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U.S. health officials are preparing to release new guidance for doctors stressing the need to ask every patient with an apparent respiratory infection about their vaping history. The updated guidance will also advise physicians on how to diagnose and manage patients who may have both a lung infection and a vaping injury. (Steenhuysen, 10/10)

U.S. health officials on Thursday reported 26 deaths and 1,299 confirmed and probable cases so far from a mysterious respiratory illness tied to vaping. Last week, the Centers for Disease Control and Prevention (CDC) reported 1,080 cases and 18 deaths from the illness. As of Oct. 8, confirmed deaths were reported from 21 states, including one each from California, Connecticut, Georgia, Massachusetts, Michigan, New York, Texas and Pennsylvania. (10/10)

The vaping patients suffered injuries to their lungs that some researchers have compared with the mustard-gas exposures that damaged the lungs of soldiers during World War I. “For most acute lung injuries, it takes awhile for the injury to improve. The insult could be one quick strike, and yet the healing can take weeks,” said Louis DePalo, a pulmonologist at Mount Sinai Health System in New York City. One of Dr. DePalo’s patients who had been severely ill has recovered fully, he said, but one of his milder cases had been slower to regain complete lung function and might not get it back. (Abbott, 10/10)

Federal and state health authorities are testing vaping materials and studying tissue samples from patients in an effort to find the cause of the outbreak. They are particularly concerned about the huge amount of illicit THC products in circulation, which contain unknown mixtures of solvents, diluting agents and flavorings that may be toxic to the lungs. (Grady, 10/10)

Dr. Anne Schuchat, the CDC’s principal deputy director, last week called the illnesses a “very concerning outbreak” with no signs of abating. “We haven’t seen a measurable drop in the occurrences of new cases,” she said at the time. “The data that we’ve seen doesn’t suggest it has peaked, it doesn’t suggest this is declining.” (Lovelace, 10/10)

Of the 573 patients who provided information about what products they had used, 76 percent reported vaping THC, with or without nicotine-containing products. Thirty-two percent said they vaped THC exclusively, while 13 percent said they only vaped nicotine products. (Hellmann, 10/10)

Oregon’s caseload has also been growing, with nine victims – two of them fatal – reported as of Oct. 8. At least five of the victims purchased products at legal marijuana retail shops. State health officials have said they don’t know what precise products or chemicals made the people ill, leaving open the possibility that the patients had tampered with the products before using them. (Zarkhin, 10/10)

The thousands of shops that sprang up in cities and towns across the country over the past decade to sell vaping products have seen a stunning reversal of fortune, with their sales plunging in just two months amid news reports that vaping has sickened nearly 1,300 people and killed 26. People who turned to vaping products to help them quit smoking have been turning away, even teenagers who used the products illegally, although the U.S. Centers for Disease Control says most of the people who suffered lung injuries from vaping were using products containing THC, a component of marijuana. (10/10)

Juul Labs Inc. said sales-software changes it designed to stop underage shoppers from buying its e-cigarettes at the cash register were successful in a company study, nearly eliminating such purchases. The company plans to present a poster at the 7th Annual Vermont Center on Behavior & Health Conference Thursday touting the success of the new standards in a test run this year. Juul said retailers that adopted them cut down sharply on underage sales. Within two years, the company has said, it wants all stores that sell its products to use them. (Brown, Huet and Brustein, 10/10)

Even though “quitlines” were designed to help people kick cigarette habits, calls and texts from people who use e-cigarettes are climbing as more people fall ill with a mysterious and devastating respiratory illness linked to vaping. Health officials are investigating 1,080 cases in 48 states and the U.S. Virgin Islands, including at least 18 deaths. In California, more than 110 residents have fallen ill, at least two of whom died, according to the California Department of Public Health. (Almendrala, 10/10)