NASHVILLE (AP) — Tennessee officials are asking health care providers to report cases of suspected serious respiratory illness among patients who use electronic cigarettes or other vaping devices.

The state Department of Health says the federal Centers for Disease Control and Prevention is investigating a cluster of severe pulmonary disease among people who use e-cigarettes or vapes. More than 150 cases have been reported in 16 states.

The department says some symptoms include coughing, shortness of breath and fatigue, with symptoms worsening over days or weeks before hospital admission.

Other symptoms may include fever, chest pain, nausea, abdominal pain and diarrhea. Most cases are among adolescents and young adults.

State Epidemiologist Tim Jones says officials will look for common factors on specific vaping components or brands that may be the source of the illness.