More than 200 people have become ill since June after using e-cigarettes.

Last month, a 2nd patient died from the vaping-related illness in Illinois.

Oregon health authorities are investigating the death of someone hospitalized with a severe respiratory illness after using a THC vape product, The Daily Grind news service reported.

“We don’t yet know the exact cause,” investigator Ann Thomas said. “Whether they’re caused by contaminants, ingredients in the liquid or something else. “We don’t know what is safe.”

In July, researchers confirmed that the chemicals Juul uses to flavor its vape liquids can produce harmful chemicals – called acetals – that are known to irritate the respiratory system.

Juul is planning to open a $125 million plant in Lexington County.

Last week, FDA investigators found Vitamin E acetate in samples of the vaping products used by individuals suffering from the unnamed respiratory illness.

A separate investigation by New York State found “very high levels of Vitamin E acetate” in black-market cannabis cartridges.

“We haven’t looked at the toxicity of Vitamin E in the lungs,” says researcher Laura Crotty Alexander. “The lungs are designed to exchange gas molecules; they’re not designed to be exposed to other chemicals.”

In a report published last Friday, investigators describe the presence of oil-carrying immune cells (called “lipid-laden macrophages”) inside the lungs of 9 patients suffering from vape lung.

“These cells are distinctive, and we don’t often see them,” said researcher Scott Aberegg. “That made everybody start to think carefully about why they were there. Are they scavenging debris in the lungs that was introduced through vaping?”

A separate study, detected the same cells in 7 of 14 patients treated for vape lung.

“We need to determine if these cells are specific for the illness or are seen in vaping patients who are not ill and don’t have symptoms,” Aberegg said.

“If they are only seen in patients who get sick, we can begin to make some connections between what we’re seeing in the lipid-laden macrophages and whatever components of the vaping oil may be causing this.”