%0 Journal Article
%T Characteristics of an outbreak of e-cigarette, or vaping, product use-associated lung injury-North Carolina, 2019
%J North Carolina medical journal
%D 2021
%A Tanz, Lauren J.
%A Christensen, Ariel
%A Knuth, Kendall B.
%A Hoffman, Molly N.
%A Dandeneau, Dana
%A Koehler, Kate
%A Moore, Zack
%A Herndon, Sally
%A Davidson, Kevin
%A Fleischauer, Aaron
%V 82
%N 6
%P 384-392
%X BACKGROUND In August 2019, the North Carolina Division of Public Health (NCDPH) began investigating e-cigarette, or vaping, product use-associated lung injury (EVALI) cases as part of a national response. We describe clinical, epidemiologic, and laboratory findings of North Carolina EVALI patients.<br><br>METHODS NCDPH requested that physicians report cases of respiratory illness or bilateral pulmonary infiltrates or opacities in patients who reported using e-cigarette, or vaping, products and had no infection or alternative plausible diagnoses. We reviewed medical records, interviewed patients, and tested vaping products for substances.<br><br>RESULTS During August 13, 2019-February 18, 2020, 78 EVALI cases were reported in North Carolina. Median age of cases was 24 years (range: 13-72 years); 49 (63%) patients were male. Symptoms included cough (n = 70; 90%), shortness of breath (n = 66; 85%), and gastrointestinal symptoms (n = 63; 81%). Seventy-five patients (96%) were hospitalized, 32 (41%) required intensive care, and 12 (16%) required mechanical ventilation; none died. Among 20 patients interviewed, most reported using tetrahydrocannabinol (THC) (n = 16; 80%) or nicotine-containing products (n = 14; 70%). All obtained THC-containing products from informal sources, such as family, friends, or dealers, as THC is illegal in North Carolina. Among 82 products tested, 74 (90%) contained THC, cannabidiol, or cannabinol; 54 (66%) contained vitamin E acetate.LIMITATIONS In North Carolina, EVALI is not reportable by law, and THC is illegal. Thus, cases and exposures are likely underreported.<br><br>CONCLUSIONS THC-containing products, particularly those containing vitamin E acetate, are associated with EVALI. Persons should not use these products, particularly from informal sources. Continued communication of health risks to persons who use e-cigarette, or vaping, products is essential.<p /> <p>Language: en</p>
%G en
%I Medical Society of the State of North Carolina
%@ 0029-2559
%U http://dx.doi.org/10.18043/ncm.82.6.384