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story.lead_photo.caption FILE - In this Feb. 20, 2014, file photo, a patron exhales vapor from an e-cigarette at a store in New York. Only two years ago e-cigarettes were viewed as holding great potential for public health: offering a way to wean smokers off traditional cigarettes. But now Juul and other vaping companies face an escalating backlash that threatens to sweep their products off the market. (AP Photo/Frank Franklin II, File)

Although the number of confirmed (or probable) cases of pulmonary disease brought on by use of e-cigarettes in Missouri has risen to 22, only one death has been attributed to the condition.

The state Department of Health and Senior Services on Friday released data that show 18 of the cases involved males and four involved females.

The Eastern region of the state contained 12 of the cases; Western, six; Southwest, one; Southeast one; Central, one; and Northern, none.

Fourteen of the cases involved people ages 15-24, while 25- to 34-year-olds accounted for three; 35-44, three; and 45-54, two.

A mid-40s man died of the disease at Mercy Hospital St. Louis the week of Sept. 15. His death is among 18 confirmed deaths related to vaping in the United States and Virgin Islands.

The man developed mild respiratory symptoms that worsened, leading to hospitalization Aug. 22. Doctors transferred him to Mercy on Sept. 4.

Centers for Disease Control and Prevention data shows in probable and confirmed cases, symptoms have progressed to a point where doctors ordered X-rays. Those X-rays found "pulmonary infiltrate," which is pus, blood or protein in the lungs, usually associated with pneumonia, tuberculosis and nocardosis (a bacterial infection).

The exact cause of the infection still eludes investigators.

As of Oct. 1, there had been 1,080 lung injury cases associated with using vaping products reported to the CDC from 48 states. Deaths have occurred in 15 states.

All patients reported a history of using e-cigarettes. Most reported using THC (the psychoactive ingredient in marijuana) or other cannabinoids in the devices. They oftentimes used vitamin E to thicken the product, and they sometimes modified their vaping devices, according to DHSS Director Randall Williams.

DHSS now requires physicians to report possible vaping-associated pulmonary illnesses.

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