Two young people who used vaping products have been diagnosed with severe pulmonary lung diseases, bringing the total number of Washington state cases to three in what health officials say is a statewide outbreak of severe illnesses.

The two Spokane County patients, one a teen and the second in their 20s, reported vaping before becoming ill, the state Department of Health said Monday, based on reports from the Spokane Regional Health District.

Last week, health officials confirmed the first case involving a King County teenager.

A common product, device or additive among the three has not been identified, but an investigation is ongoing.

The patients’ symptoms match what the Centers for Disease Control and Prevention have asked state and local health groups to look for,  state Health Officer Kathy Lofy said in a news release.

The King County teen is recovering after being hospitalized last month with fever, cough and shortness of breath. He had used an e-cigarette with nicotine with propylene glycol and saffron for three years, according to Public Health — Seattle & King County.

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At least seven people have died from and more than 450 others have been diagnosed with severe lung diseases linked to vaping devices and products. Some products contain nicotine, many with sweet and fruity flavors. Health officials in Tulare County, California confirmed Monday evening that a resident died from complications associated with the use of e-cigarettes.

President Donald Trump said last week that his administration plans to ban non-tobacco-flavored vaping products amid concern about health risks and the increasing use among teenagers. In King County, one in four high-school seniors has reported using an e-cigarette in the past 90 days, according to Public Health — Seattle & King County.

The popular vaping company Juul was warned that it needed to stop claiming that its e-cigarettes are safer than smoking, because no vaping products have been proven to be less harmful than cigarettes or other tobacco products.

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