You signed in with another tab or window. Reload to refresh your session.You signed out in another tab or window. Reload to refresh your session.You switched accounts on another tab or window. Reload to refresh your session.Dismiss alert
CDC, U.S. Food and Drug Administration (FDA), state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of severe pulmonary disease associated with e-cigarette product (devices, liquids, refill pods, and/or cartridges) use. This investigation is ongoing and has not identified a cause, but all reported cases have a history of using e-cigarette products.
E-cigarettes are devices that deliver an aerosol to the user by heating a liquid that usually contains nicotine, flavorings, and other chemicals. E-cigarettes can also be used to deliver marijuana or other substances.
As of September 6, 2019, over 450 possible cases of lung illness associated with the use of e-cigarette products have been reported to CDC from the following 33 states and 1 U.S. territory: AR, CA, CO, CT, DE, FL, GA, IA, IL, IN, KS, KY, LA, MD, MI, MN, MT, NC, NE, NJ, NM, NY, OH, OR, PA, SC, TN, TX, UT, VA, VT, WI, WV, and the U.S. Virgin Islands). These numbers may change frequently.
Five deaths have been confirmed in California, Illinois, Indiana, Minnesota, and Oregon.
CDC worked with states to create a case definition to classify cases in a consistent way. State investigators determine if cases are confirmed or probable after examining the medical records of suspected cases and consulting with the clinical care team to exclude other possible causes. Unlike nationally reportable conditions, these cases are requiring clinicians and public health to interview patients to determine product use and individual behaviors.
CDC will report numbers of confirmed and probable cases once states have finalized their classification of cases.
We expect that states and clinicians may look back for older cases based on CDC’s case definition. States are in the process of classifying current possible cases as well as older cases.
No evidence of infectious diseases has been identified; therefore lung illnesses are likely associated with a chemical exposure. Initial published reports from the investigation point to clinical similarities among cases. Patients report e-cigarette use and similar symptoms and clinical findings. These align with the CDC health advisory released August 30, 2019.
The investigation has not identified any specific substance or e-cigarette product that is linked to all cases. Many patients report using e-cigarette products with liquids that contain cannabinoid products, such as tetrahydrocannabinol (THC).
These investigations are ongoing. CDC will provide updates when more information is available.
While this investigation is ongoing, consider not using e-cigarette products.
If you do use e-cigarette products and you experience symptoms like those reported in this outbreak, seek medical care promptly. CDC and the FDA will continue to alert the public throughout this investigation.
Adults who do not currently use tobacco products should not start using e-cigarette products.
If you do use e-cigarette products, you should not buy these products off the street (for example, e-cigarette products with THC or other cannabinoids).
You should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications. If you need help quitting tobacco products, including e-cigarettes, contact your doctor or other medical provider.
If you are concerned about your health after using an e-cigarette product, you can also call your local poison control center at 1-800-222-1222.
CDC and FDA encourage the public to submit detailed reports of any unexpected health or product issues related to tobacco or e-cigarette products to the FDA via the online Safety Reporting Portal.
Symptoms of Severe Pulmonary Disease Reported by Some Patients in This Outbreak
Patients in this investigation have reported symptoms such as:
cough, shortness of breath, or chest pain
nausea, vomiting, or diarrhea
fatigue, fever, or weight loss
Some patients have reported that their symptoms developed over a few days, while others have reported that their symptoms developed over several weeks. A pulmonary infection does not appear to be causing the symptoms, which have generally not improved with antibiotic treatment alone.
As this investigation continues, CDC encourages clinicians to report possible cases of e-cigarette-associated pulmonary disease to their local or state health department for further investigation.
If e-cigarette product use is suspected as a possible cause for a patient’s lung disease, a detailed history of the substances used, the sources, and the devices used should be obtained, as outlined in the HAN, and efforts should be made to determine if any remaining product, devices, and liquids are available for testing.
Recommendations for Local and State Public Health Departments
CDC encourages local and state health departments to notify CDC about possible cases promptly, and contact CDC for the most recent versions of the surveillance case definitions, reporting guidelines, and case investigation forms.
Local and state public health departments that need data collection tools should email CDC at eocevent101@cdc.gov.
CDC, several states, and federal partners are investigating a multistate outbreak of severe pulmonary disease associated with using e-cigarette products. The investigation is ongoing and has not identified a cause, but all reported cases have indicated use of e-cigarette products.
Based on reports from several states, patients have experienced respiratory symptoms (cough, shortness of breath, or chest pain), and some have also experienced gastrointestinal symptoms (nausea, vomiting, or diarrhea) or non-specific symptoms (fatigue, fever, or weight loss). Some patients have reported that their symptoms developed over a few days, while others have reported that their symptoms developed over several weeks. Some patients have reported gastrointestinal symptoms began before respiratory symptoms. Fever, elevated heart rate, and elevated white blood cell count have been reported, even though no infectious disease has been identified. Many patients sought medical care in ambulatory settings, sometimes over several visits, before they were admitted to the hospital.
Many patients have required medical treatment with supplemental oxygen. Some required assisted ventilation. Some patients have been treated with corticosteroids with demonstrated improvement. Evidence does not suggest an infectious disease is the cause of the severe pulmonary disease. Antibiotic therapy alone has not consistently been associated with clinical improvement.
Investigation of the Outbreak
CDC, FDA, state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of pulmonary disease associated with e-cigarette product (devices, liquids, refill pods, and/or cartridges) use. This ongoing investigation seeks to identify the exposures, demographic, clinical, and laboratory features and behaviors of patients. All patients have reported e-cigarette product use. Some patients have reported using e-cigarettes containing cannabinoid products, such as THC. To date, the investigation has not identified any single substance or e-cigarette product that has been consistently associated with illness.
State health departments are working with FDA to enable collection of e-cigarette product specimens for testing at the U.S. FDA Forensic Chemistry Center.
Links with this icon indicate that you are leaving the CDC website.
The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website's privacy policy when you follow the link.
CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.
For more information on CDC's web notification policies, see Website Disclaimers.
Cancel Continue
Add Tags ?
AddDeleteNo
close
close
The text was updated successfully, but these errors were encountered:
Skip directly to site content Skip directly to page options Skip directly to A-Z link
Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People
Search
×
Submit
For a full list of topics: A-Z Index
Smoking & Tobacco Use
Section Navigation Outbreak of Lung Illness Associated with Using E-cigarette Products
Home
Outbreak of Lung Illness Associated with Using E-cigarette Products
minus
Related Pages
Investigation Notice
Posted September 6, 2019 at 9:50pm ET
CDC, U.S. Food and Drug Administration (FDA), state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of severe pulmonary disease associated with e-cigarette product (devices, liquids, refill pods, and/or cartridges) use. This investigation is ongoing and has not identified a cause, but all reported cases have a history of using e-cigarette products.
E-cigarettes are devices that deliver an aerosol to the user by heating a liquid that usually contains nicotine, flavorings, and other chemicals. E-cigarettes can also be used to deliver marijuana or other substances.
On This Page
Latest Outbreak Information
Top of Page
Map of Reported Cases
Top of Page
Recommendations for the Public
While this investigation is ongoing, consider not using e-cigarette products.
If you do use e-cigarette products and you experience symptoms like those reported in this outbreak, seek medical care promptly. CDC and the FDA will continue to alert the public throughout this investigation.
Regardless of the ongoing investigation:
If you are concerned about your health after using an e-cigarette product, you can also call your local poison control center at 1-800-222-1222.
CDC and FDA encourage the public to submit detailed reports of any unexpected health or product issues related to tobacco or e-cigarette products to the FDA via the online Safety Reporting Portal.
Top of Page
Symptoms of Severe Pulmonary Disease Reported by Some Patients in This Outbreak
Top of Page
Recommendations for Healthcare Providers
As this investigation continues, CDC encourages clinicians to report possible cases of e-cigarette-associated pulmonary disease to their local or state health department for further investigation.
If e-cigarette product use is suspected as a possible cause for a patient’s lung disease, a detailed history of the substances used, the sources, and the devices used should be obtained, as outlined in the HAN, and efforts should be made to determine if any remaining product, devices, and liquids are available for testing.
Top of Page
Recommendations for Local and State Public Health Departments
CDC encourages local and state health departments to notify CDC about possible cases promptly, and contact CDC for the most recent versions of the surveillance case definitions, reporting guidelines, and case investigation forms.
Local and state public health departments that need data collection tools should email CDC at eocevent101@cdc.gov.
Top of Page
Investigation Details
August 30, 2019
CDC, several states, and federal partners are investigating a multistate outbreak of severe pulmonary disease associated with using e-cigarette products. The investigation is ongoing and has not identified a cause, but all reported cases have indicated use of e-cigarette products.
Based on reports from several states, patients have experienced respiratory symptoms (cough, shortness of breath, or chest pain), and some have also experienced gastrointestinal symptoms (nausea, vomiting, or diarrhea) or non-specific symptoms (fatigue, fever, or weight loss). Some patients have reported that their symptoms developed over a few days, while others have reported that their symptoms developed over several weeks. Some patients have reported gastrointestinal symptoms began before respiratory symptoms. Fever, elevated heart rate, and elevated white blood cell count have been reported, even though no infectious disease has been identified. Many patients sought medical care in ambulatory settings, sometimes over several visits, before they were admitted to the hospital.
Many patients have required medical treatment with supplemental oxygen. Some required assisted ventilation. Some patients have been treated with corticosteroids with demonstrated improvement. Evidence does not suggest an infectious disease is the cause of the severe pulmonary disease. Antibiotic therapy alone has not consistently been associated with clinical improvement.
Investigation of the Outbreak
CDC, FDA, state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of pulmonary disease associated with e-cigarette product (devices, liquids, refill pods, and/or cartridges) use. This ongoing investigation seeks to identify the exposures, demographic, clinical, and laboratory features and behaviors of patients. All patients have reported e-cigarette product use. Some patients have reported using e-cigarettes containing cannabinoid products, such as THC. To date, the investigation has not identified any single substance or e-cigarette product that has been consistently associated with illness.
State health departments are working with FDA to enable collection of e-cigarette product specimens for testing at the U.S. FDA Forensic Chemistry Center.
Top of Page
Key Resources
Top of Page
Multimedia
CDCTobaccoFree
Page last reviewed: September 6, 2019
Content source: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
home Home
Social_govd govD Get Email Updates
To receive email updates about Smoking & Tobacco Use, enter your email address:
Email Address
What's this
Submit
Quick Links
1-800-784-8669
Related CDC Sites
Smokers®
Prevention and Control
Cancer Control Program
Health
More CDC Sites
HAVE QUESTIONS?
Visit CDC-INFO
Call 800-232-4636
Email CDC-INFO
CDC INFORMATION
About CDC
Jobs
Funding
Policies
File Viewers & Players
Privacy
FOIA
No Fear Act
OIG
Nondiscrimination
Accessibility
CONNECT WITH CDC
Facebook
Twitter
Youtube
Instagram
Syndicate
CDC TV
RSS
Email
U.S. Department of Health & Human Services
USA.gov
CDC Website Exit Disclaimer external icon
file_external
Exit Notification/Disclaimer Policy
Close
Links with this icon indicate that you are leaving the CDC website.
For more information on CDC's web notification policies, see Website Disclaimers.
Cancel Continue
Add Tags ?
AddDeleteNo
close
close
The text was updated successfully, but these errors were encountered: