NSSP Develops Queries to Support Lung Injury Response

In mid-August 2019, NSSP staff began working with members of the NSSP CoP and CDC’s National Center for Injury Prevention and Control (the Injury Center) to develop queries that could support CDC’s ongoing multistate lung injury response. The NSSP and Injury Center teams collaborated with community partners to draft and refine two definitions.

One query was designed to capture records that mention e-cigarette usage, and the other query searches for instances of severe respiratory injuries. The latter query includes respiratory distress and unexplained pneumonia and excludes infectious disease (e.g., influenza, pertussis, Legionella, bacterial pneumonia, and upper respiratory infection), asthma, sickle cell disease, cystic fibrosis, suicide, dialysis, diabetes, epilepsy, pregnancy, cancers, vehicle crashes, firearm injuries, heat-related illness, opioid and stimulant use, and other potential etiologies.

The NSSP team implemented a vaping query into NSSP–ESSENCE as a preset category. However, the severe respiratory injury query has not been added to the NSSP–ESSENCE application as a pre-built search option because lessons learned from health departments indicate that it is most useful when adapted to available local data. For example, jurisdictions with access to triage notes or other fields, such as pulse oximetry, may incorporate these into the search to reduce noise. The query can also be limited to patients who were hospitalized using discharge codes in the Advanced Query Tool. Jurisdictions that do not use ESSENCE can adapt the text of the query for use in their own local syndromic surveillance system.

Both queries may identify emergency department visits and hospitalizations that are unrelated to the current outbreak.

Next Steps

• CDC continues to work closely with state and local health departments by providing tools to help them investigate a cluster of lung injuries linked to e-cigarettes, particularly among adolescents and young adults.
• CDC and NSSP CoP partners are collaborating to apply these queries to bolster state-led case finding and explore the use of syndromic data to understand epidemiologic features of the outbreak.

CDC Resource:

Outbreak of Lung Illness Associated with Using E-cigarette Products: Investigation Notice