How to Differentiate Vaping-Related Lung Injury From Influenza or Respiratory Infections

The Centers for Disease Control and Prevention (CDC) has released interim guidance for physicians treating patients with lung injury caused by suspected use of e-cigarette or vaping products. As rates of influenza and other respiratory infections rise during the winter, the agency cautions that it may be challenging for healthcare providers to differentiate between e-cigarette or vaping product use–associated lung injury (EVALI) and the flu because symptoms of the two health conditions are similar. These symptoms can include fever, cough, headache, myalgias and fatigue. The CDC says it’s critical that healthcare providers recognize EVALI quickly in order “to reduce severe outcomes.”

 As outlined by the CDC, physicians are advised to:

1. ask patients with respiratory, gastrointestinal, or constitutional symptoms about the use of e-cigarette or vaping products;
2. evaluate those suspected to have EVALI with pulse oximetry and obtain chest imaging, as clinically indicated; 
3. consider outpatient management for clinically stable EVALI patients who meet certain criteria;
4. test patients for influenza, particularly during influenza season, and administer antimicrobials, including antivirals, in accordance with established guidelines;
5. use caution when considering prescribing corticosteroids for outpatients, because this treatment modality has not been well studied among outpatients, and corticosteroids could worsen respiratory infections;
6. recommend evidence-based treatment strategies, including behavioral counseling, to help patients discontinue using e-cigarette or vaping products; and
7. emphasize the importance of annual influenza vaccination for all persons aged 6 months or older, including patients who use e-cigarette or vaping products.

Click here for more details on the CDC recommendations.

MLMIC encourages all our insured physicians, other healthcare providers and facility staff to educate themselves regarding vaping illness and the current recommendations for treating these patients.