BOISE, Idaho (KLIX)-Idaho health officials say there are two confirmed cases of respiratory illnesses in people who vaped or used electronic cigarettes. The Idaho Department of Health and Welfare says the two Idaho patients are recovering and are among the hundreds of people in 33 states who may be suffering from illnesses linked to using electronic cigarettes and other vaping devices.

More than 400 possible cases are being investigated by federal agencies in 33 states after five people may have died. The department advises consumers who use vaping products to avoid buying items of the street and not to modify or add any substances to products bought in stores. They also recommend people who vape to seek medical attention as quickly as possible if they have difficulty breathing. Health care providers are being asked to report respiratory problems if patients have been using vaping devices or e-cigarettes. “Idaho healthcare providers are notifying us of patients with severe respiratory symptoms who report vaping in the days or weeks before they became very sick,” said Deputy State Epidemiologist Dr. Kathryn Turner in a prepared statement. “We are investigating each report and looking for things that might be common among the patients as well as asking about the types of vaping products and devices people have used to try and pinpoint the source of these illnesses.”

Idaho health officials say they are concerned with the popular use of vaping products among teens and young adults, especially because many of the products contain nicotine. The South Central Public Health District in Twin Falls also issued a statement concerning the use of nicotine products: “Vaping can be very addictive and lead to severe dependence issues. Typically a person trying to quit nicotine addiction can show symptoms of anger issues, increased stress, lack of concentration, and mood swings,” said Cody Orchard, South Central Public Health District Health Educator. “In our region, we have teenagers who wake up in the middle of the night craving nicotine, struggle in class, and even repeat grades because they can’t focus without their vape.”

Patients with reported respiratory illness had symptoms that included cough, shortness of breath, chest pain that grows worse over time, including fever, fatigue, nausea, vomiting and/or diarrhea.