Syndromic Surveillance for E-Cigarette, or Vaping, Product Use–Associated Lung Injury

Hartnett, Kathleen P.; Kite-Powell, Aaron; Patel, Megan T.; Haag, Brittani L.; Sheppard, Michael; Dias, Taylor; King, Brian A.; Melstrom, Paul; Ritchey, Matthew D.; Stein, Zachary; Idaikkadar, Nimi; Vivolo-Kantor, Alana M.; Rose, Dale A.; Briss, Peter A.; Layden, Jennifer E.; Rodgers, Loren; Adjemian, Jennifer

doi:10.1056/nejmsr1915313

Cited by 98 publications

(74 citation statements)

References 10 publications

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“…This suggests that a change might have occurred in the constituents of illicit THC-containing e-cigarette, or vaping, products, including the addition of VEA, shortly before June 2019, when these patients began to have symptoms. This timeline is consistent with the spike in EVALI-related emergency department visits observed nationwide in June 2019 (9), and with law enforcement seizures in Minnesota that found VEA in all THC cartridges seized in a September 2019 raid, but not in any products seized in 2018 (8).…”

supporting

confidence: 82%

E-cigarette, or Vaping, Product Use–Associated Lung Injury Among Clusters of Patients Reporting Shared Product Use — Wisconsin, 2019

Pray¹,

Atti²,

Tomasallo³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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supporting

confidence: 82%

E-cigarette, or Vaping, Product Use–Associated Lung Injury Among Clusters of Patients Reporting Shared Product Use — Wisconsin, 2019

Pray¹,

Atti²,

Tomasallo³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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“…The majority of patients with EVALI report vaping tetrahydrocannabinol (THC)-containing counterfeit street e-cig products. By December 2019, there have been over 2,500 hospitalized EVALI patients, most of whom are men younger than 35 years of age [1]. Patients hospitalized with EVALI have manifested a variety of radiological imaging patterns consistent with lipoid pneumonia, eosinophilic pneumonia, and chemical damage to the lung tissue [2,3].…”

Section: Introductionmentioning

confidence: 99%

Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

Muthumalage

Friedman

McGraw

et al. 2020

Toxics

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The Centers for Disease Control declared e-cigarette, or vaping, product use-associated lung injury (EVALI) a national outbreak due to the high incidence of emergency department admissions and deaths. We have identified chemical constituents in e-cig counterfeit cartridges and compared these to medical-grade and CBD containing cartridges. Apart from vitamin E acetate (VEA) and tetrahydrocannabinol (THC), other potential toxicants were identified including solvent-derived hydrocarbons, silicon conjugated compounds, various terpenes, pesticides/plasticizers/polycaprolactones, and metals. This study provides additional insights into the chemicals associated with EVALI cartridges and thus may contribute to the underlying disease mechanism of acute lung injury.

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“…The situation is evolving rapidly. It is suggested that the prevalence may be reducing (from September to October 2019 and now to December) (Hartnett et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…E-cigarette or vaping product use-associated lung injury had proved fatal in 39 (2%) of a total of 2051 cases by November 2019 (Blount et al, 2019) and in 57 out of 2355 cases by December 2019 (Ellington et al, 2020). Cases, emergency room visits and hospitalisations have all declined from a peak in September 2019 (Hartnett et al, 2020;Krishnasamy et al, 2020).…”

Section: Clinical Featuresmentioning

confidence: 99%

“…The epidemiology and natural history are not well defined; milder forms of acute syndrome may as yet be unrecognised, the effects of exposure to individual components of electronic nicotine delivery systems remain to be described, the prognosis if exposure is stopped, and the response to corticosteroids and any long-term sequelae are unclear. The suggestion from Centers for Disease Control and Prevention reports and recent surveillance (Hartnett et al, 2020) that the incidence may have decreased between September and December 2019 may be over-optimistic. Potential causative mechanism(s), particularly in patients who have not been exposed to tetrahydrocannabinol, require elucidation as does the significance of lipoid pneumonia in some of the cases.…”

confidence: 99%

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E-cigarette or vaping product use-associated lung injury

Ind

2020

Br J Hosp Med

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E-cigarette or vaping product use-associated lung injury is a recently recognised, acute pulmonary syndrome which has been reported (particularly from June to October 2019) throughout the USA, but not in Europe (although one probable case, in the UK, has been reported; Medicines and Healthcare products Regulatory Agency, 2020 ). It presents acutely, most often in young men, as severe pulmonary consolidation, usually with respiratory failure. The mortality is around 2%. The cause(s) are unknown, but it is associated with vaping, particularly using unlicensed cannabis-containing products with tetrahydrocannabinol. Vitamin E acetate, often present in tetrahydrocannabinol-containing vape products as a solvent, has been implicated, as it has been identified in the bronchoalveolar lavage fluid of patients with e-cigarette or vaping product use-associated lung injury. This article reviews the recent literature, including clinical features, presentation and investigations, and possible mechanisms, in the context of vaping practices in the USA and the UK.

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Syndromic Surveillance for E-Cigarette, or Vaping, Product Use–Associated Lung Injury

Cited by 98 publications

References 10 publications

E-cigarette, or Vaping, Product Use–Associated Lung Injury Among Clusters of Patients Reporting Shared Product Use — Wisconsin, 2019

E-cigarette, or Vaping, Product Use–Associated Lung Injury Among Clusters of Patients Reporting Shared Product Use — Wisconsin, 2019

Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

E-cigarette or vaping product use-associated lung injury

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