An outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) started in 2019[3] among users of illegal, unregulated cannabis vaping products,[2] almost exclusively in the United States.[4] The first cases of this particular outbreak were identified in Illinois and Wisconsin in April 2019; as of 18 February 2020, a total of 2,807 hospitalized cases, including 68 deaths, have been confirmed. According to the U.S Centers for Disease Control (CDC), “Vitamin E acetate is strongly linked to the EVALI outbreak…Evidence is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC or non-THC products, in some of the reported EVALI cases”.[2] Cases peaked in September 2019, and have slowly declined since. The CDC stopped reporting on EVALI cases in February 2020, due to the decline in cases, but as of December 2020, continues to monitor cases that may arrive in emergency departments.[5] Some states continue to record new EVALI cases. As of January 2022, the state of California has reported at least 40 cases on their update page, that were diagnosed after February 2020.[6] According to an article in the Radiological Society of North America news published in March 2022, EVALI cases continue to be diagnosed. “EVALI has by no means disappeared,” Dr. Kligerman said. “We continue to see numerous cases, even during the pandemic, many of which are initially misdiagnosed as COVID-19.”[7] There have been at least 73 cases diagnosed in Utah after the last CDC update of February 2020.
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