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 e-cigarette, or vaping, product use-associated lung injury (EVALI) have been reported in every state, including Michigan.
- Most EVALI cases in Michigan and nationwide reported vaping THC (tetrahydrocannabinol) alone or in combination with nicotine.
- Laboratory data support previous findings that vitamin E acetate is closely associated with EVALI. Vitamin E acetate was identified in the bronchoalveolar lavage (BAL) fluid from a sample of EVALI patients but not in the BAL fluid from a healthy comparison group.
- FDA updated their information about vaping product testing on February. 12, 2020. Notably, 60.6% of the samples directly linked to confirmed or probable patients reported to CDC were found to contain THC, of which 50% were found to contain vitamin E acetate.
- While it appears that vitamin E acetate is associated with EVALI, there are many different substances and product sources that are being investigated, and there may be more than one cause.
- Michigan is working with the Centers for Disease Control and Prevention (CDC) and the federal Food and Drug Administration (FDA) on this investigation.
Weekly Outbreak Update Summary:
Michigan: As of 4/25/2020, the Michigan Department of Health and Human Services has identified 77 (42 confirmed and 35 probable) cases of severe lung disease associated with vaping, including four deaths. 81.6% of 77 confirmed or probable cases reported vaping THC only or in combination with nicotine and/or other substances.
Nationwide: As of February 18, 2020, there were 2,807* 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 68 confirmed deaths in 29 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.