APHL and its member laboratories are working hard in collaboration with the
US Centers for Disease Control and Prevention (CDC), the
US Food and Drug Administration (FDA), the
Council of State and Territorial Epidemiologists (CSTE) and other public health partners to determine what is causing vaping-related lung injury across the United States. Partnership with federal agencies, state and local colleagues is essential to determining the cause of this respiratory outbreak.
Federal Response and Guidance
CDC recommends that until more is known, people who are concerned about this illness should refrain from using e-cigarette or vaping products. If you are using e-cigarettes for smoking cessation, CDC warns against returning to smoking cigarettes and recommends contacting a health care provider for other options. CDC also warns that women who are pregnant and adults who do not currently use e-cigarettes should not begin using them.
FDA is collecting and analyzing samples from the states, collating product-specific information and investigating sources. FDA is focused on determining the sources and distribution of products. Agents are responding throughout the country by collecting vaping devices including pods and cartridges, and interviewing individuals. FDA emphasizes they are gathering information and are not pursuing the prosecution of patients.
Public Health Laboratory Response
States, localities and territories are submitting products to the
FDA’s Forensic Chemistry Center. APHL is helping to facilitate triage and transfer of samples to FDA. Some APHL member labs are performing targeted and non-targeted analysis of products and, in some cases, clinical specimens.
A September 6, 2019 article published in the
New England Journal of Medicine provides a preliminary report on the
coordinated public health investigation in Illinois and Wisconsin.
APHL is working with member laboratories to support their individual responses to this outbreak.
Incident Command System
APHL has established an Incident Command System with Julianne Nassif serving as science officer. Please send any questions or concerns about the vaping illness outbreak to
email@example.com, a mailbox monitored 24/7 by APHL staff.
Community of Practice
APHL has established a community of practice for state laboratories involved in the vaping illness outbreak response. This consists of two primary modes of communication:
A searchable electronic platform or discussion board, where members may post documents and events on the calendar. Such platforms have been used effectively in other topic areas and emergency incidents.
Bi-weekly calls on Fridays at 3:00 pm ET with members of this community of practice. Calls are intended for analysts to share what they are doing to support this response, questions for their peers and best practices. Calls are restricted to APHL members and key public health partners.
APHL distributed a survey to all state and local laboratory directors on September 30, 2019 to determine activities, capabilities and needs related to the 2019 lung injury response associated with vaping. If you are a state or local public health laboratory direct and did not receive this survey, please email
firstname.lastname@example.org. Responses were due to APHL by October 7, and summary results will be created and posted as quickly as possible.
APHL requested and received specimen collection and storage guidance from CDC. To request a copy of this document please email