Health Advisory: Severe Lung Injury Associated with Electronic Cigarette Product Use or Vaping

  • MDHHS and Local Health Departments are investigating an outbreak of lung injury associated with electronic cigarette use, or vaping.
  • Patients with vaping-related lung injury have been reported in almost every state, including Michigan.
  • Most cases in Michigan and nationwide reported vaping THC (tetrahydrocannabinol) alone or in combination with nicotine.
  • On November 8, the CDC reported finding vitamin E acetate in the bronchoalveolar lavage (BAL) fluid from 29 patients, including from one Michigan case. These findings provide direct evidence of vitamin E acetate at the primary site of injury. The CDC has called vitamin E acetate a “very strong culprit” as a result of this study. However, it is possible that more than one compound or ingredient could be a cause of vaping-associated lung injury.  
  • Michigan is working with the Centers for Disease Control and Prevention (CDC) and the federal Food and Drug Administration (FDA)  to get information that can help identify what is in the vape materials that is making people sick.
  • FDA updated their information about vaping product testing on Dec. 11, 2019. Notably, 563 samples were directly linked to confirmed or probable patients reported to CDC. 80% of the 70 patients were linked to THC products, of which 77% of cases included products with vitamin E acetate as a diluent. 

Weekly Outbreak Update Summary:

Michigan: As of 12/12/2019, the Michigan Department of Health and Human Services has identified 60 (32 confirmed and 28 probable) cases of severe lung disease associated with vaping, including two deaths. 86.2% of 58 confirmed or probable cases reported vaping THC only or in combination with nicotine and/or other substances. The department is investigating an additional 6 possible cases that have been reported by health care providers. 

Nationwide: As of December 10, 2019, there were 2,409* hospitalized lung injury cases associated with the use of e-cigarette, or vaping, products reported from 50 states, the District of Columbia, and 2 U.S. territories (Puerto Rico and U.S. Virgin Islands); this includes 52 confirmed deaths in 26 states and the District of Columbia.

*Due to only reporting hospitalized EVALI cases as of December 4, 2019, CDC removed 175 nonhospitalized cases from previously reported national case counts.