ST. PAUL — The Minnesota Department of Health announced on Friday, Sept. 6, the first confirmed death in the state associated with a national outbreak of serious lung injuries related to vaping.

The death is only the fourth fatality in the nation attributed to vaping, and are part of a fast-moving outbreak of 450 vaping-related lung injuries in 33 states, severe pneumonia-like conditions requiring days or even weeks of hospitalization, and in some cases, mechanical ventilation. Minnesota lists 32 cases of lung injury as potentially vaping related, with 17 cases classified as confirmed or probable and 15 under investigation.

"I'm very sorry to report today that we have confirmed a death related to one of our cases," said health department commissioner Jan Malcolm at a call-in press conference announced on short notice Friday afternoon. "Our deepest condolences go out to the family."

Malcolm's office believes the cases share a common feature in the use of vaping liquid containing illicit THC, the psychoactive ingredient in marijuana. Officials do not believe the outbreak has affected participants in the state's program for the use of medical marijuana.

Little information has been made public about the patient who died, except that the person was over 65 and died in August following a long and complicated hospitalization. Though the patient had significant underlying health conditions, Malcom said, "the person's hospitalization began with a severe lung injury that was eventually linked to vaping. Investigators looking into the case subsequently found that the patient had vaped illicit THC." Investigators believe the patient had used the THC for the treatment of pain.

Vaping of illicit THC is for now the common denominator to all Minnesota cases, according to Malcolm.

"In Minnesota, of the cases who have been personally interviewed by investigators, all of them report vaping illicit THC products," she said. "We strongly urge people not to vape illicit THC products, that is, those purchased on the black market."

Malcolm said Minnesota is currently working in conjunction with federal and local health authorities to collect and analyze products, contaminants, drugs and devices believed to hold clues as the source of the illness.

"We still don't have enough information to identify a specific harmful agent," says Malcolm. "It could be due to the vaping devices, the THC itself, if it has contaminants or additives, or it could be contaminants in vape juice. It's possible there could be a combination of factors in play."

Also on Friday, reports emerged that federal health authorities had identified vitamin E acetate, an oil found in some vaping products containing marijuana, as an agent of concern. Though the precise cause of severe lung illness following vaping of illicit THC may be unclear, officials say, the pattern is not.

"We do know we are suddenly seeing and within the last few months an outbreak of very serious health consequences, and now a death in Minnesota, adding to what we understand to be three other deaths nationally related to inhaling vape aerosol into a very sensitive organ, the lungs," said Malcolm.

Symptoms of vaping illness include shortness of breath, fever, cough and gastrointestinal problems. Other symptoms include chest pain, headache and dizziness. Malcolm said vaping illness hospitalizations have required treatment with high doses of antibiotics and in some cases oral steroids.

The use of illicit THC in odorless vape juice is hard to detect and believed to be widespread among youth especially, making the implications for such serious health concerns potentially far-reaching. Over 40 percent of Minnesota high school students are believed to have tried e-cigarettes, with 35 percent having reported that they have vaped illicit THC.

State health officials say patients who vape and who have experienced symptoms should discontinue use of e-cigarettes and seek medical attention.