In response to the multistate outbreak of lung injury associated with e-cigarette product use (e.g., devices, liquids, refill pods, and/or cartridges), the Centers for Disease Control and Prevention (CDC) along with other federal, state, and local partners are involved in an on-going investigation. CDC has released a media advisory concerning the situation, and the Lung Injury Response Website has various available resources to educate the public, healthcare providers, and state and local health departments on key facts and recommendations. Recently added resources include key messages, a fact sheet for evaluating and caring for patients with suspected e-cigarette, or vaping, product use–associated lung injury (EVALI), and a poster for clinical settings.

At this time, 1,888 cases of lung injury have been reported from 49 states (all except Alaska) , the District of Columbia. and the U.S. Virgin Islands, and 24 states have reported 37 confirmed deaths. All reported cases have been linked to a history of e-cigarette product use or vaping. THC is present in most of the samples tested by FDA to date, and most patients report a history of using THC-containing products. Most of the people in this outbreak reported using THC-containing products, or both THC-containing products and nicotine-containing products. At this time, no single compound or ingredient used in e-cigarette, or vaping, products has emerged as the cause of this outbreak.

CDC recommends that people should not:

• Use e-cigarette, or vaping, products that contain THC.
• Buy any type of e-cigarette, or vaping, products, particularly those containing THC, off the street.
• Modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer, including products purchased through retail establishments.

Healthcare providers are urged to support response efforts by continuing to report both suspected and confirmed cases of lung injury to their state or local health department. Specimen collection, storage, and submission guidance is available. Collaboration with states, local health departments, and additional relevant partners is also critical. State public health officials should contact CDC at [email protected] regarding possible cases of e-cigarette- or vaping-associated lung injury.

For information on technical assistance with epidemiologic investigation, laboratory testing, and/or data collection tools, please contact CDC at [email protected]. Questions on the submission of non-tissue samples should be directed to [email protected].

On September 25, 2019, NACCHO sent a letter to Congress highlighting the role of local health departments in addressing youth use of e-cigarettes and the need for action to curb youth use of these products. The letter further explained how NACCHO supports the U.S. Food and Drug Administration’s plan to ban flavored e-cigarettes.

NACCHO has a liaison officer within the CDC Emergency Operations Center and is participating in national calls. For any questions, comments, and/or technical resource needs, please contact the NACCHO Preparedness Program at [email protected].