For a more detailed review of the respiratory effects of e-cigarettes, see Gotts and colleagues.[9] In the US, there was a national outbreak of EVALI, with 2807 hospitalizations and 68 deaths as of 18 February 2020.[47] This illness peaked in September 2019 and is now steadily declining.[48,49] In comparison, EVALI cases in Canada have been relatively sparse, with a total of 19 cases, 15 hospital admissions, and no deaths reported as of 11 March 2020.[50] EVALI was first reported in the US in August 2019 in a case series that included 53 patients.[51] Most of those patients presented with respiratory symptoms (dyspnea, cough, chest pain), gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain), and constitutional symptoms (fever, chills, malaise)
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