E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and other associated respiratory illnesses: Tabletop Discussion and Research Report Submission Ceremony

On the 23rd of January 2022 (Sunday), a tabletop discussion on EVALI and associated respiratory illnesses was held at Hotel Pulse Grande Putrajaya. YBhg. Datuk Dr Chong Chee Kheong, Deputy Director-General of Health (Public Health) officiated the event, which was also attended by YBhg. Datuk Dr Norhayati Binti Rusli, Director of Disease Control Division, Ministry of Health Malaysia and Professor Dr Nazirah Binti Hasnan, Director of University Malaya Medical Centre (UMMC). The tabletop discussion was organised by UMMC and the Department of Social and Preventive Medicine, in collaboration with the Disease Control Divison, Ministry of Health Malaysia.

The main purpose of this tabletop discussion was to share and disseminate findings from a prospective cohort study conducted in UMMC from January to November 2021 on the incidence of EVALI among severe acute respiratory illness (SARI) patients with a history of electronic cigarette use. 

The event began with an introduction to electronic cigarettes and vaping, followed by an overview of EVALI, and finally a summary and conclusion to the project. The use of electronic cigarettes or vapes is thought to be the cause of the emergence of EVALI, a new type of disease. The symptoms of EVALI illness are similar to those of influenza and other lung disorders, including COVID-19. It is difficult for doctors to tell the difference between influenza, COVID-19, and EVALI in the early stages of disease diagnosis. Around the world, the disease is spreading at an alarming rate. According to statistics from the United States as of February 2020, the total number of patients hospitalised as a result of EVALI was 2,807, with 68 people dying.

A research team led by UMMC Respiratory Physician Dr Wong Chee Kuan was formed to conduct studies and research on this disease. Co-investigators from UMMC, the Department of Social and Preventive Medicine and the Ministry of Health, Malaysia make up the study team.

Team Members of EVALI Project:

Principle Investigator	Dr Wong Chee Kuan	Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre
Co-investigators	Associate Professor Dr Farizah Binti Mohd Hairi	Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya
	Dr Noraryana Binti Hassan	Tobacco Control Sector and FCTC Secretariat, Disease Control Division, Ministry of Health, Malaysia
	Dr Norliana Binti Ismail	Tobacco Control Sector and FCTC Secretariat, Disease Control Division, Ministry of Health, Malaysia
	Dr Muhamad Hairul Nizam Bin Abd Hamid	Tobacco Control Sector and FCTC Secretariat, Disease Control Division, Ministry of Health, Malaysia
	Dr Muaz Bin Sayuti	Tobacco Control Sector and FCTC Secretariat, Disease Control Division, Ministry of Health, Malaysia
	Dr Mohd Afiq Bin Mohd Nor	Department of Emergency Medicine, University of Malaya Medical Centre
	Dr Vijayan A/L Munusamy	Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre
	Dr Teo Woon Shen	Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre
	Dr Khuan Wai Hou	Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre
	Marhainie Binti Mohamad	Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Centre
	Nur Fadhlina Binti Othman	Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya
	Ariyani Rinaldi	Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya
	Ummi Nadiah Binti Yusoff	Tobacco Control Sector and FCTC Secretariat, Disease Control Division, Ministry of Health, Malaysia

Table Top Discussion on EVALI

The research, which has been continuing for approximately a year, received sponsorship and assistance from the World Health Organization (WHO). The aim was to determine the incidence of EVALI among severe acute respiratory infection (SARI) patients with a history of electronic cigarettes used in UMMC. Between January and November 2021, 60 patients with a history of using e-cigarettes were tested, and three were diagnosed with EVALI. The incidence of EVALI among SARI cases was determined to be 840 per 100,000. 

The results of this study are expected to assist the Ministry of Health Malaysia in formulating policies and strict control measures on the issue of the use of electronic cigarettes in Malaysia.

Almost 40 participants attended this event including medical professionals, academicians and journalists. It was also attended by Dr Lim Yin Cheng from the Department of Social and Preventive Medicine; A/P Dr Amer Siddiq Amer Nordin, Dr Siti Idayu Hasan and Dr Megat Mohamad Amirul Amzar bin Megat Hashim from the Nicotine Addiction Research Collaboration Group (NARCC).

This report was written by Dr Lim Yin Cheng, Associate Professor Dr Farizah Mohd Hairi, and Nur Fadhlina Othman, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.