Colorado health officials said Wednesday that the number of people in the state with a severe vaping-related illness has increased to six, with four of the individuals hospitalized.

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Craig Mitchelldyer, The Associated Press

In this April 16, 2019, photo, a woman exhales while vaping from a Juul pen e-cigarette in Vancouver, Wash.

The increase in cases comes a month after state health officials confirmed Colorado’s first case of the illness. Previously, there were four known cases in the state.

“As our outbreak report shows, this illness is affecting mostly young Coloradans who reported vaping either marijuana, nicotine or both,” Dr. Daniel Shodell, deputy director of disease control and environmental epidemiology at the state health department, said in a statement.

“Our advice has not changed: We want people to quit vaping until we have a clear understanding of what is causing this illness,” Shodell said.

The illness is part of an outbreak that has made at least 380 individuals sick in 36 states and the U.S. Virgin Islands. California health officials confirmed this week that at least the seventh person has died from the illness, The Washington Post reported.

Symptoms of the illness include shortness of breath, chest pain, cough, fatigue and possibly fever, according to the Colorado Department of Public Health and Environment.

State and federal health officials, who have linked the illness to e-cigarettes, still do not know the specific cause of the lung illness. In Colorado, patients have reported using marijuana and nicotine products, including vaping both substances, according to the state health department. 

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