Update: Interim Guidance for Health Care Providers regarding the Management Approach of Patients with Suspected E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI)

Date: Thursday, November 21, 2019

Time: 2:00–3:00p.m. ET


CDC, the U.S. Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders continue to investigate a national outbreak of electronic cigarette (e-cigarette), or vaping, product use–associated lung injury (EVALI).

EVALI remains a diagnosis of exclusion because, at present, no specific test or marker exists for its diagnosis, and evaluation should be guided by clinical judgment. Because patients with EVALI can present with symptoms similar to influenza or other respiratory infections (e.g., fever, cough, headache, myalgias, or fatigue), it might be difficult to differentiate EVALI from influenza or CAP (community-acquired pneumonia) on initial presentation, and EVALI may cooccur with respiratory infections. A large number of patients will be presenting to healthcare facilities with respiratory symptoms during the winter season who may not meet criteria for hospital admission, and this will be happening in the context of a national outbreak of EVALI.

During this COCA Call, U.S. health care providers will learn recommendations for managing patients with suspected or known EVALI when respiratory infections such as influenza are more prevalent in the community, as published in MMWR on November 19, 2019.

At the conclusion of the session, the participant will be able to accomplish the following:

  1. Describe the questions to ask patients who present with respiratory, gastrointestinal, or constitutional symptoms about the use of e-cigarette, or vaping products, and how to evaluate patients with suspected EVALI according to CDC recommendations.
  2. Define the criteria for patients who may be appropriate candidates for outpatient management of EVALI.
  3. Discuss the importance of influenza vaccination and testing; empiric use of antimicrobials, including antivirals (as clinically indicated); and consultation with specialists, as appropriate, to optimize patient management.
  4. Describe how corticosteroids for the treatment of EVALI in the outpatient setting may worsen respiratory infections commonly seen in the outpatient setting.


CDR Mary (Molly) Evans, MD, MPH (USPHS)
Clinical Task Force Lead, 2019 CDC EVALI Response
Medical Officer, Division of Overdose Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention

CAPT Timothy Uyeki, MD, MPH (USPHS)

Chief Medical Officer, Influenza Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention

CAPT Jennifer Wiltz, MD, MPH, FAAP, FAHA (USPHS)
Clinical Task Force Deputy, 2019 CDC EVALI Response
Senior Medical Officer, Division for Heart Disease and Stroke Prevention
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

A few minutes before the webinar begins, please click the below link to join:
https://zoom.us/j/824203014external icon

Or join by iPhone one-tap :
US: +16468769923,,824203014#  or +16699006833,,824203014#

Or join by Telephone (for higher quality, dial a number based on your current location):
Dial US: +1 646 876 9923  or +1 669 900 6833

Webinar ID: 824 203 014

International numbers are available: https://zoom.us/u/anixAVglVexternal icon

Continuing Education is not offered for this COCA Call.

  • Physicians
  • Nurses
  • Pharmacists
  • Veterinarians
  • Physician Assistants
  • Health Educators
  • Other Clinicians
  • Contact Information:coca@cdc.gov
  • Support/Funding:Centers for Disease Control and Prevention, Emergency Risk Communication Branch
  • Method of Participation:You may participate in the educational activity by viewing the program information above.
Page last reviewed: November 18, 2019