1. DCHHS Updates: Outbreak of Severe Pulmonary Illnesses Associated with Use of E-Cigarette Products
Philip Huang, MD, MPH
Director/ Health Authority
Dallas County Health and Human Services
September 17, 2019

2. Multistate Outbreak of Severe Pulmonary Illnesses Associated with Use of E-Cigarette Products

5. National Outbreak Background
CDC, FDA, state and local health departments have been investigating a multistate outbreak of severe pulmonary disease associated with e-cigarette products (aka “vaping”)
No specific cause or product has been identified, but all reported cases have a history of vaping
Many patients report vaping liquids that contain cannabinoid products, particularly THC
As of August 27, 2019
215 possible cases from 25 states have been reported, with one death
Available evidence does not currently suggest infectious disease to be the cause of the illnesses

6. Clinical Features of Patients with Severe Lung Disease
Patients across the country have been experiencing the following symptoms:
Cough, shortness of breath, chest pain
Nausea, vomiting, diarrhea
Fatigue, fever, weight loss
Symptoms typically have developed over a few days
Most patients have not improved after antibiotic treatment
Many experience some improvement after steroid treatment

7. Cases Reported from Dallas Hospitals
As of September 4, 2019:
DCHHS has received reports of 10 patients hospitalized in Dallas County facilities, potentially associated with use of e- cigarette products
Median age of 19 years (range 13-44)
90% have reported vaping THC products
All but one of the cases were healthy prior to onset of illness
To date, infectious origins have been ruled out for 70% of cases

8. Recommendations for the Public
Youth and young adults should not use e-cigarette products
They are illegal for use in Texas for people under the age of 21
Women who are pregnant should not use e-cigarette products
Adults who do not currently use tobacco products should not start using e-cigarette products.
If you do use e-cigarette products, you should not buy these products off the street
You should not modify e-cigarette products or add any substances to these products
Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications. If you need help quitting tobacco products, including e-cigarettes, contact your doctor or other medical provider.