Four Oregonians have now been struck with a severe lung disease linked to e-cigarettes, state health officials said Tuesday.

One of the victims died in July. Another fell ill in September and has so far mostly recovered, the victim told The Oregonian/OregonLive.

The Oregon Health Authority didn’t release any additional information about the two new cases of severe lung illness, including what products they used, when they fell ill or whether they’re currently hospitalized. The announcement came the same day as Washington officials said that state’s vaping-related cases of severe lung illness grew to three.

Six people have died from the illness nationwide, including the Oregon victim. That person reportedly used e-cigarettes, or vape pens, with THC, the psychoactive chemical in marijuana. Another Oregon victim reported vaping the nicotine e-cigarette Juul, a brand that has become wildly popular in the last several years. These are the only cases so far identified in the state.

Federal health officials have reported more than 380 confirmed cases of severe lung disease connected with vaping in 36 states, down from an estimate of 450 that included cases tied less definitively to vaping.

Multiple state and federal agencies have been scrambling to identify the cause of the outbreak. As of Sept. 5, the Oregon Health Authority had homed in on two legal marijuana retail stores where the Oregon victim shopped before falling ill and dying.

Oregon marijuana retailers began removing vaping products last week and offering returns on previously purchased vape pens.

Two of the federal agencies investigating the illnesses, the Food and Drug Administration and the Centers for Disease Control and Prevention, haven’t identified a definitive cause of the illness. But the agencies have both urged people against vaping and, in particular, against vaping marijuana oils.