Initial findings from the investigation into serious lung illnesses associated with e-cigarette products point to clinical similarities among those affected. Patients report similar exposures, symptoms and clinical findings and these align with the CDC health advisory released last week. While many of the patients, but not all, reported recent use of THC-containing products, some reported using both THC- and nicotine-containing products. A smaller group reported using nicotine only.
No evidence of infectious diseases has been identified in these patients, therefore lung illnesses are likely associated with a chemical exposure. However, it is too early to pinpoint a single product or substance common to all cases, according to authors of articles published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) and the New England Journal of Medicine.
CDC, FDA, and state partners are combining information about e-cigarette exposures, results from FDA testing of product samples, and clinical testing results to identify a cause or causes of these illnesses.
CDC launched a multistate investigation into the lung illnesses on August 1, 2019, and has worked closely since then with FDA, states and other public health partners, and clinicians to determine the cause. As of today, more than 25 states have reported possible cases of lung illnesses associated with use of e-cigarette products (e.g., devices, liquids, refill pods, and cartridges).
At least two deaths have been reported to CDC. Additional cases of lung illness are being investigated to determine whether they are linked to e-cigarette use and have similar clinical features. This includes looking back for older cases based on CDC’s case definition. States are in the process of classifying possible cases, and this information will be reported next week.
CDC has created an incident command structure to respond to these illnesses and is working with FDA and states to investigate whether the illnesses may be linked to specific devices, ingredients, or contaminants in the devices, or substances associated with e-cigarette product use. On August 30, 2019, states were asked to submit data to CDC about lung illnesses associated with e-cigarette product use, as well as information about the types of e-cigarette products used. CDC is currently receiving data from affected states and will share updates as more information becomes available.
CDC encourages clinicians to immediately report possible cases of e-cigarette-associated lung disease to their local or state health department for further investigation. If e-cigarette product use is suspected as a possible cause for a patient’s lung disease, a detailed history of the substances used, the sources, and the devices used should be obtained, as outlined in the HAN (Health Alert Network), and efforts should be made to determine if any remaining product, devices, and liquids are available for testing.
While this investigation is ongoing, people should consider not using e-cigarette products. People who do use e-cigarette products should monitor themselves for symptoms and promptly seek medical attention for any health concerns. Regardless of the ongoing investigation, people who use e-cigarette products should not buy these products off the street and should not modify e-cigarette products or add any substances that are not intended by the manufacturer. E-cigarette products should never be used by youth, young adults, pregnant women, or adults who do not currently use tobacco products.
