Sept. 27 (UPI) -- Illicit prepackaged THC products appear to be playing a major role in the outbreak of severe lung illnesses related to vaping, representatives from the Centers for Disease Control and Prevention said in a teleconference Friday.
Meanwhile, the national death count from the lung illness is now officially 12, and a 13th death was reported by a hospital in North Carolina but was not included in the CDC count because the agency releases figures only once a week.
Nationally, 805 patients have been diagnosed with vaping-related lung injury, the CDC said, and medical authorities believe there are more to come.
Hospitalized patients have experienced coughing, shortness of breath or chest pains, and some also have experienced nausea, vomiting or diarrhea, as well as fatigue, fever or weight loss, the CDC said.
Based on the data, the agency recommends that people refrain from using e-cigarette or vaping products, particularly those that contain THC.
On the national level, out of 514 patients, 77 percent told doctors they used pre-packaged THC vapes or THC vapes along with nicotine vapes, and only 16 percent reported only using nicotine vapes, said Anne Schuchat, the CDC's principal deputy director.
Most of the patients are young men between the ages of 18 and 34, with a median age of 23, investigators said.
Illinois and Wisconsin have reported 86 patients had been admitted to intensive care units with severe lung problems, and about two-thirds of them are under age 24, health officials said.
Patients in many cases had to be put on ventilators because they were unable to breathe on their own and many might have critical lung damage for the rest of their lives, authorities said.
In Illinois and Wisconsin, 66 percent of patients surveyed said they used an illicit THC cartridge identified as "Dank Vapes," said Jennifer Layden, chief medical officer and state epidemiologist at the Illinois Department of Public Health. Of the patients interviewed, most said they acquired the pre-filled vape cartridges from family or friends or on the street.
Dank Vapes packages were among those singled out by New York state health authorities linking cases there to vaping illness.
Dank Vapes appears to be a phantom brand that sells packaging and cartridges off the internet that are filled with materials from black market dealers, said Mark Hoashi, founder of the Doja app, an online review site for all sorts of cannabis products, legal and illegal.
"If you are just a hustler who just buys a bit of oil and you want to make some money, you can buy 100 packages at a time, fill the cartridges and sell them, and the packaging looks like an actual brand," Hoashi told UPI last week.
The CDC said investigators at the U.S. Food and Drug Administration's forensic labs have not yet identified the substance or substances that have been found in sample vape pens obtained from patients.
Earlier, the FDA, CDC and New York State Department of Health identified vitamin E acetate as a black market thickener substance that might be linked to the lung injuries.
But an investigation by NBC News, released Friday and based on laboratory testing, showed that all of the 10 illicit vapes studied contained the fungicide myclobutanil, which when heated can transform into poisonous hydrogen cyanide.
Asked about hydrogen cyanide, CDC medical spokespeople said they did not know whether the FDA investigators had found it in the vapes they were testing. Those results are delayed because this is "an increasingly complex investigation," Schuchat said.
The NBC investigation found that none of the legally purchased vapes contained vitamin E acetate, but 13 of 15 black market vapes tested did, the report said.
Used in the cosmetic industry, vitamin E acetate was the primary ingredient in a cutting product called "Honey Cut" that appeared on the market in this spring and was quickly replicated by other marketers of terpenes and additives for THC and CBD vapes.
New York state issued subpoenas earlier this month to several marketers of vitamin E acetate cutting oil, who have since pulled their products from the market.
From the time the crisis was announced at the beginning of September, the sales of vape products in licensed medical and recreational cannabis stores have dropped by 15 percent, according to an analysis by New Frontier Data.
The company said an estimated 273 million vape pens have been sold through legal U.S. markets from 2017-2019, making up about 15 percent of total legal cannabis product sales.
Meanwhile, legal cannabis companies have been rushing to develop anti-counterfeiting measures to protect brands that have cost millions of dollars to develop.
Last week, California-based marijuana firm KushCo Holdings rolled out anti-counterfeit hologram labels that the company says can be authenticated through the supply chain via a QR code.
Another company, Boston-based solo sciences has developed a packaging code and app that can allow customers to trace legal cannabis products through the supply chain. Ashesh (Alex) Shah, CEO of solo sciences recently claimed that 80 percent of THC cartridges sold in the United States are counterfeits.
Nick Kovacevich, the KuschCo CEO, compared the crisis of dangerous illegal THC vapes to bootleg liquor during Prohibition and he called for a national regulatory structure for cannabis.
"There's no black market for alcohol in the U.S. because people know the brands and trust them and are willing to play through a legal channel," Kovacevich said. "You wouldn't risk drinking moonshine and going blind to save $30 bucks."