Federal and state health officials are warning people not to use e-cigarettes, particularly those containing marijuana extracts, as the number of people sickened by a vaping-related lung illness continues to grow.
The U.S. Centers for Disease Control and Prevention is probing the mysterious vaping illness in 49 states, where health officials have reported nearly 1,300 cases to date.
At least 29 people, including a Massachusetts woman, have died.
“This outbreak might have more than one cause, and many different substances and product sources are still under investigation,” the CDC said in a weekly advisory.
In Massachusetts, the number of cases of lung injuries associated with use of e-cigarettes or vaping products continues to rise, according to health officials.
On Wednesday of last week, the state Department of Public Health reported 10 new cases of the vaping-related illness. DPH previously reported the state’s first death from the illness, of a woman in her 60s from Hampshire County.
Increasingly, the nationwide probe is pointing toward black-market cannabis products. Many of the patients are reported to have vaped THC, the psychoactive ingredient in marijuana.
“To date, national and state data suggest that products containing THC, particularly those obtained off the street or from other informal sources (e.g., friends, family members, or illicit dealers), are linked to most of the cases and play a major role in the outbreak,” the CDC said.
But the agency acknowledges that investigators aren’t sure if THC is the problem, or if the culprit is some other substance added to vaping liquid.
Until the exact cause is narrowed down, the federal agency is urging people to avoid using vaping products “particularly those containing THC, off the street.”
Among the Massachusetts cases, at least 20 patients have reported using THC-based vaping products in addition to nicotine. Eight reported vaping nicotine only.
As of last Wednesday, health care providers and local boards of health had reported at least 152 possible cases to the state.
“We don’t know what specifically is causing the lung injuries in these cases, but we do know the one thing they have in common is the use of e-cigarettes, or vaping,” Public Health Commissioner Monica Bharel said in a statement.
At least three states — Massachusetts, New York and Michigan — have banned the sale of flavored vaping products amid the rising number of vaping-related lung illnesses.
Gov. Charlie Baker announced a public health emergency on Sept. 24 and imposed a four-month ban covering all vaping products and devices.
Baker said the temporary ban was needed to give researchers time to study concerns about the health effects of e-cigarettes and come up with tougher regulations.
The move effectively shut down hundreds of vape stores and forced recreational and medical marijuana dispensaries to remove vaping items from their shelves.
Health groups such as the American Lung Association support the bans, saying e-cigarettes are hooking a new generation on nicotine products and should be outlawed.
But efforts to keep the products off store shelves as the federal probe grinds on are increasingly running into legal challenges from the vaping industry.
Last week a Michigan judge temporarily blocked that state’s weeks-old ban on flavored e-cigarettes, saying it has hurt vaping businesses and may force adults to return to smoking more harmful tobacco products. Michigan was the first state to declare a vape ban, which took several weeks to implement.
And last month, a New York state appeals court preliminarily blocked the state from enforcing a prohibition on flavored e-cigarette sales.
A federal judge in Boston was scheduled to hear arguments last week in a legal challenge against Massachusetts’ ban, but the hearing was postponed at the request of lawyers representing vaping businesses who said they wanted to focus on similar litigation filed in Suffolk Superior Court.
U.S. District Court judge Indira Talwani denied a request last week for a temporary restraining order on Baker’s ban. A Suffolk Superior Court judge was expected to hear arguments in a state challenge to Baker’s vape.