SPOKANE, Wash. — Two cases of severe lung and respiratory illness related to e-cigarette use and vaping have been confirmed in Spokane County, according to the state Department of Health.

The cases are among three in Washington state that the DOH announced it would review to see if they met the Centers for Disease Control and Prevention guidelines for vaping-related illness last week.

“The symptoms of these patients match what the Centers for Disease Control and Prevention have asked all state and local health jurisdictions to be on the lookout for in regards to the nationwide investigation into this matter,” said Washington State Health Officer Kathy Lofy. “This is now a statewide outbreak.”

Spokane County Health Officer Bob Lutz held a press conference on Monday with updates about the cases and said people should avoid vaping as the investigation continues.

"The cause of this outbreak remains unknown at this time. Vaping is not safe," Lutz said. "Everyone should be aware of the risk of severe lung disease and should avoid vaping at this time until the cause of the outbreak is known."

Lutz warned those who do continue to vape to not buy any vaping products or materials that are off-the-street or not from a trust manufacturer. He also said it is not currently an accepted method of tobacco cessation.

The two Spokane County victims, one of whom is a teen and the other who is in their 20s, experienced shortness of breath, unproductive coughs that persisted for multiple days and chest pain, Lutz said.

Lutz said the health department has been concerned about vaping for "quite some time" and the main concern is what is causing the illnesses.

"That's the million-dollar question: What is the common denominator?" Lutz said.

The SRHD is asking anyone experiencing chest pain, persistent cough or shortness of breath who vapes to seek medical attention. They also want the public, especially teens and underage users of vaping-products, to know of the activity's dangers.

"I think for me, the bottom line is vaping is not safe," Lutz said.

All three cases reported vaping prior to their illness but the DOH has not identified a product, device or additive common to all three cases. Investigations into the specifics of products, devices and additives are ongoing.

The DOH will update confirmed cases on its website as more facts become available.

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Washington has one other confirmed case of vaping-related illness out of King County. There have been no confirmed deaths in Washington state so far.

Two cases of respiratory disease related to the use of vaping products have also been confirmed in Idaho.

Six deaths have been confirmed nationwide in relation to vaping, in addition to hundreds of cases of illness, according to the CDC.

In August, the CDC and the Food and Drug Administration launched a multi-state investigation regarding an outbreak of severe lung disease associated with the use of vaping devices and e-cigarette products.

State health officials urge clinicians to report any known hospitalized cases of severe lung disease associated with vaping to their local health department.

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