Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping — United States, 2019
Authors: Cria G. Perrine, Cassandra M. Pickens, Tegan K. Boehmer, Brian A. King, Christopher M. Jones, Carla L. DeSisto, Lindsey M. Duca, Akaki Lekiachvili, Brandon Kenemer, Mays Shamout, Michael G. Landen, Ruth Lynfield, Isaac Ghinai, Amy Heinzerling, Nathaniel Lewis, Ian W. Pray, Lauren J. Tanz, Anita Patel, Peter A. Briss, Jennifer Adjemian, Minal Amin, Jose Aponte, Vaughn Barry, Diane Browning, Jordan Cates, Gyan Chandra, Karen Chang, Katelyn Chiang, Jennifer Chevinsky, Augustina Delaney, Angela Dunn, Molly Evans, Victoria Fields, Aaron Fleischauer, Macarena Garcia, Caitlin Green, Arianna Hanchey, Kathleen Hartnett, Brooke Hoots, Asad Islam, Charlotte Kaboré, Vikram Krishnasamy, Mohammed Lamtahri, Jennifer Layden, Dana Meany-Delman, Jonathan Meiman, Christina Mikosz, Maureen Miller, Yousra Mohamoud, Erin Moritz, Varsha Neelam, David Nitschke, Kevin O’Laughlin, Samantha Olson, Tia Rogers, Nicki Roth, Phil Salvatore, Alana Vivolo-Kantor, Angela Werner, Jason Wilken
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

Electronic cigarettes (e-cigarettes), also called vapes, e-hookas, vape pens, tank systems, mods, and electronic nicotine delivery systems (ENDS), are electronic devices that produce an aerosol by heating a liquid typically containing nicotine, flavorings, and other additives; users inhale this aerosol into their lungs (1). E-cigarettes also can be used to deliver tetrahydrocannabinol (THC), the principal psychoactive component of cannabis (1). Use of e-cigarettes is commonly called vaping. Lung injury associated with e-cigarette use, or vaping, has recently been reported in most states (2-4). CDC, the Food and Drug Administration (FDA), state and local health departments, and others are investigating this outbreak. This report provides data on patterns of the outbreak and characteristics of patients, including sex, age, and selected substances used in e-cigarette, or vaping, products reported to CDC as part of this ongoing multistate investigation. As of September 24, 2019, 46 state health departments and one territorial health department had reported 805 patients with cases of lung injury associated with use of e-cigarette, or vaping, products to CDC. Sixty-nine percent of patients were males, and the median age was 23 years (range = 13-72 years). To date, 12 deaths have been confirmed in 10 states. Among 514 patients with information on substances used in e-cigarettes, or vaping products, in the 30 days preceding symptom onset, 76.9% reported using THC-containing products, and 56.8% reported using nicotine-containing products; 36.0% reported exclusive use of THC-containing products, and 16.0% reported exclusive use of nicotine-containing products. The specific chemical exposure(s) causing the outbreak is currently unknown. While this investigation is ongoing, CDC recommends that persons consider refraining from using e-cigarette, or vaping, products, particularly those containing THC. CDC will continue to work in collaboration with FDA and state and local partners to investigate cases and advise and alert the public on the investigation as additional information becomes available.