Update: Characteristics of Patients in a National Outbreak of E-cigarette, or Vaping, Product Use–Associated Lung Injuries — United States, October 2019
Abstract
What is already known about this topic?
CDC and partners are investigating the ongoing outbreak of e-cigarette, or vaping, product use–associated lung injury (EVALI) in the United States, the District of Columbia, and one U.S. territory.
What is added by this report?
As of October 22, 2019, a total of 1,604 cases of EVALI, including 34 deaths, were reported to CDC. Based on data collected as of October 15, 2019, use of tetrahydrocannabinol (THC)-containing products in the 3 months preceding symptom onset was reported by 86% of patients. The median age of EVALI patients who survived was 23 years, and the median age of EVALI patients who died was 45 years.
What are the implications for public health practice?
Most EVALI patients report using THC-containing products before symptom onset. CDC recommends that persons should not use e-cigarette, or vaping, products containing THC. Because the specific compound or ingredient causing EVALI is not known, persons should consider refraining from use of all e-cigarette, or vaping, products.
| Characteristic | No. /Total No. (%†) | ||
|---|---|---|---|
| EVALI patients who survived | EVALI–associated deaths | All EVALI patients | |
| Sex | |||
| Male | 947/1,349 (70) | 17/29 (59) | 964/1,378 (70) |
| Female | 402/1,349 (30) | 12/29 (41) | 414/1,378 (30) |
| Age group (yrs) | |||
| 13–17 | 735/1,335 (55)§ | 2/29 (7)§ | 196/1,364 (14) |
| 18–24 | 541/1,364 (40) | ||
| 25–34 | 339/1,335 (25) | 5/29 (17) | 344/1,364 (25) |
| 35–44 | 165/1,335 (12) | 7/29 (24) | 172/1,364 (13) |
| 45–64 | 79/1,335 (6) | 8/29 (28) | 87/1,364 (6) |
| 65–75 | 17/1,335 (1) | 7/29 (24) | 24/1,364 (2) |
| Median age, yrs (range) | |||
| Overall | 23 (13–72) | 45 (17–75) | 24 (13–75) |
| Male | 23 (13–68) | 55 (17–71) | 23 (13–71) |
| Female | 25 (13–72) | 43 (27–75) | 25 (13–75) |
| Race/Ethnicity¶ | |||
| White | 283/365 (78) | 15/18 (83) | 298/383 (78) |
| Black or African American | 22/365 (6)** | 1/18 (6)** | 9/383 (2) |
| American Indian or Alaska Native | 4/383 (1) | ||
| Asian, Native Hawaiian, or other Pacific Islander | 5/383 (1) | ||
| Other | 5/383 (1) | ||
| Hispanic | 60/365 (16) | 2/18 (11) | 62/383 (16) |
| Substances used in e-cigarette, or vaping, products ††,§§ | |||
| THC-containing products, any use | 733/848 (86) | 16/19 (84) | 749/867 (86) |
| Nicotine-containing products, any use | 545/848 (64) | 7/19 (37) | 552/867 (64) |
| Both THC- and nicotine-containing products, any use | 451/848 (53) | 4/19 (21) | 455/867 (52) |
| THC-containing products, exclusive use | 282/848 (33) | 12/19 (63) | 294/867 (34) |
| Nicotine-containing products, exclusive use | 94/848 (11) | 3/19 (16) | 97/867 (11) |
| No THC- or nicotine-containing products reported | 21/848 (2) | 0/19 (0) | 21/867 (2) |
Abbreviation: THC = tetrahydrocannabinol.
* Reported as of October 15, 2019.
† Percentages might not add up to 100% because of rounding.
§ Data for the 13–17 and 18–24 age groups were combined to protect patient identity.
¶ Whites; blacks or African Americans; American Indians or Alaska Natives; Asians, Native Hawaiians and other Pacific Islanders; and Others were non-Hispanic. Hispanic persons could be of any race.
** Data for persons in the following race/ethnicity groups were combined to protect patient identity: black or African American; American Indian or Alaska Native, Asian, Native Hawaiian, or other Pacific Islander, and Other.
†† In the 3 months preceding symptom onset; categories not mutually exclusive.
§§ Data on both THC- and nicotine-containing product use required to be included.
RPR Commentary
This is a summary of information on cases and deaths in the U.S. due to e-cigarettes or vaping. The data is summarized in the table. James W. Mold, MD, MPH