Vaping-Related Lung Disease Gets New Name

AUSTIN October 18, 2019 - The vaping-related condition that has sickened at least 119 Texans, and hundreds more nationwide, has been named EVALI, or e-cigarette or vaping product use-associated lung injury.

The new name was noted last week in newly issued guidance for clinicians from the Centers for Disease Control and Prevention (CDC). 

The CDC’s guidance urges physicians to be on alert for EVALI, particularly as flu and respiratory virus season picks up. Each of those illnesses has similar symptoms: shortness of breath, night sweats, low oxygen levels, and hazy spots on a lung X-ray.

As of Oct. 15, 119 cases have been identified in Texas, including one death, the Department of State Health Services (DSHS) said. Health officials are gathering information about 21 other possible cases in Texas.

As of Oct. 8, EVALI has sickened 1,299 people across 49 states, Washington, D.C., and the U.S. Virgin Islands, the CDC guidance said. Twenty-six deaths have been reported from 21 states.

Texas health officials last week rolled out a new form for physicians to use to report cases of lung injury or illness in patients who have used e-cigarette or vaping products within 90 days of symptom onset.

The form should be completed and returned, along with relevant medical records, to your local health department or the DSHS Environmental Surveillance and Toxicology Branch via fax (512-776-7249 or 512-776-7222), or encrypted email.

More information on e-cigarettes and the vaping epidemic, including the new form, can be found on the DSHS’ website.

The CDC has several recommendations for physicians who suspect severe lung disease caused caused by e-cigarettes, including:  

  • Report cases of severe pulmonary disease of unclear etiology and a history of e-cigarette product use within the past 90 days to your state or local health department. Reporting of cases may help CDC and state health departments determine the cause or causes of these pulmonary illnesses.
  • Ask all patients who report e-cigarette product use within the last 90 days about signs and symptoms of pulmonary illness.
  • If e-cigarette product use is suspected as a possible etiology of a patient’s severe pulmonary disease, obtain detailed history regarding: 
    • Substance(s) used: nicotine, cannabinoids (e.g., marijuana, THC, THC concentrates, CBD, CBD oil, synthetic cannabinoids [e.g., K2 or spice], hash oil, Dank vapes), flavors, or other substances
    • Substance source(s): commercially available liquids (i.e., bottles, cartridges, or pods), homemade liquids, and re-use of old cartridges or pods with homemade or commercially bought liquids
    • Device(s) used: manufacturer; brand name; product name; model; serial number of the product, device, or e-liquid; if the device can be customized by the user; and any product modifications by the user (e.g., exposure of the atomizer or heating coil)
    • Where the product(s) were purchased
    • Method of substance use: aerosolization, dabbing, or dripping
    • Other potential cases: sharing e-cigarette products (devices, liquids, refill pods, or cartridges) with others
  • Determine if any remaining product, including devices and liquids, are available for testing. Testing can be coordinated with the local or state health departments.  

Suspected cases should be reported to DSHS at (512) 776-7268.

Thanks to Texas Medical Association advocacy, lawmakers this year passed a law that raises the minimum age to buy tobacco and vaping products from 18 to 21 (except for military personnel). The law took effect Sept. 1.

If you’re looking for ways to talk effectively to teenagers about the dangers of vaping, the Texas Health and Human Services Commission is offering a free online course entitled Escape the Vape: Help Stop the E-Cigarette Epidemic Among Adolescents.

And if you’re looking for more information and resources on tobacco and nicotine addiction in Texas, check out the TMA website.

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