CDC UPDATE: Data Suggests Lung Injury Cases Have Declined Since Peak in September 2019
The Centers for Disease Control and Prevention (CDC) reported on January 9, 2020 that, based on syndromic data on emergency department visits, cases of the e-cigarette, or vaping, product use-associated lung injury (EVALI) have been declining since a peak in September. The outbreak began in June 2019.
Laboratory data supports previous findings that vitamin E acetate is closely associated with EVALI. Vitamin E acetate is used as an additive in the production of e-cigarette, or vaping, products.
Recent laboratory testing of fluid samples collected from the lungs of 51 patients with EVALI, submitted to CDC from 16 states, found vitamin E acetate in 48 of the 51 BAL fluid samples, but not in the BAL fluid from the healthy comparison group.
Health care providers should encourage patients NOT to use e-cigarette, or vaping, products that contain THC, particularly from informal sources like friends, or family, or in-person or online dealers.
Based on the findings on EVALI patient rehospitalization and death, CDC has updated its guidance to clinicians to minimize these outcomes. Rapid recognition by health care providers of patients with EVALI and an increased understanding of treatment considerations could reduce morbidity and mortality associated with this injury.
As of January 7, 2020, a total of 2,602 hospitalized EVALI cases or deaths have been reported to CDC from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands). Fifty-seven deaths have been confirmed in 27 states and the District of Columbia.
The Kansas Department of Health and Environment (KDHE) has reported that 2 Kansans have died from vaping related illnesses since September 10, 2019. Kansas currently has 23 probable/confirmed vaping related cases, including the 2 deaths.
Of the Kansas cases, 74% are male and the collective ages range from 15-67 years old. 21 of the 23 were hospitalized. Regarding the types of vaping products used, there was a combination or those reporting using only nicotine, only THC, only CBD, and a combination of THC and nicotine.
As this investigation continues, Kansas dentists should report possible cases of EVALI to KDHE for further investigation. If EVALI is suspected, a detailed history of the substances used, the sources of products, duration and frequency of use, and the devices used and how they are used should be obtained.
For assistance with managing patients suspected of illness related to recreational, illicit, or other drugs, call your local poison control center at: