Update from the Centers for Disease Control and Prevention, October 31, 2019:  

About the Outbreak:

  • As of October 29, 2019, 1,888* cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported to CDC from 49 states (all except Alaska), the District of Columbia, and 1 U.S. territory.
    • Thirty-seven deaths have been confirmed in 24 states (as of October 29, 2019).
    • Latest outbreak information is updated every Thursday.

About Patient Exposure:

  • All EVALI patients have reported a history of using e-cigarette, or vaping, products.
    • THC is present in most of the samples tested by FDA to date, and most patients report a history of using THC-containing products.
    • The latest national and state findings suggest products containing THC, particularly those obtained off the street or from other informal sources (e.g. friends, family members, illicit dealers), are linked to most of the cases and play a major role in the outbreak.

Among 867 patients with information on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset** (as of October 15, 2019):

  • About 86% reported using THC-containing products; 34% reported exclusive use of THC-containing products.
  • About 64% reported using nicotine-containing products; 11% reported exclusive use of nicotine-containing products.

* The increase in lung injury cases from last week represents both new patients and recent reporting of previously-identified patients to CDC.

** Based on complete reports received.

  • CDC is expanding the range of available laboratory testing.
    • CDC is currently testing bronchoalveolar lavage (BAL) fluid samples, as well as blood or urine samples paired to BAL fluid samples.
    • CDC is testing pathologic specimens, including lung biopsy or autopsy specimens, associated with patients.
    • CDC is offering aerosol emission testing of case-associated product samples from e-cigarette, or vaping, products and e-liquids. Analysis of aerosol emissions will augment FDA’s ongoing work to characterize e-liquid and will improve our understanding of exposure among case-patients associated with the Lung Injury outbreak. CDC is coordinating e-cigarette, or vaping, product analysis with FDA.
    • Results may provide insight into the nature of the chemical exposure(s) contributing to this outbreak.
  • CDC developed guidance documents to assist public health laboratories, healthcare providers, and pathologists, and others, with specimen collection, storage, and submission.