OLYMPIA, Wash. (AP) – Washington State Department of Health officials say two more Washington residents have received medical treatment for severe lung disease linked to vaping in what officials say is now a statewide outbreak.

Officials said Monday that the Spokane Regional Health District reported the new cases involve a teen and someone in their 20s. The first confirmed case was reported last week in a Seattle-area teen. Officials said previously that teen had been hospitalized with a fever, cough and shortness of breath.

Officials say the patients in all three cases reported vaping prior to illness.

Washington State Health Officer Kathy Lofy said Monday the cases now comprise a statewide outbreak.

She says the patients’ symptoms match what the Centers for Disease Control and Prevention have asked state and local health jurisdictions to be on the lookout for in regards to the national investigation and outbreak.