The California Department of Public Health (CDPH) issued a health alert on August 27, 2019 regarding 36 cases of vaping-associated pulmonary injury (VAPI) requiring hospitalization across California.
These cases have been identified since June 2019. While the exact cause of illness is not yet known, most cases involve vaping the cannabis compounds tetrahydrocannabinol (THC) and/or cannabidiol (CBD), with some reports involving vaping nicotine products.
At this time, no infectious etiology has been determined and over 200 similar cases are being investigated by the Centers for Disease Control and Prevention (CDC) in at least 23 other states.
The CDPH alert contains details on the cases reported in California, background information on vaping, and an updated case definition.
CDPH asks that clinicians be alert for suspected cases presenting with respiratory complaints in both outpatient and inpatient settings in the context of recent use of vaping or "dabbing" devices, and an initial diagnosis of pneumonia or bronchitis that did not respond to antibiotics.
If cases occur locally, clinicians are asked to:
- Collect and hold the original product and/or devices if the patient has on hand so that the product and device can be tested.
- Report the case by phone to the applicable local health department.
Reporting
The local health department will report the case to CDPH and, if needed, interview patients and/or family members, arrange the transfer of available biospecimens, and collect available vaping products and/or devices.
County of Los Angeles Department of Public Health: 1.626.299.3504
Long Beach Health and Human Services: 1.562.570.4302
Pasadena Public Health Department: 1.626.744.6089
New Cessation Resources
The California Smokers' Helpline has a new counseling line dedicated to people who want to quit vaping. The toll-free number is 1.844.8.NO.VAPE. The Helpline also has promotional materials available to download and post in your office.
For more information about the Helpline's cessation services, including telephone counseling, mobile apps, online chat and a texting program, visit their Free Services web page.
Action Items for Physicians
► Ask patients presenting with respiratory complaints in both outpatient and inpatient settings about their use of vaping or “dabbing” devices, especially patients who had an initial diagnosis of pneumonia or bronchitis that did not respond to antibiotics. For patients who do vape, ask these follow-up questions:
- Type of vape used
--Do you vape nicotine-containing substances
--Do you vape substances that contain cannabis or cannabinoid compounds like THC and CBD?
- Amount of use
--When was the last time you vaped?
--How often do you vape?
--How long have you been vaping?
- Source
--Where do you purchase your vaping supplies?
--What brands are your vaping devices, cartridges, and oils?
► Report suspected cases to the local health department within one business day.
- An official from your local health department may interview the patient or family members.
- The local health department will contact the hospital lab to arrange the transfer of biospecimens remaining from the patient to the public health lab. You do not have to order any specific cultures or tests on blood or urine that you would not normally request for the care of the patient.
- The local health department may collect vape devices and cartridges from the patient or family for testing.
View the full CDPH communication at LAHAN.