The number of vaping associated pulmonary illness cases documented in the US now numbers over 800. However, to date, there have been no reported cases of pulmonary illness linked to vaping in BC. There is one confirmed case in Quebec and a possible case in Ontario.

As the national case definition of Severe Pulmonary Disease Associated with Vaping or Dabbing has been finalized, there is now additional guidance to assist physicians in investigating and reporting possible cases.

If you suspect vaping-associated pulmonary disease, the following investigations must be performed:

  • Respiratory viral panel, influenza polymerase chain reaction (PCR) or rapid test

Also please consider the following investigations, if clinically indicated, to assist in making a case determination:

  • Other tests to rule out infectious causes, including blood cultures, sputum cultures, BAL, Legionella urine antigen assays, and an HIV test
  • Chest imaging investigations, including CXR and/or CT
  • Investigations to rule out plausible alternative diagnoses, including cardiac, rheumatologic, or neoplastic processes

If a patient has not yet received adequate work-up to rule out an infectious process, OR a patient has an infection that does not fully explain the respiratory disease process, please still report, as the patient may be considered a probable case. If infection fully explains the patient’s disease process, this patient will not be considered a case and reporting is not required. 

Patients do not have to be hospitalized to be considered potential cases.

The Fraser Health reporting form may be used to support your reporting, and can be faxed to 604-930-5414. You can also phone the MHO line at 604-587-3828.

Below are the latest detailed case definitions. They are for surveillance not diagnostic purposes.

Thank you for your diligence in reporting on this novel illness.


Confirmed case:

History of vaping or dabbing in the 90 days prior to symptom onset

AND

Pulmonary infiltrate, such as opacities on plain film chest radiograph or ground-glass opacities on chest computed tomography

AND

Absence of pulmonary infection on initial work-up: Minimum criteria include negative respiratory viral panel, influenza polymerase chain reaction (PCR) or rapid test, if local epidemiology supports testing. All other clinically indicated respiratory infectious disease testing (e.g., urine antigen for Legionella, sputum culture if productive cough, bronchoalveolar lavage (BAL) culture if done, blood culture, human immunodeficiency virus (HIV)-related opportunistic respiratory infections if appropriate) must be negative.

AND

No evidence in medical records of alternative plausible diagnoses (e.g., cardiac, rheumatologic or neoplastic process).


Probable case:

History of vaping or dabbing in the 90 days prior to symptom onset

AND

Pulmonary infiltrate, such as opacities on plain film chest radiograph or ground-glass opacities on chest computed tomography

AND

Infection identified via culture or polymerase chain reaction, but clinical team believes this is not the sole cause of the underlying respiratory disease process   OR   minimum criteria to rule out pulmonary infection not met (testing not performed) and clinical team believes infection is not the sole cause of the underlying respiratory disease process

AND

No evidence in medical record of alternative plausible diagnoses (e.g., cardiac, rheumatologic or neoplastic process).


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