulmonary infection does not appear to be causing the symptoms, which have generally not improved with antibiotic treatment alone."
The CDC says:
Youth and young adults should not use e-cigarette products.
Women who are pregnant should not use e-cigarette products.
Adults who do not currently use tobacco products should not start using e-cigarette products.
If you do use e-cigarette products, you should not buy these products off the street (for example, e-cigarette products with THC or other cannabinoids).
You should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications. If you need help quitting tobacco products, including e-cigarettes, contact your doctor or other medical provider.