Update: Characteristics of Patients in a National Outbreak of E-cigarette, or Vaping, Product Use–Associated Lung Injuries — United States, October 2019
Authors: Erin D. Moritz, Lauren B. Zapata, Akaki Lekiachvili, Emily Glidden, Francis B. Annor, Angela K. Werner, Emily N. Ussery, Michelle M. Hughes, Anne Kimball, Carla L. DeSisto, Brandon Kenemer, Mays Shamout, Macarena C. Garcia, Sarah Reagan-Steiner, Emily E. Petersen, Emily H. Koumans, Matthew D. Ritchey, Brian A. King, Christopher M. Jones, Peter A. Briss, Lisa Delaney, Anita Patel, Kara D. Polen, Katie Sives, Dana Meaney-Delman, Kevin Chatham-Stephens, Adebola Adebayo, Jennifer Adjemian, Minal Amin, Jose Aponte, Grace Appiah, Christina Armatas, Melissa Arons, Sukhshant Kaur Atti, Michelle Banks, Vaughn Barry, Amy Board, Tegan Boehmer, John Bowyer, Lauren Boyle-Estheimer, Diane Browning, David Bui, Jordan Cates, Gyan Chandra, Karen Chang, Jennifer Chevinsky, Katelyn Chiang, Pyone Cho, George Cone, Matthew Cone, Kristen Cowan, Augustina Delaney, Lindsey Duca, Angela Dunn, Shideh Delrahim Ebrahim-Zadeh, Jeff Engel, Molly Evans, Victoria Fields, Aaron Fleishauer, Jennifer Freed, Allison Gately, Isaac Ghinai, Caitlin Green, Janet Hamilton, Arianna Hanchey, Kathleen Hartnett, Amy Heinzerling, Dessica Hodges, Brooke Hoots, Asad Islam, Mia Israel, Yunho Jang, Sumera Jiva, Jona Johnson, Charlotte Kaboré, Emily Kiernan, Uzay Kirbiyik, Hannah Kisselburgh, Mimisha Kothari, Vikram Krishnasamy, Mohammed Lamtahri, Michael Landen, Jennifer Layden, Mark Layer, Ruth Lynfield, Kristen Marshall, Keegan McCaffrey, Eva McLanahan, Jonathan Meiman, Christina Mikosz, Maureen Miller, Roger Mir, Yousra Mohamoud, Livia Navon, Varsha Neelam, David Nitschke, Rashid Njai, Kevin O’Laughlin, Samantha Olson, Cria Perrine, Cassandra Pickens, Mary Pomeroy, Aaron Kite Powell, Ian Pray, Tia Rogers, Nicole Roth, Phillip Salvatore, Caroline Schrodt, Sarah Shafer, Dhara Shah, Raschelle Smalley, Steven Sumner, Lauren Tanz, Mark Tenforde, Vilma Thomas, Megan Toe, Kate Varela, Alana Vivolo, Jason Wilken, Peter Yang, Anna Yousaf
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

CDC, the Food and Drug Administration, state and local health departments, and other public health and clinical stakeholders are investigating a national outbreak of electronic-cigarette (e-cigarette), or vaping, product use-associated lung injury (EVALI) (1). As of October 22, 2019, 49 states, the District of Columbia (DC), and the U.S. Virgin Islands have reported 1,604 cases of EVALI to CDC, including 34 (2.1%) EVALI-associated deaths in 24 states. Based on data collected as of October 15, 2019, this report updates data on patient characteristics and substances used in e-cigarette, or vaping, products (2) and describes characteristics of EVALI-associated deaths. The median age of EVALI patients who survived was 23 years, and the median age of EVALI patients who died was 45 years. Among 867 (54%) EVALI patients with available data on use of specific e-cigarette, or vaping, products in the 3 months preceding symptom onset, 86% reported any use of tetrahydrocannabinol (THC)-containing products, 64% reported any use of nicotine-containing products, and 52% reported use of both. Exclusive use of THC-containing products was reported by 34% of patients and exclusive use of nicotine-containing products by 11%, and for 2% of patients, no use of either THC- or nicotine-containing products was reported. Among 19 EVALI patients who died and for whom substance use data were available, 84% reported any use of THC-containing products, including 63% who reported exclusive use of THC-containing products; 37% reported any use of nicotine-containing products, including 16% who reported exclusive use of nicotine-containing products. To date, no single compound or ingredient used in e-cigarette, or vaping, products has emerged as the cause of EVALI, and there might be more than one cause. Because most patients reported using THC-containing products before symptom onset, CDC recommends that persons should not use e-cigarette, or vaping, products that contain THC. In addition, because the specific compound or ingredient causing lung injury is not yet known, and while the investigation continues, persons should consider refraining from the use of all e-cigarette, or vaping, products.