National Outbreak Case Definitions: Severe Pulmonary Disease Associated with Vaping or Dabbing

Date of last revision: September 25, 2019^{Footnote *}
Date of last review: September 25, 2019

Confirmed

History of vaping or dabbing^{Footnote †} in the 90 days prior to symptom^{Footnote **} 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

History of vaping or dabbing^{Footnote †} in the 90 days prior to symptom^{Footnote **} 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^{Footnote §} 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^{Footnote §} 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).