• Published
  • By 104FW Public Health Office

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.

Vaping was initially heralded as a healthier alternative to smoking cigarettes and was supposed to be a way for people to stop smoking all together, instead, there is now an official investigation by both the CDC and the FDA. The concern is how rapidly severe lung disease is occurring in young people who vape and how teenagers and young adults are individuals affected.

The rapid increase in cases had now led to a temporary prohibition on vape product sales in Massachusetts. On Tuesday, 24 Sep 19, Governor Baker declared a public health emergency and banned sales of all vaping products for four months while the official investigation is ongoing.

Case Information

As of 17 Sep 19, a total of 530 cases of lung injury associated with the use of e-cigarette or vaping products have been reported in 38 states and 1 U.S. territory. The CDC has confirmed seven deaths in 6 states.

The CDC has received complete sex and age data on 373 of 530 cases.

  • Nearly three fourths (72%) of cases are male
  • Two thirds (67%) of cases are 18 to 34 years old
  • 16% of cases are under 18 years and 17% are 35 years or older

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 were 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.
  • 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.

The On-going Investigation


  • The investigation has not identified any specific e-cigarette or vaping product (devices, liquids, refill pods, and/or cartridges) or substance that is linked to all cases.
  • The CDC suspects "chemical exposure," but experts have not yet identified a specific agent as the culprit.
  • The FDA is analyzing a collection of over 120 product samples provided by state public health officials for the presence of a broad range of chemicals, including nicotine, THC and other cannabinoids, cutting agents, additives, pesticides, opioids, poisons, heavy metals and toxins.



  • If you are an adult who used e-cigarettes containing nicotine to quit cigarette smoking, do not return to smoking cigarettes.
  • If you have recently used an e-cigarette or vaping product and you have symptoms like those reported in this outbreak see a healthcare provider.
  • Anyone who uses an e-cigarette or vaping product should not buy these products (e.g., e-cigarette or vaping products with THC or CBD oils) off the street, and should not modify or add any substances to these products that are not intended by the manufacturer.
  • Adults who do not currently use tobacco products should not start using e-cigarette products.

Seek a Professional Opinion

If you vape and have concerns about your health or experience any difficulty breathing, shortness of breath, or chest pain, you should seek the advice of your medical provider. Pay attention, as flu season is starting and symptoms could mimic the flu. For more information on how to stop smoking or vaping, please schedule an appointment with a MDG provider and they can review all available options! If you have any additional questions or concerns about vaping-associated pulmonary disease, please see the 104th MDG or your healthcare provider.


104th Public Health Office


References: CDC, NY Times, CNBC, WNPR