Lung Injury Associated with E-Cigarette Use: An Update

As of September 24, 2019: 

• 805 reported cases of lung injury associated with e-cigarette use

• 50-99 cases reported in 4 states

• 12 deaths confirmed in 10 states

• Specific chemical exposure(s) causing the outbreak currently unknown

*Vaping concentrated marijuana

Patients with lung injury associated with e-cigarette use had: 

• History of e-cigarette use, vaping, or dabbing within 90 days before symptom onset

• Imaging studies showing lung injury

• Lack of evidence of infection (confirmed cases) OR infection not thought to be sole cause of lung injury or infectious disease testing was not done (probable cases)

• Absence of alternative plausible diagnoses

Among 805 cases, basic patient characteristics received for 771 patients. Among these patients: 

• 91% were hospitalized

• 69% were male; 30% female

• Median duration between symptom onset and hospitalization: 6 days

• Median age: 23 years

• ~62% aged 18-34 years; ~16.2% aged <18 years

Among 514 patients who used e-cigarettes in the 30 days prior to symptom onset:

• Majority (76.9%) used THC-containing products vs nicotine-containing products (56.8%)

• Majority used THC-only products (36%) vs nicotine-only products (16%)

CDC Recommendations: 

• Continuously monitor number of cases, characteristics AND substances used with e-cigarettes

• Counsel patients to refrain from using e-cigarettes, especially ones with THC

• Adults who use e-cigarettes as cessation aide should NOT return to traditional, combustible cigarettes

CDC Recommendations (cont.):

• Patients who use e-cigarettes should not get them from informal sources or black-market

• Patients should not modify e-cigarette devices or add substances that are not intended by the manufacturer

• Both THC- and nicotine-containing vapes bought legally in US also contain harmful ingredients