EVALI: How do I manage

It is believed that e-cigarette entered Malaysian market in 2000 and gained popularity in 2010s. The number of e-cigarette users almost was estimated to be 1.1 million based on National Health and Morbidity Survey 2019.

Middle of 2019, several cases of acute and subacute lung injury caused by e-cigarette use were reported in the USA.

The number of cases increased within a short period of time, leading to the Center of Disease Control and Prevention of the USA announcing EVALI outbreak in September 2019. The conditions were serious as patients had to be admitted and, in some cases, ventilated. There were casualties as well. By Feb 2020, more than 2800 cases with 68 deaths were reported to CDC from all over the USA. Sporadic cases were also reported outside USA and Malaysia is not exempted. At the end of 2019, early 2020, Malaysia had 2 cases of probable EVALI.

The diagnosis of EVALI, is made based on 2019 Lung Injury Surveillance Primary Case Definitions outlined by the United States Center for Disease Control and Prevention. The 2 main components of the case definition are exposure to e-cigarette use and abnormal finding on imaging examination. Up to date, EVALI is treated symptomatically. Systemic corticosteroids may be used in severe cases. Several regimens have been used tailoring to severity of illness.