STATE OF WISCONSIN
Department of Health Services
Division of Public Health

1 West Wilson Street
PO Box 2659
Madison WI 53701-2659
Telephone: 608-266-1251
Fax: 608-267-2832
TTY: 800-947-3529

Date: July 25, 2019
To:

BEOH-2019-02

Wisconsin Healthcare Providers, Infection Preventionists, Local Health Departments, and
Tribal Health Agencies

From: Jonathan Meiman, MD
Chief Medical Officer and State Occupational and Environmental Disease
Epidemiologist, Bureau of Environmental and Occupational Health (BEOH)

Severe Pulmonary Disease Among Adolescents who Reported Vaping
PLEASE DISTRIBUTE WIDELY
During July 2019, 8 cases of severe pulmonary disease among adolescents were reported to the
Wisconsin Department of Health Services (DHS). Patients resided in the counties of Milwaukee,
Waukesha, and Winnebago and presented with respiratory symptoms including cough, shortness
of breath, and fatigue. Symptoms worsened over a period of days or weeks before admission to
the hospital. Other symptoms reported by some patients included fever, anorexia, pleuritic chest
pain, nausea, and diarrhea. Chest radiographs showed bilateral opacities, typically in the lower
lobes, and CT imaging of the chest showed diffuse ground-glass opacities, often with subpleural
sparing. Evaluation for infectious etiologies was negative in all patients. Some patients had
progressive respiratory compromise requiring endotracheal intubation but subsequently
improved with systemic steroids.
DHS is currently investigating the possible cause of these illnesses. All patients reported vaping
in the weeks and months prior to hospital admission. The names and types of products used
remain unknown, and patient interviews are ongoing. Clinicians are encouraged to remain alert
for potential cases among persons presenting with progressive respiratory symptoms who report
a history of inhalation drug use, particularly vaping.
Clinicians who become aware of cases similar to those described above are encouraged to report
them to their local public health officer. DHS is actively tracking cases, and clinician assistance
is appreciated to determine the scope and cause of this disease cluster. For questions, please
contact Megan Elderbrook in the Bureau of Environmental and Occupational Health at 608-2661120 during business hours.

dhs.wisconsin.gov