Three patients have been hospitalized in North Carolina since late July.
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The severity of the disease has varied. The department of health said some required treatment in the intensive care unit and assistance to breathe.
The symptoms were similar to pneumonia caused by bacterial or viral infections, the health department said.
The causes of the illnesses are unknown but officials said all patients reported using e-cigarettes or vaping devices in the weeks before their illness began.
NCDHHS is coordinating with other organizations to investigate.
Recently, officials in Wisconsin said 11 teenagers and young adults were hospitalized due to lung damage linked to vaping.
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"We encourage all North Carolinians to avoid vaping products and e-cigarettes," said State Health Director and DHHS Chief Medical Officer Elizabeth Tilson, M.D. "Although the causes of the recently reported cases are still under investigation, this is a reminder of the potentially severe health consequences of vaping."
No specific brand name or source has been identified as the cause of illness.
The health department said vaping products and e-cigarettes contain harmful substances, including heavy metals, volatile organic compounds, and ultrafine particles that can be inhaled into the lungs.
Symptoms reported from patients include shortness of breath, fever, cough and nausea or vomiting. Anyone experiencing these symptoms should contact their doctor or seek medical care and report any use of vaping devices within the past three months.