Two more people have died from vaping-related illnesses in the United States.
On Tuesday, the Florida Department of Health posted an updated case count to include one death. On Wednesday, the Georgia Department of Public Health also reported one death.
These two deaths bring the total number nationwide to 11.
The person in Georgia had a history of “heavy nicotine vaping,” but did not report a history of vaping other substances, such as THC, the Georgia Department of Public Health announced on Wednesday. So far the state has identified nine cases of vaping-related illness, including this death, and other possible cases are being reviewed.
A nationwide outbreak
The United States is currently facing a multi-state outbreak of lung injury associated with vaping, according to the US Centers for Disease Control and Prevention.
Nine other deaths have been identified as part of this outbreak – two in California, two in Kansas, and one each in Illinois, Indiana, Minnesota, Missouri and Oregon.
As of last week, at least 530 cases of lung injury associated with the use of e-cigarettes or vaping products have been reported to the CDC.
New cases are being confirmed daily and the CDC expects the number of vaping-related illnesses reported this week to be “hundreds higher” than last week, said Dr. Anne Schuchat, principal deputy director of the CDC, during a House Energy and Commerce subcommittee hearing on Wednesday.
The CDC is expected to update the number of illnesses on Thursday.
A specific cause of the outbreak remains unknown, but all reported cases of lung injury have a history of e-cigarette use or vaping. According to the CDC, most patients have reported a history of using e-cigarette products containing THC, or tetrahydrocannabinol, the psychoactive substance in cannabis. Many patients have reported using THC and nicotine. Some have reported the use of e-cigarette products containing only nicotine.
The CDC, US Food and Drug Administration, state and local health departments, and other clinical and public health partners are investigating the nationwide outbreak.
Georgia Gov. Brian Kemp and Department of Public Health Commissioner Dr. Kathleen Toomey on Wednesday urged people to follow the CDC recommendation to not not use e-cigarettes or other vaping devices while this investigation is ongoing.
“Without knowing the specific cause of the vaping-associated illness, discontinuing use of e-cigarettes and vaping devices is the best prevention against becoming ill,” according to a press release from the department.
People who are getting sick typically develop a cough, shortness of breath, nausea, chest pain, and some people vomit, have abdominal pain, and fever. If you think you are sick and have been vaping, go see a doctor right away.
What lawmakers are doing
Some states are taking action to address this outbreak.
On Wednesday, Rhode Island Gov. Gina Raimondo signed an executive order directing the state’s health department to establish “emergency regulations” forbidding the sale of flavored vaping products in the state.
Massachusetts Gov. Charlie Baker on Tuesday called for a temporary four-month ban on the sale of all e-cigarettes and vaping products in his state in response to the outbreak.
Earlier this month, Michigan banned the sale of flavored e-cigarettes and New York banned most flavored e-cigarettes. In June, San Francisco became the first US city to effectively ban all e-cigarette sales.
Get CNN Health's weekly newsletter
Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.
On the national front, the FDA has been working on a compliance policy related to enforcing premarket authorization requirements for flavored e-cigarettes, excluding tobacco flavored. The policy is expected to be finalized in coming weeks.
As it has been described, the policy would require all flavors other than tobacco to be taken off the market and then get “premarket authorization” before attempting to return to the market.