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Jan. 16 (UPI) -- The number of deaths attributed to THC vaping-related lung illness climbed again this week, federal health officials said as they noted that patients told health researchers they purchased legal vaping products at dispensaries. The total number of deaths from lung illness increased by three to 60 in 27 states and the District of Columbia, federal health officials said Thursday. More deaths are under investigation.
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The total number of cases of patients hospitalized in all 50 states rose to 2,668, up 66 from 2,602 last week.
The Centers for Disease Control and Prevention and U.S. Food and Drug Administration have said that the outbreak of e-cigarette or vaping product use-associated lung injury, or EVALI, has been linked to THC vapes tainted with cutting ingredient vitamin E acetate.
The outbreak still is under investigation, and health officials said there could be more than one cause to the disease.
Sources of vapes
While federal health agencies have warned people not to use THC vaping products acquired from illicit or informal sources, a report released this week showed that some patients told investigators they bought vaping products legally at dispensaries.
Out of 809 patients who self-reported using THC vapes in Illinois, Wisconsin and Utah, 131 patients, or 16 percent, said they used only legally purchased vaping products, and 51 said they used both illicit and legally purchased products. Most patients, 627, said they acquired the vapes from informal sources.
Three percent of patients told investigators they bought THC vapes at medical dispensaries and 8 percent said they bought them at recreational dispensaries, the report said. The report warned that patients might not admit, or remember, where they purchased vaping products, and that some reports were from family members.
"Even in states where marijuana has been legalized for recreational use by adults, it might be difficult to determine whether a source is licensed through the state," the report said. Crackdowns by the California Bureau of Cannabis in December seized nearly 10,000 illegal vape pens across the state in just three days, CDC said.
In September, the Oregon Health Authority said one of the state's first fatalities was a patient who told health investigators she bought marijuana from a licensed dispensary. Oregon has legalized medical and recreational marijuana.
In December, state health officials in Massachusetts, where marijuana is also legal, said six hospitalized EVALI patients told investigators they bought vaping products from legal sources.
Teens ages 13 to 17 were most likely to buy THC vaping products from illicit sources, with 122 out of 130, or 94 percent identifying their sources as from friends, family members or dealers, the report said.
States with the most patients who told health investigators they bought vapes from illicit sources were Alaska, Hawaii, Idaho, Iowa, Mississippi, Montana, Oklahoma, Rhode Island, South Dakota, and Vermont.
EVALI patients were hospitalized after symptoms of shortness of breath, coughing, chest pain and gastrointestinal ailments including abdominal pain, nausea, vomiting and diarrhea. Other patients exhibited fever, chills and weight loss.
