Investigation: 5 Things You Need to Know
THC Vaping: 4 Tips to Stay Safe
The Wisconsin Department of Health Services and local health departments are investigating a cluster of people with severe lung disease who all reported recent vaping, a majority of them saying they vaped THC products.
For the latest case counts, visit our Outbreaks and Investigations webpage.
- Age. Most patients are adolescents and young adults, but some patients are adults in older age groups.
- Symptoms. Patients often have a range of initial symptoms, including shortness of breath, chest pain, cough, nausea, vomiting, fever, and weight loss.
- Severity. The majority of patients went on to develop severe breathing problems requiring hospitalization, and in some cases, had to be put on ventilators in order to breathe.
- Deaths. No deaths have been reported in Wisconsin.
- Geography. Counties with cases include: Adams, Brown, Burnett, Dane, Dodge, Door, Douglas, Fond du Lac, Grant, Green, Jefferson, Juneau, Kenosha, La Crosse, Lincoln, Marathon, Milwaukee, Monroe, Outagamie, Pierce, Portage, Racine, Rock, Sauk, Shawano, Sheboygan, St. Croix, Vernon, Walworth, Washington, Waukesha, Waupaca, and Winnebago.
For the latest updates on the nationwide outbreak and the latest public health recommendations, visit the Centers for Disease Control and Prevention's (CDC) outbreak webpage.
The majority of cases reported using e-cigarettes or other vaping devices to inhale THC-containing products, such as waxes and oils.
- THC is the active ingredient in marijuana.
- Vaping cartridges containing THC may contain chemicals or additives that are unknown, unregulated, and unsafe.
- Among patients who reported vaping THC, a wide variety of brand names and flavorings were reported.
- We urge the public to avoid vaping any THC products.
- This is a complex and ongoing investigation, and we are working to gather information about the products used, collect products for testing, and investigate new cases. We will continue to provide updates when new information becomes available.
- August 29: Majority of Wisconsin Lung Disease Patients Who Reported Vaping Cite THC Products
- August 8: Older Age Groups Now Included in Investigation of Lung Disease Among People Who Reported Vaping
- August 2: New Cases Identified in Investigation of Lung Disease Among Teens and Young Adults Who Reported Vaping
For Health Care and Lab Professionals
We continue to investigate reports of vaping-associated lung injury throughout Wisconsin. The tools below are intended to help clinicians and clinical labs identify, manage, and report possible cases.
Detailed clinical information about vaping-associated lung injury can be found in our clinical fact sheet, P-02503. This guide is intended to help clinicians identify, manage, and treat patients with this condition.
How to report
Patients who present with respiratory and/or gastrointestinal symptoms, have abnormal chest imaging, and have a history vaping in the past 90 days should be reported to your local health department for investigation of possible vaping-associated lung injury.
Please fill out this case report form and return it to your local health department or DHS (see instruction on form). Please also have your patient complete the vaping questionnaire (page 2 of the case report form) and send it back with the attached case report form.
If your patient has e-cigarette or vaping products they are willing to submit for laboratory testing, let them know to fill out the patient vaping survey, and that their local health department will collect these during their investigation.
Submitting clinical specimens
Available clinical specimens collected from patients with possible vaping-associated lung injury should be sent to the Wisconsin State Lab of Hygiene (WSLH). WSLH is requesting residual samples of the following specimens types for all suspected cases:
- Lung tissue biopsy
- Bronchoalveolar lavage (BAL) fluid
If one or more of these specimens has been collected from your patient, please encourage your clinical laboratory to send the specimens to WSLH using the following guidance:
- WSLH instructions: Guide to preparing, packaging, and shipping specimens to WLSH for vaping-associated lung injury
- WSLH requisition form: Please send to WSLH with each sample
- CDC - Updated Interim Guidance for Health Care Providers (10/11/2019)
- CDC - Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping: For Healthcare Providers
- CDC - Health Advisory: Severe Pulmonary Disease Associated with Using E-Cigarette Products
- September 10 memo outlining updated case information
- July 25 memo outlining initial case information
- Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury — United States, October 2019. Morbidity and Mortality Weekly Report (10/11/2019)
- E-cigarette Product Use, or Vaping, Among Persons with Associated Lung Injury - Illinois and Wisconsin, April—September 2019. Morbidity and Mortality Weekly Report (9/27/2019)
- Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping—United States, 2019. Morbidity and Mortality Weekly Report (9/27/2019)
- Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Preliminary Report. New England Journal of Medicine (9/6/2019)
- Severe Pulmonary Disease Associated with Electronic Cigarette Product Use - Interim Guidance. Morbidity and Mortality Weekly Report (9/6/2019)
For the Public
In light of the recent outbreak of vaping-associated lung injuries in Wisconsin and across the U.S, we recommend the following:
- Do not use e-cigarette or vaping products that contain THC.
- Do not buy any e-cigarette or vaping products, particularly those with THC, from friends, dealers, or other unregulated sources.
- The use of e-cigarettes is unsafe for all ages, including youth and young adults. Nicotine is highly addictive and can harm teen brain development, which continues into the early to mid-20s. If you don't currently use tobacco products, do not start using e-cigarettes or vaping products.
- There is no safe tobacco product. All tobacco products, including e-cigarettes, carry a risk.
- If you are ready to quit smoking, call 1-800-QUIT NOW for free help. There are FDA-approved medications to help you quit.
- If you are a youth or adult addicted to marijuana, visit the Substance Abuse and Mental Health Services Administration's Treatment Locator to find treatment in your area, or call 1-800-662-HELP (4357).
- If you have recently used an e-cigarette or vaping product and you have symptoms like those reported in the outbreak, see your doctor.
For more information, visit the CDC's outbreak webpage.
To learn more about vaping and e-cigarettes: