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Andy Ramkumar, who works at Gotham Vape in Queens, vapes on the retailer on September 17, 2019 in New York Metropolis.

Spencer Platt | Getty Photographs Information | Getty Photographs

Docs researching the reason for a sudden respiratory sickness that is killed a minimum of 16 folks within the U.S. since July say a mixture of “toxic chemical fumes,” not oils as beforehand anticipated, could also be what’s making sufferers sick, in line with a brand new examine.

Researchers from the Mayo Clinic examined lung biopsies from 17 sufferers suspected of getting a perplexing vaping sickness that is sickened greater than 805 folks since April. Docs have beforehand mentioned it resembled a uncommon type of pneumonia attributable to the buildup of fatty substances referred to as lipids.

Nevertheless, not one of the circumstances examined by the Mayo Clinic researchers confirmed any proof of lipoid pneumonia, in line with the examine revealed Wednesday within the New England Journal of Medication. It is the primary formal examine analyzing tissue samples of sufferers who’ve fallen unwell from vaping.

“It seems to be some kind of direct chemical injury, similar to what one might see with exposures to toxic chemical fumes, poisonous gases and toxic agents,” mentioned Dr. Brandon Larsen, a surgical pathologist at Mayo Clinic Arizona and a lead creator of the examine. “Based on what we have seen in our study, we suspect that most cases involve chemical contaminants, toxic byproducts or other noxious agents within vape liquids.”

The pathologists mentioned analysis on lung accidents linked to vaping remains to be in its early phases and that the findings needs to be interpreted with warning.

The vaping sickness outbreak has now unfold to 46 states and one territory, in line with the Facilities for Illness Management and Prevention. Public well being officers in 13 states have reported deaths.

The CDC has dispatched greater than 100 medical doctors and investigators to establish the precise explanation for the lethal sickness. Early signs embody coughing, shortness of breath, fatigue, chest pains, nausea, vomiting and diarrhea.

Most sufferers have reported a historical past of utilizing e-cigarette merchandise containing THC, in line with the CDC. Nevertheless, many sufferers have reported utilizing THC and nicotine, the company mentioned. Some have reported using vaping merchandise containing solely nicotine.

Of the 17 sufferers within the examine, 71% had vaped with marijuana or hashish oils. The entire sufferers had acute lung harm and two of the sufferers died, the researchers mentioned.

State, native and worldwide well being regulators are taking motion amid the outbreak.

Michigan is the primary state to ban gross sales of flavored e-cigarettes, and San Francisco is the primary U.S. metropolis to ban gross sales of the merchandise. Boulder, Colorado, has handed the same measure. Washington state Gov. Jay Inslee directed officers to ban the merchandise final week.

Till they’ve extra data, public well being officers are urging customers to not use e-cigarettes or different vaping merchandise. The CDC additionally recommends not utilizing vaping merchandise off the road and never including substances to merchandise that aren’t supposed by the producer.

— CNBC’s Angelica LaVito contributed to this report.

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