UPDATE August 23, 2019: As of 5:00 p.m., August 22, 193 potential cases of severe lung illness associated with e-cigarette product use had been reported by 22 states (CA, CT, IL, IN, IA, MN, MI, NC, NJ, NM, NY, PA, TX, UT, WI, and additional states pending verification). These were reported between June 28th and August 20th of this year.

CDC is providing consultation to state health departments about a cluster of pulmonary illnesses possibly related to e-cigarette product use, or “vaping,” primarily among adolescents and young adults. Many states have alerted CDC to possible (not confirmed) cases and investigations into these cases are ongoing. In addition, the U.S. Food and Drug Administration (FDA) is working with CDC and state health officials to gather information on any products or substances used and providing technical and laboratory assistance. FDA 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 Reporting Portalexternal icon.‎ While some cases in each of the states are similar and appear to be linked to e-cigarette product use, more information is needed to determine what is causing the illnesses.

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More than 149 possible cases of severe lung illness associated with e-cigarette product use were reported by 15 states (CA, CT, IL, IN, IA, MN, MI, NC, NJ, NM, NY, PA, TX, UT, and WI) from June 28, 2019, to August 20, 2019.

No deaths have been reported.

CDC and states have not identified a cause, but all reported cases have e-cigarette product use or “vaping.” Available evidence does not suggest that an infectious disease is the principal cause of the illness. Investigators have not identified any specific product or compound that is linked to all cases. In many cases, patients reported a gradual start of symptoms including breathing difficulty, shortness of breath, and/or chest pain before hospitalization. Some cases reported mild to moderate gastrointestinal illness including vomiting and diarrhea and fatigue as well. In many cases, patients have acknowledged recent use of tetrahydrocannabinol (THC)-containing products while speaking to healthcare personnel or in follow-up interviews by health department staff; however, no specific product has been identified in all cases, nor has any product been conclusively linked to illnesses.

Even though cases appear similar, it is not clear if these cases have a common cause or if they are different diseases with similar presentations. The State Departments of Health are investigating the possible cause of the illness by testing patient specimens and e-cigarette products. State-specific epidemiologic investigations are ongoing.

The Wisconsin and Illinois departments of health have asked CDC for assistance investigating the illnesses in their states. The investigation is ongoing and more information will be shared as it is available.

CDC notified U.S. healthcare systems and clinicians about the illnesses and what to watch for via a Clinician Outreach and Communication Activity (COCA) Clinical Action Message. For information about a specific state, contact that state’s health department.

For information on electronic cigarettes visit: www.cdc.gov/e-cigarettes