BALTIMORE – Maryland’s health department is investigating five cases of severe lung illness in people who became ill after vaping in the last two months.

The department said Wednesday the patients reported respiratory symptoms such as shortness of breath and pain associated with breathing and coughing.

The department says other symptoms included fever, nausea, vomiting and diarrhea.

The cases showed no clear infectious cause, and all required hospitalization.

So far, none of the cases in Maryland has been fatal.

The department says the cases are part of the nearly 200 reported incidents of vaping-related illnesses in 22 states, resulting in at least one death.

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