The official number of people who have died after suffering from lung injuries linked to the use of vape pens and e-cigarettes has risen to 64.
The U.S. Centers for Disease Control and Prevention said the deaths have been confirmed in 28 states and the District of Columbia as of Feb. 4. Four of those deaths occurred in the last three weeks, and more deaths are currently under investigation.
A total of 2,758 hospitalizations have been reported to the CDC from across all 50 states, and D.C., Puerto Rico and the U.S. Virgin Islands.
The federal agency now refers to these injuries as EVALI (e-cigarette, or vaping, product use-associated lung injury).
Though the death toll has risen to more than five dozen, the CDC says that emergency hospital visits for vaping-related illnesses are declining since they peaked in September.
However, some researchers say they continue to see a steady flow of patients coming in with lung injuries after vaping.
Dr. Laura Crotty Alexander, a pulmonologist at the University of California, San Diego, who has been studying the effects of e-cigarettes since 2013, said she still consistently receives patients suffering from EVALI.
“When I look at the numbers on the CDC website, it looks like there’s been this huge dropoff [in EVALI cases] since October. I’m not convinced that that is accurate,” Alexander told HuffPost, adding that she sees at least two patients with these conditions per week at UCSD’s School of Medicine.
“We are still seeing so many cases here [in San Diego],” she added. “I don’t think it’s over yet.”
In November, the CDC identified vitamin E acetate, an ingredient added to some vaping products that use THC, the chemical in marijuana that produces a “high,” as a possible culprit in the illnesses and deaths.
On its website, the CDC notes that the ingredient, an oil, is “strongly linked” to the outbreak.
“Vitamin E acetate has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states,” the CDC writes.
The CDC now recommends that manufacturers and vape users refrain from adding vitamin E acetate to any of their products.
Alexander is concerned that the sense of urgency surrounding the dangers of vape products was quickly dying out while the health risks remain.
“Patients with EVALI can become incredibly ill,” she said, adding that treatment sometimes requires highly invasive procedures, including lung transplants.
“In addition, some patients are dying within two to three days of being discharged from the hospital ― which is terrifying,” Alexander told HuffPost.
And though the CDC has identified vitamin E acetate as a problematic ingredient in vape products, Alexander said many of her patients still use products containing vitamin E.
The Food and Drug Administration placed a nationwide ban on vaping products that contain sweet, mint or fruit flavoring in an attempt to make vape products and e-cigarettes less appealing to minors in early January.
Among 2,668 cases of lung illness reported by the CDC as of Jan. 14, 52% involved patients who were 24 or younger.
Fifteen percent of those cases involved patients who were 18 or younger.
Tobacco and menthol flavors have been allowed to remain on the market.