The Vaping Illness Outbreak: What We Know So Far
September 26, 2019
An outbreak of severe lung disease among users of electronic cigarettes continues to spread to new patients and states, and public health officials say it's too soon to point to a cause.
According to the latest report from the Centers for Disease Control and Prevention, a total of 805 cases have been reported in 46 states and the U.S. Virgin Islands. The CDC has confirmed 12 deaths, in 10 states. Nearly three-quarters of cases are male and 83% are under the age of 35, out of the 373 cases for which the CDC has complete data.
Public health officials are taking urgent steps to identify what is causing previously healthy vape users to develop pneumonia-like symptoms. But the results are still inconclusive.
In a press briefing on Sept. 19, the CDC reported that states continue to see new cases. "It is an ongoing outbreak," said Dr. Anne Schuchat, the CDC's principal deputy director.
Here's what we know so far about the outbreak.
What seems to be causing the illness?
The CDC suspects "chemical exposure," but experts have not yet identified a specific agent as the culprit. There is no definitive link to any brand of device, ingredient, flavor or substance. The outbreak has affected users of both THC- and nicotine-containing products, but it is more prevalent among THC vapers than users who self-report using only nicotine products. Because a large number of the patients reported combining nicotine products with THC or CBD products, some researchers are looking into whether the illness may be a result of mixing substances.
In all confirmed cases, patients reported vaping within 90 days of developing symptoms, and most had vaped within a week of symptom onset. Patients with confirmed cases have been tested to rule out infections that could explain their symptoms. There is no indication that the outbreak is contagious.
What are the symptoms?
Patients report experiencing rapid onset of coughing, weight loss and significant breathing difficulties. Other symptoms may include nausea, vomiting and diarrhea. Symptoms generally appear over the course of a few days but can take as long as a few weeks to arise. The majority of patients are hospitalized, and while many of their symptoms overlap, their various diagnoses have included lipoid pneumonia (which can occur when oil enters the lungs), acute eosinophilic pneumonia (caused by the buildup of a type of white blood cell in the lungs) and acute respiratory distress syndrome.
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Recommendations on Preventing Influenza in 2019-2020
September 5, 2019
The American Academy of Pediatrics (AAP) recommends that all children ages 6 months and older are vaccinated for influenza for the 2019-2020 season, preferably by the end of October, with either the flu shot or the nasal spray vaccine.
The AAP expresses no preference for the shot or the nasal spray vaccine this season, in accordance with guidance provided by the Centers for Disease Control and Prevention (CDC), as described in the policy statement, "Recommendations for Prevention and Control of Influenza in Children, 2019-2020." The statement will be published in the October 2019 Pediatrics.
"The best way to keep children healthy and in school is to get the flu vaccine by the end of October," said Flor Munoz, MD, FAAP, member of the AAP Committee on Infectious Diseases. "The flu virus is unpredictable, spreads easily and can cause serious illness, so we urge vaccination in children and adolescents to protect them, their family and community, as well."
The annual flu vaccine significantly reduces a child's risk of severe influenza and death, especially in children younger than 5 years old and those with underlying medical conditions. As of Aug. 10, the United States CDC reported 129 influenza-associated pediatric deaths occurring during the 2018-2019 season. During the 2017-18 season, the CDC estimated that 80 percent of the 186 children who died from flu-associated complications had not been vaccinated against influenza.
This year, all influenza vaccines will be quadrivalent vaccines, to protect against the four strains of the influenza virus expected to circulate this season, including two A and two B strains. All licensed vaccines contain the same influenza viruses. The quadrivalent inactivated influenza vaccine (IIV4) is available for intramuscular injection for everyone 6 months of age and older, including healthy persons and those with high-risk conditions; the live attenuated influenza vaccine (LAIV4) is a nasal spray mist that is also appropriate for healthy children 2 years of age and older.
Read more at HealthyChildren.org.