Background
E-cigarette or vaping product use–associated lung injury (EVALI) is a severe pulmonary illness associated with the use of e-cigarettes or vaping products. EVALI was first identified in late 2019 when the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), along with state and local health departments investigated a nationwide outbreak of the disease. Reported cases had a high hospitalization rate and were primarily among adolescents and young adults. EVALI was primarily linked to the vitamin E acetate additive in tetrahydrocannabinol (THC)-containing vaping products. Cases of EVALI began to decline in early 2020, in part, due to rapid public health action to promote public awareness of the disease. However, EVALI is still a public health concern for West Virginia considering the state’s high rate of e-cigarette and vaping use. The West Virginia Bureau for Public Health encourages healthcare providers to consider EVALI as a differential diagnosis when treating patients with severe pulmonary symptoms who report a history of vaping.
Clinical Presentation and Evaluation
Symptoms of EVALI mimic an acute respiratory illness with symptoms including shortness of breath, fever, cough, fatigue and gastrointestinal symptoms (nausea, vomiting, abdominal pain, and diarrhea). Other symptoms may include weight loss, dizziness and chest pain. Symptoms may worsen over a period of days or weeks before admission to the hospital. On hospital admission, most patients are febrile, tachycardic and hypoxic. Symptoms may result in hospitalizations lasting multiple weeks with some patients requiring mechanical ventilation. Clinicians should ask patients who report pulmonary symptoms about vaping. Consultation with pulmonologists should be considered when treating patients who have pulmonary symptoms and report a history of vaping. Because symptoms are similar to those with an infection, a thorough evaluation for infectious diseases should be conducted.
If vaping is suspected as the etiology of a patient’s illness, it is important to inquire what type of product as well as if the patient is using commercially available devices and/or liquids; sharing products (devices, liquids, refill pods and/or cartridges) with other people; reusing old cartridges or pods (with homemade or commercially bought products) or heating the drug to concentrate it and then using a specific type of device to inhale the product (i.e., “dabbing”).
Resources
Health Effects of Vaping: https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html.
Interim Guidance for Health Care Providers for Managing Patients with Suspected EVALI: https://www.cdc.gov/mmwr/volumes/68/wr/mm6846e2.htm?s_cid=mm6846e2_w.
The E-cigarette or Vaping Product Use–Associated Lung Injury Epidemic: Pathogenesis, Management, and Future Directions: An Official American Thoracic Society Workshop Report: https://pmc.ncbi.nlm.nih.gov/articles/PMC9819258/.
West Virginia Division of Tobacco Prevention: https://dhhr.wv.gov/wvdtp/Pages/default.aspx.
Hancock County Health Department
P.O. Box 578
850 N. Chester Street
New Cumberland, WV 26047
(Get Directions)
Jackie L. Huff
Administrator
304 564-3343 ext 123
304 670-2484
Becky Weekley
Office Assistant II
304 564-3343 ext 121
Carolyne Baker
RS, REHS
304 564-3343 ext 130
Michelle Berneburg
RN Supervisor, Epidemiology, Immunizations, Tuberculosis
304 564-3343 ext 129
Morgan Watson
Nursing, HIV/STD program
304-564-3343 ext 132
John Plesa
BOH member
Term July 2023- June 2028
Democrat/Clay
Ronnie Jones
BOH member-Chair
Term July 2022-June 2027
Republican/Butler
Lisa Ludovici
BOH member
Term July 2023-June 2028
Republican/Grant
Tamara Pettit
BOH member
Term April 2024- June 2029
No Party Affliation/Grant
Sandra Haspel
BOH member
Term July2020-June 2025
Democrat/ Butler
Posted 07/22/24
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