Case Definition

Severe Pulmonary Disease Associated with E-cigarette Use Outbreak Case Definition (CDC) - August 26, 2019
	Confirmed	Using an e-cigarette ("vaping") or dabbing* in 90 days prior to symptom onset
		AND
		Pulmonary infiltrate, such as opacities on plain film chest radiograph or ground-glass opacities on chest CT
		AND
		Absence of pulmonary infection on initial work-up: Minimum criteria include negative respiratory viral panel, influenza PCR or rapid test if local epidemiology supports testing. All other clinically indicated respiratory ID testing (e.g., urine Antigen for Streptococcus pneumoniae and Legionella, sputum culture if productive cough, bronchoalveolar lavage (BAL) culture if done, blood culture, HIV-related opportunistic respiratory infections if appropriate) must be negative
		AND
		No evidence in medical record of alternative plausible diagnoses (e.g., cardiac, rheumatologic or neoplastic process).
	Probable	Using an e-cigarette ("vaping") or dabbing* in 90 days prior to symptom onset
		AND
		Pulmonary infiltrate, such as opacities on plain film chest radiograph or ground-glass opacities on chest CT
		AND
		Infection identified via culture or PCR, 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 this 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).
	Footnotes	* Using an electronic device (e.g., electronic nicotine delivery system (ENDS), electronic cigarette, e-cigarette, vaporizer, vape(s), vape pen, dab pen, or other device) or dabbing to inhale substances (e.g., nicotine, marijuana, THC, THC concentrates, CBD, synthetic cannabinoids, flavorings, or other substances).
		**Clinical team caring for the patient.