New York State health investigators announced they believe cannabis-containing e-cigarette, or vape, products may be responsible for a string of mysterious lung-related illnesses reported across the state. In all 34 cases recorded in New York, patients reported using at least one cannabis-containing vape product before becoming ill.

"The cases of pulmonary illnesses associated with vaping are continuing to rise across New York State and the country," said Health Commissioner Howard Zucker in a statement. "We urge the public to be vigilant about any vaping products that they or any family members may be using and to immediately contact their health care provider if they develop any unusual symptoms. In general, vaping of unknown substances is dangerous, and we continue to explore all options to combat this public health issue."

At a most recent count, the Center for Disease Control and Prevention (CDC) reports at least 450 cases of pulmonary disease associated with vaping in half of US states. At least five people have died in California, Minnesota, Illinois, Indiana, and Oregon as a result of the infections.

Just last week, a joint investigation by the CDC and US Food and Drug Administration (FDA) launched parameters for health officials across the US to diagnose and report pulmonary illnesses in patients who had a history of vaping. Agency officials have collected more than a dozen samples in New York containing a range of products that include THC and cannabis-derived cannabinoids, nicotine, synthetic cannabinoids, opioids, and pesticides. Because recreational marijuana is not legal in New York, officials suspect that many products are counterfeits of those available in other states.

Lab tests indicate high levels of an additive called vitamin E acetate in almost every sample. "At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing," the NY health department statement said. "Vitamin E acetate is not an approved additive for New York State Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products that were tested."

The nutritional supplement is not known to cause an issue when applied to the skin or ingested, but the health effects of inhaling the oil are still unknown.

In many states, including New York, cannabis-containing products are not legally available for recreational use which means they are not tested or regulated by federal agencies. Recent reports of modified e-cigarette cartridges can contain other potentially harmful additives, cannabis, vitamins, and even Viagra – something officials say can be especially dangerous. Experts remind users to never use vape products bought “off the street”. Though e-cigarettes can be useful in helping cigarette smokers quit, the science community is still working to understand the potential risks and benefits of vaping, which has also been linked to increased inflammation and impaired lung function, altered DNA, and repression of the immune system.

Seek medical attention if you use vape products and experience coughing, shortness of breath, and chest pain, gastrointestinal symptoms (nausea, vomiting, diarrhea), fatigue, fever, headache, or weight loss.