Update: Interim Guidance for Health Care Providers for Managing Patients with Suspected E-cigarette, or Vaping, Product Use–Associated Lung Injury — United States, November 2019

Characteristics of Patients Experiencing Rehospitalization or Death After Hospital Discharge in a Nationwide Outbreak of E-cigarette, or Vaping, Product Use–Associated Lung Injury — United States, 2019

“…Therefore, the best way for persons to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette, or vaping, products. Adults who continue to use e-cigarette, or vaping, products should carefully monitor themselves for symptoms and see a health care provider immediately if they develop symptoms similar to those reported in this outbreak (5,10). Irrespective of the ongoing investigation, e-cigarette, or vaping, products should never be used by youths, young adults, or pregnant women.…”

Pulmonary Toxicity and the Pathophysiology of Electronic Cigarette, or Vaping Product, Use Associated Lung Injury

“…Some patients received prophylactic antibiotics, however, no infection was detected in these patients with EVALI. As EVALI is a manifestation of several components, accordingly the clinical characteristics, diagnosis, and therapeutic interventions are evolving Gentzke et al, 2019;Jatlaoui et al, 2019;Kalininskiy et al, 2019;Chatham-Stephens et al, 2019;Taylor et al, 2019). The recovered patients showed susceptibility to infections, and recent data show that these patients were re-admitted for further treatments.…”

“…Emerging evidence indicates that the acute effects of ENDS or vaping products use on the respiratory system are of particular concern (Khan et al, 2018;Sommerfeld et al, 2018;Viswam et al, 2018;Layden et al, 2019;Madison et al, 2019). To date, all 50 US states have reported "a cluster of mysterious pulmonary illnesses" that may be related to E-Cig use with at least 2,291 potential cases and 48 associated fatalities as of December 3, 2019 (Blagev et al, 2019;Chatam-Stephens et al, 2019;Gentzke et al, 2019;Jatlaoui et al, 2019;Kalininskiy et al, 2019;Taylor et al, 2019). In addition, there are at least seven published case reports from 2012 to 2018 describing similar conditions in E-Cig users with no identifiable infectious etiology and the differential diagnosis includes acute lung injury, atypical pneumonitis, eosinophilic or lipoid pneumonia, as reviewed in (Khan et al, 2018;Viswam et al, 2018).…”

Update: Interim Guidance for Health Care Professionals Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use–Associated Lung Injury and for Reducing the Risk for Rehospitalization and Death Following Hospital Discharge — United States, December 2019

“…CDC, the Food and Drug Administration, state and local health departments, and public health and clinical stakeholders continue to investigate a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1)(2)(3)(4). Clinical guidance from CDC and state partners for EVALI continues to evolve as more information about EVALI becomes available (5)(6)(7)(8). Among EVALI patients who were rehospitalized or who died after discharge for an EVALI-related hospitalization, a recent study found a high rate of comorbidities and a median interval from discharge to readmission of 4 days and a median interval from discharge to death of 3 days; at least one quarter of rehospitalizations and deaths occurred within 2 days of discharge (9).…”