Canadian health officials say anyone who has used an e-cigarette or vaping products, and has symptoms such as shortness of breath, cough, chest pain, with or without vomiting, diarrhea, abdominal pain or fever is advised to consult a health-care professional.
Public and political opinion appears to be hardening, however, with the administration of US President Donald Trump announcing in September it would ban in the coming months flavored e-cigarette products which are particularly attractive to young people.
As of October 1, 1,080 people who have a history of vaping have been diagnosed with some type of serious lung injury, such as severe breathing problems or lung damage.
Dr Brandon Larsen, a surgical pathologist at Mayo Clinic Arizona and a lead author of the study, said the researchers saw "a severe chemical injury" much different from what doctors see in tobacco or marijuana smokers.
Persichilli said among the things the state can do without legislation would be increasing the number of inspectors who go into vape shops to ensure that laws are being followed.
The Centers for Disease Control and Prevention said 1,080 confirmed and probable cases have been reported in 48 states and one USA territory as of Tuesday afternoon. The average age of those who died is almost 50.
Federal and state health officials still haven't identified the single common element between all of these vaping cases, making the ultimate cause unknown.
Of the 578 patients that CDC has information from, 78 percent reported using THC-containing products.
People who switched to vaping to cut down on smoking cigarettes should not go back to cigarettes, Canadian and USA health officials said.
"Unfortunately, the outbreak.is continuing at a brisk pace" and there's no sign of it slowing, the CDC's Dr. Anne Schuchat said in a Thursday call with reporters.
"We still don't know what exactly causes these injuries, but it's important to remember that this is a relatively recent development", she said, "and e-cigarettes have been on the market for a long time. which tells me something has relatively recently started being added to the liquids".
People have died in 10 states, Schuckat said, and people have fallen ill in 48 states and the Virgin Island. As the investigation continues, they said those percentages might change. "The data we are getting does not suggest this has peaked", she said.