Dank Vapes seem to be associated with many cases of e-cigarette and vaping-product associated lung injury (EVALI) popping up across the country, the U.S. Centers for Disease Control and Prevention (CDC) announced Friday.
The CDC has already pointed to products containing the marijuana compound THC—particularly those tainted by the additive vitamin E acetate—as a likely cause of many of the nearly 2,300 EVALI cases and 48 deaths reported during the outbreak. Now, for the first time, the agency has released national data about specific brands used by individuals before they got sick.
More than half the 482 hospitalized EVALI patients who provided specific product information to the CDC reported using products from Dank Vapes, which the CDC calls “a class of largely counterfeit THC-containing products of unknown origin.” An Inverse investigation found that Dank Vapes is not a legitimate company, but rather a label often affixed to counterfeit products produced by unknown makers. “They act like a cannabis company, but they actually don’t exist. They’re in the packaging industry,” a cannabis industry entrepreneur told Inverse.
The CDC’s investigation points to the nebulous network’s reach. Patients in every region said they had used Dank Vapes products, though they were used a bit more often in the Midwest, Northeast and South than the West. The CDC has already reported evidence that Dank Vapes products were associated with illnesses in Illinois and Wisconsin.
Other vaping brands used by patients in the CDC’s report include TKO, Rove, Smart Cart, Kingpen and Cookie, many of which were used by more people in the West than anywhere else.
In a statement provided to TIME, Kingpen manufacturer Loudpack drew a distinction between reputably made Kingpen products, which are only available at California dispensaries, and bootleg products posing as Kingpen’s. “The Kingpen products in the CDC report are dangerous because they are illegal. They are not regulated or tested—nor are they the award-winning, authentic products manufactured by Loudpack,” the statement reads. “Legal, regulated, licensed and tested cannabis companies must stop being blamed for the actions by illegal entities, who we work day and night to prevent from putting more patients and consumers in harm’s way.”
Though the data helps advance the CDC’s investigation, there are still many unanswered questions. The nearly 500 patients included in the latest report said they had used 152 different products in all, making it difficult to nail down which ones are the possible sources of illnesses—especially since some patients use e-cigarettes from multiple brands.
It’s also not totally clear whether THC-containing products are to blame for all cases of EVALI. Eighty percent of the 1,782 hospitalized EVALI patients for whom the CDC has information about product use said they had vaped THC in the three months before symptoms (35% exclusively), but 54% also said they had used nicotine (13% exclusively). Smaller numbers also reported additionally or exclusively using products containing CBD, a non-psychoactive marijuana compound.
There was some good news in the report, however. The CDC says the number of EVALI diagnoses has declined each week since mid-September, suggesting that the outbreak may be approaching its end.