Note: This webpage is no longer current and is for historical purposes only. See Health Effects of Vaping for the latest information.

2019 Local E-cigarette, or Vaping, Product Use Associated Lung Injury (EVALI) Situation 

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Updates

Medical providers across the United States noticed sudden and serious lung problems linked to vaping in June 2019. Medical providers in many states reported cases of E-cigarette, or Vaping, Product Use Associated Lung Injuries (EVALI). Cases were reported in California and in San Diego County. EVALI is also known as Vaping-Associated Pulmonary Injury (VAPI). The specific cause of EVALI has not yet been found. Local, state, and federal health officials are investigating the cause of EVALI. 

In California, most cases of EVALI reported vaping cannabis or cannabidiol (CBD) oils. No specific common vaping products have been identified. Investigators noticed a pattern of cases purchasing vape cartridges from “pop-up shops.” These unlicensed shops open for an unknown amount of time, advertise by word of mouth, and move locations often. All cases in California needed hospital care. Most cases needed respiratory support. 

San Diego County cases reported vaping cannabis products and/or CBD oils from:

• “Pop-up shops”, 
• Other unlicensed retailers, and 
• The internet. 

No infectious cause has been found for these EVALI cases. However, the Centers for Disease Prevention and Control (CDC) has identified vitamin E acetate as a chemical of concern among people with EVALI. Vitamin E is sometimes added to THC vaping products to thicken them. Vitamin E has been found in THC vaping products used by San Diego residents who had EVALI. 

Between June 2019 and October 6, 2021, San Diego County reported 64 confirmed and probable EVALI cases among residents. All cases needed hospital care. There has been one death. Ages of patients have ranged from 17 to 76 years, with a median age of 30.5 years, and 50% have been male.

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Communications

County of San Diego

• California Health Alert Network (CAHAN) San Diego Communications
  • Health Advisory: E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) (6/11/20)
  • Health Advisory: Vaping-associated Pulmonary Injury (10/3/19)
  • Health Advisory: Vaping-associated Pulmonary Injury (8/28/19)
• County News Center
  • San Diego Woman Dies from Vaping-Related Lung Injury (6/11/20)

California Department of Public Health

• Health Advisory: E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) Cases During California’s COVID-19 Response (5/9/20)
• Health Advisory: Vaping Associated Pulmonary Injury (10/1/19)
• Health Advisory: Vaping Related Lung Illness: A Summary of the Public Health Risks and Recommendations for the Public (9/24/19)
• Health Advisory: California Department of Public Health Issues Public Health Advisory Urging Everyone to Refrain from Vaping (9/24/19)

Centers for Disease Control and Prevention 

• Interim Guidance for Health Care Professionals Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use–Associated Lung Injury and for Reducing the Risk for Rehospitalization and Death Following Hospital Discharge (12/20/19)
• Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury (11/19/19)
• CDC Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping

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For more information, call the Epidemiology Unit at (619) 692-8499 or send an e-mail.