The CDC has issued two advisories — one on how to evaluate flu-like symptoms in the face of concerns about vaping, and the other about how the CDC will count and report e-cigarette and vaping–associated lung injuries (EVALIs).
Given that EVALI symptoms are similar to those of influenza, the agency makes several recommendations in MMWR, among them:
Ask patients with flu-like symptoms about their use of e-cigarettes and vaping
Strongly consider influenza testing during flu season
Evaluate suspected EVALI cases with pulse oximetry and chest imaging
Consider outpatient management for stable EVALI
Use corticosteroids with caution in patients who aren't admitted
From an epidemiologic standpoint, the CDC says it will no longer count nonhospitalized EVALI cases, given that hospitalized and nonhospitalized patients share similar characteristics and that only 5% of cases were nonhospitalized.
The advisory recommends that patients with EVALI can be managed as outpatients if they have oxygen saturations at 95% or above on room air, no respiratory distress, and no comorbid conditions that could impair pulmonary reserve.
Separately on Tuesday, the American Medical Association called for an immediate ban on all vaping and e-cigarette products, except those that have FDA approval for smoking cessation and are available with a prescription.
Source: NEJM Journal Watch