CDC Issues a Health Alert for E-Cigarette Products

With the eruption of a multistate outbreak of severe pulmonary disease associated with using e-cigarette products (devices, liquids, refill pods, and cartridges) the federal Centers for Disease Control and Prevention is working to get information out to the public about its concerns, and to provide recommendations for clinicians, public health officials and the public based on currently available information.

E-cigarettes typically contain nicotine, most also contain flavorings and other chemicals, and some may contain marijuana or other substances. They are known by many different names and come in many shapes, sizes, and device types. The devices may be referred to as “e-cigs,” “vapes,” “e-hookahs,” “vape pens,” “mods,” tanks, or electronic nicotine delivery systems (called ENDS). 

Some of the popular e-cigarette devices resemble actual tobacco-cigarettes and also have designs similar to items such as a USB flash drive, pens, and other familiar or unique shapes. 

Typically, those using e-cigarettes refer to the use as “vaping” or “juuling.” There are also devices called “dab” pens. 

According to the CDC, e-cigarettes can contain harmful or potentially harmful substances, including nicotine, heavy metals such as lead, volatile organic compounds and cancer-causing chemicals. E-cigarette products may also be used to deliver illicit substances into the user. 

The CDC strongly urges youth, young adults and pregnant women to not use e-cigarettes. Additionally, the CDC indicates that the Food and Drug Administration (FDA) has not given approval for the use of e-cigarettes as an aid to quitting smoking. 

As of Aug. 27, there have been 215 possible cases, from 25 states, of pulmonary illness. The cases are under investigation by the CDC. According to the CDC, one patient in Illinois who had a history of recent e-cigarette use was hospitalized with severe pulmonary disease. That patient died. 

Of the 215 cases, all patients reported that they were users of e-cigarettes and the CDC is continuing to investigate the cause of the e-cigarette-associated pulmonary disease. 

Many patients also reported using e-cigarettes containing cannabinoid products such as THC or CBD. 

According to the CDC, patients who are believed to have the e-cigarette-associated pulmonary disease have experienced respiratory symptoms such as cough, shortness of breath, or chest pain, and some have also experienced gastrointestinal symptoms such as nausea, vomiting, or diarrhea. They also have indicated they have some non-specific symptoms such as fatigue, fever, or weight loss. 

Many of the patients being tracked sought initial care in ambulatory settings, such as a clinic or Primary Care provider visit. Some patients required several visits before being admitted to a hospital. Many patients required supplemental oxygen, some required assisted ventilation and oxygenation, and some were intubated.  

According to the CDC, no single substance or e-cigarette product has been consistently associated with illness. CDC is working closely with state health departments to collect product specimens for testing at the U.S. FDA Forensic Chemistry Center. 

As part of its advisory, the CDC is issuing a number of recommendations for the public: 

• If you are concerned about these specific health risks, consider refraining from using e-cigarette products. 
• Regardless of the ongoing investigation, anyone who uses e-cigarette products should not buy these products off the street (e.g., e-cigarette products with THC, other cannabinoids) and should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer. 
• Regardless of the ongoing investigation, e-cigarette products should not be used by youth, young adults, pregnant women, as well as adults who do not currently use tobacco products. 
• If you use e-cigarette products, monitor yourself for symptoms such as cough, shortness of breath and chest pain and promptly seek medical attention if you have concerns about your health.  
• Adult smokers who are attempting to quit cigarette smoking should use evidence-based treatments, including counseling and FDA-approved medications 
• If you are concerned about harmful effects from e-cigarette products, call the local poison control center at 1-800-222-1222. 
• The CDC encourages the public to submit detailed reports of any unexpected tobacco or e-cigarette-related health or product issues to the FDA via the online Safety ReportingPortal: https://www.safetyreporting.hhs.gov. 

The above information on electronic cigarettes and similar devices is sourced from https://www.cdc.gov/e-cigarettes