The Indiana State Department of Health confirmed Friday the first death of an Indiana resident, and third nationally, due to severe lung injury linked to e-cigarette use or “vaping.”

The death, which occurred in an adult, was confirmed Sept. 5 as part of an investigation involving local and federal health officials.

At a press conference Friday afternoon, Indiana State Health Commissioner Kris Box and Deputy Commissioner Pam Pontones outlined how they determined the cause of death and the growing number of vaping-related illnesses.

“Nothing is known for certain as to what is causing these injuries, so what we’re doing at the state department of health in collaboration with other states, the CDC and the FDA is looking at medical histories, conducting interviews with cases and close relatives and testing products that may be available to gather more information on what is causing these injuries and how they can be prevented,” Pontones said.

Indiana is investigating 30 cases of severe lung injury linked to vaping. The majority of the Indiana cases have occurred among individuals aged 16 to 29. 

And while more and more cases of the mysterious illness are being reported daily, Box and Pontones said neither they or the CDC are willing to call it an epidemic just yet.

“We are seeing the numbers of cases increase across the country, but some of this is due to states starting to report cases as there is now a mechanism to report those cases,” Pontones said. 

Box said the illness can look like pneumonia on a chest x-ray but has no infectious agent, as would standard pneumonia.

“To really understand what the underlying injury is will probably require tissue samples from some of these lungs to look at them under a microscope,” Box said. “What we know is that these individuals are not able to take oxygen from the air and put that into their bloodstream.

“There is obviously a damage to the lung preventing that and we do know that it’s vaping associated, but not specifically what is causing that.”

Symptoms can include: Shortness of breath; Cough; Chest pain; Fatigue; Fever; Weight loss; Nausea; Abdominal pain; Diarrhea

ISDH is working with affected individuals and their families to obtain products used by the patients and send them to the U.S. Food and Drug Administration for testing, Pontones said. Officials have not yet found any one substance linked to all Indiana cases.

National response

U.S. health officials on Friday again urged people to stop vaping until they figure out why some are coming down with serious breathing illnesses.

Officials said they had identified 450 possible cases, including at least three deaths, in 33 states.

No single vaping device, liquid or ingredient has been tied to all the illnesses, officials said. Many of the sickened — but not all — were people who said they had been had been vaping THC, the chemical that gives marijuana its high.

Health officials have only been counting certain lung illnesses in which the person had vaped within three months. Most are teens.

The illnesses have all been reported this year, and the number has been growing quickly in the last month as more and more states have begun investigations. 

“We’re all wondering if this is new or just newly recognized,” Dr. Dana Meaney-Delman of the Centers for Disease Control and Prevention told reporters Friday.

Also Friday, the New England Journal of Medicine released a series of articles about cases reported in Illinois, Wisconsin and Utah.

The articles detail 53 illnesses in Illinois and Wisconsin and noted that nearly one-fifth of the cases were people who said they vaped nicotine and not anything that contained THC or CBD oil.

For that reason, doctors and health officials are continuing to suggest people stay away from all vaping products until the investigation establishes exactly what’s at the root of the illnesses.

The Associated Press contributed to this report. 

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