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A second person died of a serious lung disease after being coughed, according to a senior investigator in the Oregon case. The investigator stated that the person had apparently become ill after being emptied of T.H.C. from a product bought in a leisure marijuana store in the state.
The researcher, Dr. Ann Thomas, a pediatrician and public health physician who heads Oregon's incident management team, said the person died in July after being hospitalized and ventilated. Dr. Thomas refused to identify the person or reveal his age or sex, but stated that the patient was "in good health and quickly became very sick."
According to Dr. Thomas, the doctor who cared for the patient admitted several weeks later that his lung infection was compatible with a syndrome suspected of being linked to a vaping that affected more than 200 people in the country this summer, according to federal health authorities.
Until now, it is known that another patient died, an adult in Illinois, and this second death – more than a thousand kilometers away – highlights what public health authorities consider as a serious and deeply disconcerting thrust of vapor-related diseases.
Federal authorities at the Centers for Disease Control and Prevention and the Food and Drug Administration have been working with state investigators to determine which toxin or substance could be at the root of the problem. The CDC said in a statement that he was aware of the death in Oregon.
The Oregon investigator, Dr. Thomas, echoed other authorities, claiming that she had heard that many cases involved THC, the chemical that strongly induces marijuana, but cautioned that It's too early to know for sure whether marijuana-related vaping is a cause.
Friday, the C.D.C. warned people not to use vaping ingredients bought on the street and to stop modifying the nicotine or cannabis devices used for the electronic cigarette.
The fact that the deceased in Oregon appears to have legally purchased the product raises questions about a theory that products that make people sick are counterfeited, falsified by a jury or altered by consumers or retailers mixing their own vaping liquids.
"At this point," said Dr. Thomas, "we'd say we do not really know what's safe."
"We must continue to look for ways to raise public awareness of how to ensure youth safety," she added. "I know it sounds a bit dramatic, but for the moment we do not know what causes them."
Mark Pettinger, a spokesman for the Oregon Liquor Control Commission, which regulates marijuana sales in the state, said the agency was ready to use its tracking system to research the origin of the vaping device involved. Mr Pettinger said the agency was also willing to recall any product deemed dangerous.
Until now, most patients were adolescents or adults aged 20 to 30 years, hospitalized for severe shortness of breath, vomiting, fever and fatigue. Some have been put on ventilators or in intensive care units.
Spray technology is too recent to allow long-term research on its effects on health. The devices have been touted as a safer way for smokers to get their nicotine dose without inhaling the carcinogenic toxins from burning tobacco. While traditional cigarettes poison the lungs by covering them with carcinogenic chemicals burned, electronic cigarettes act by turning nicotine into aerosolized vapor that seems much less toxic.
However, public health officials have become alarmed at the number of non-smoking teenagers who have become addicted to nicotine through the devices and the increasing use of these devices to inhale cannabis-based products, including THC
Health investigators believe that there are dozens of vaping-inhaled chemicals that could be causing what appears to be a severe inflammatory reaction in the lungs, a disease that is very similar to pneumonia and that can essentially strangle affected people if they are not treated properly. Some patients have been successfully treated with high doses of steroids, a therapy generally used to calm inflammation.
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