Vaping-Associated Pulmonary Illness

The Tennessee Department of Health is asking health care providers across the state to report any cases of suspected serious respiratory illness they treat among patients who use electronic cigarettes or other vaping devices.

Patients have had symptoms including cough, shortness of breath and fatigue, with symptoms growing worse over a period of days or weeks before admission to the hospital. Other symptoms may include fever, chest pain, nausea, abdominal pain and diarrhea. If you are experiencing these symptoms, see a health care provider.

TDH will investigate any cases reported to look for common factors and collect information on specific components or brands of vaping products that may be the source of the illness.

x-ray image of lungs

Tennessee Investigation (as of January 16, 2020):

  • 78* lung injury cases associated with e-cigarette use or vaping have been reported to TDH.
    • 69 of the 78 cases have required hospitalization
  • Two deaths** have been confirmed.
  • Among 78 cases with data on age and sex:
    • 64 percent are male.
    • The median age is 24 years and ages range from 15 to 63 years.
    • 81 percent are under 35 years old.
  • To date, national data suggest that products containing THC, particularly those obtained off the street or from other informal sources (e.g., friends, family members, or illicit dealers), are linked to most of the cases and play a major role in the outbreak.


*Case - evidence of respiratory illness, with no other cause identified, and report vaping in the last 90 days.

**Death – included in the number of cases

As of November 11, 2019, in order to remain consistent with CDC data collection and reporting, TDH will investigate lung injury cases that required hospitalization only, and will no longer investigate lung injury patients that were only treated as outpatients.


Reporting Suspected Cases

Health care providers can report suspected cases through any of the following means:

  • Fill out this form and return by email to or by fax to 615-741-3857, or
  • Contact your regional or metropolitan health department, or
  • Email TDH at to report suspect cases as soon as possible. Please provide
    • Patient’s home county
    • Brief clinical description
    • Reporting provider’s name, email address, telephone number

Additional Resources