Two vaping advisories released by CDC

The United States Centres for Disease Control and Prevention (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 Morbidity and Mortality Weekly Report (MMWR), among them:Ask patients with flu-like symptoms about their use of e-cigarettes and vapingStrongly consider influenza testing during flu seasonEvaluate suspected EVALI cases with pulse oximetry and chest imagingConsider outpatient management for stable EVALIUse corticosteroids with caution in patients who are not admitted

From an epidemiologic standpoint, the CDC says it will no longer count non-hospitalised EVALI cases, given that hospitalised and non-hospitalised patients share similar characteristics and that only 5% of cases were non-hospitalised.

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.