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. 2019 Oct 4;68(39):860-864.
doi: 10.15585/mmwr.mm6839e1.

Characteristics of a Multistate Outbreak of Lung Injury Associated With E-cigarette Use, or Vaping - United States, 2019

Collaborators, Affiliations
Free PMC article

Characteristics of a Multistate Outbreak of Lung Injury Associated With E-cigarette Use, or Vaping - United States, 2019

Cria G Perrine et al. MMWR Morb Mortal Wkly Rep. .
Free PMC article

Erratum in

  • Erratum: Vol. 68, No. 39.
    MMWR Morb Mortal Wkly Rep. 2019 Oct 11;68(40):900. doi: 10.15585/mmwr.mm6840a5. MMWR Morb Mortal Wkly Rep. 2019. PMID: 31600765 Free PMC article. No abstract available.

Abstract

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.

Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Figures

FIGURE 1
FIGURE 1
Number of cases of lung injury associated with e-cigarette use, or vaping (n = 805) — United States, including two territories, 2019 Abbreviations: DC = District of Columbia, PR = Puerto Rico; VI = U.S. Virgin Islands. *As of September 24, 2019, 1–9 cases had been reported by 23 states and one territory; 10–29 cases had been reported by 14 states; 30–49 cases had been reported by five states; 50–99 cases had been reported by four states, and 0 cases had been reported by four states and DC. Additional cases being investigated are not reflected on this map.
FIGURE 2
FIGURE 2
Dates of symptom onset (n = 590) and hospital admission (n = 674) among patients with lung injury associated with e-cigarette use, or vaping — United States, March 31–September 21, 2019

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