Oregon Vaping Illness Investigation

Oregon Health Authority is participating in the investigation of a nationwide outbreak of respiratory illnesses associated with use of vaping devices, and is working with local public health and health care partners to track any illnesses in Oregon.

Public health warning: Stop using vaping products

The Oregon Health Authority is urging Oregonians to stop using all vaping products until federal and state officials have determined the cause of serious lung injuries and deaths linked to the use of both cannabis and nicotine vaping products.
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Oregon Cases

Updated November 12, 2019

In Oregon, 17 cases have been reported, 2 of which resulted in death.

Of the 17 cases of lung injuries associated with vaping in Oregon, OHA can confirm that there are cases involving individuals under the age of 18.
Oregon cases include a mix of cannabis-only vaping, nicotine-only vaping and a combination of both.

Resources

For Clinicians

Reporting requirements, updates and resources

The OHA Public Health Division and local public health departments are urging clinicians to be on alert for signs of severe respiratory illness among individuals who report vaping or e-cigarette use.

Disease Reporting

Clinicians must report within one working day any patient who has been hospitalized or who died from radiographically or histologically demonstrated lung injury following a history of e-cigarette use or vaping in the preceding 90 days.

Reports may be made to the local public health authority; or to the Oregon Health Authority (phone 971-673-1111; fax 971-673-1100; online reporting form).

Emergency Rule Online Reporting Form

Resources

For Local Public Health Authorities

Reporting requirements, investigative guidelines, custody forms and intake form

The OHA Public Health Division and clinicians are urging local public health departments to be on alert for signs of severe respiratory illness among individuals who report vaping or e-cigarette use.

Local public health departments must report within one working day any patient who has been hospitalized or who died from radiographically or histologically demonstrated lung injury following a history of e-cigarette use or vaping in the preceding 90 days.

Report all cases under investigation (see VALI Investigative Guidelines for case definitions) to PHD and enter case into Orpheus within one working day of initial physican report.

Investigative Guidelines (pdf) VALI Intake Form (pdf) Case Interview Form (pdf)

Chain of Custody Form: OHA (pdf) FDA (pdf)

Information from CDC

Updates and MMWR reports

CDC’s most up-to-date, publicly available information
What CDC recommends
For the latest CDC press materials, visit CDC’s newsroom.

MMWR Reports

Evaluation of Bronchoalveolar Lavage Fluid from Patients in an Outbreak of E-cigarette, or Vaping, Product Use-Associated Lung Injury — 10 state, August-October 2019.

Recent CDC laboratory testing of biologic samples from 29 patients with EVALI submitted to CDC from 10 states found vitamin E acetate in all of the BAL fluid samples. THC was identified in 82% of the samples and nicotine was identified in 62% of the samples.
CDC tested for a wide range of substances found in e-cigarette, or vaping, products, including plant oils, petroleum distillates like mineral oil, medium-chain triglyceride oil (MCT oil), and terpenes, which are compounds found in or added to THC products. No other chemicals were detected.
These findings provide direct evidence of vitamin E acetate within the lungs at the primary site of injury. This is the first time we have detected a potential chemical of concern in biologic samples from patients with EVALI.
Our findings still do not rule out other possible compounds or ingredients that may be contributing to these lung injuries.
This work complements the ongoing work of FDA and some state public health laboratories to characterize e-liquid exposures. It also highlights the extensive collaboration between federal, state, and local partners.

Risk Factors for E-Cigarette, or Vaping, Product Use Associated Lung Injury (EVALI) Among Adults Who Use E-Cigarette, or Vaping, Products— Illinois, July-October 2019

In Illinois, E-cigarette, or vaping, product use behaviors of 66 patients with these lung injuries aged 18–44 years who were interviewed as part of the ongoing outbreak investigation were compared with a subset of 519 survey respondents aged 18–44 years who reported use of THC-containing e-cigarette, or vaping, products. These findings suggest that compared to adult survey respondents who reported use of THC-containing products and had not developed lung injury, EVALI patients were more likely to report:

Obtaining THC-containing e-cigarette, or vaping, products through informal sources (e.g. a dealer, a friend, or off the street);
Using e-cigarette, or vaping, products more than five times per day;
Using a THC-containing product called Dank Vapes; and
Using THC-containing products exclusively.