The US Centers for Disease Control and Prevention announced Thursday there are 380 confirmed and probable cases of lung disease associated with vaping across 36 states and the US Virgin Islands. Six deaths have been confirmed in six states: California, Illinois, Indiana, Kansas, Minnesota, and Oregon.
That's a smaller number of illnesses than the agency had previously stated because it has updated the way it reports cases of lung disease associated with e-cigarette use. It's now reporting confirmed and probable cases, rather than possible cases or cases under investigation.
Last week, the CDC had reported that there are more than 450 possible cases of vaping-related lung disease across 33 states and the US Virgin Islands.
There are hundreds more cases under investigation around the country, according to a CNN analysis of numbers reported by state health departments this week.
The states and territory with confirmed cases are Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, North Carolina, North Dakota, Nebraska, New Jersey, New Mexico, Nevada, New York, Ohio, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, West Virginia and the US Virgin Islands.
The specific cause of these illnesses remains unknown. An ongoing multistate CDC investigation into the illnesses has not yet identified any specific e-cigarette or vaping product or substance that is linked to all cases, according to the agency.
"Until we know more, if you are concerned about these specific health risks, CDC recommends that you consider refraining from using e-cigarette or vaping products," according to the CDC's updated website.
"If you are an adult who used e-cigarettes containing nicotine to quit cigarette smoking, do not return to smoking cigarettes," the CDC recommends. "If you have recently used an e-cigarette or vaping product and you have symptoms like those reported in this outbreak see a healthcare provider."
New actions to regulate e-cigarettes
This update in the way cases are being reported comes just days after the Trump administration announced an effort to crack down on youth vaping by planning to remove all flavored e-cigarettes -- other than tobacco-flavored vapes -- from the marketplace.
The administration "is making it clear that we intend to clear the market of flavored e-cigarettes to reverse the deeply concerning epidemic of youth e-cigarette use that is impacting children, families, schools and communities," US Health and Human Services Secretary Alex Azar said in a press announcement on Wednesday.
"We will not stand idly by as these products become an on-ramp to combustible cigarettes or nicotine addiction for a generation of youth."
As part of this plan, the US Food and Drug Administration intends to finalize a policy in the coming weeks that would prioritize the agency's enforcement of certain requirements for non-tobacco-flavored e-cigarettes, including mint and menthol, in an effort to clear the market of unauthorized products.
"The FDA plans to share more on the specific details of the plan and its implementation soon," according to the announcement.
Leading e-cigarette maker Juul has maintained that its products are intended to convert adult smokers to what it described in the past as a less-harmful alternative. In other communications, the company has said it cannot make claims its products are safer, in line with FDA regulations.
"We strongly agree with the need for aggressive category-wide action on flavored products. We will fully comply with the final FDA policy when effective," Ted Kwong, a spokesperson for Juul Labs, said after the Trump administration announcement.
Michigan Gov. Gretchen Whitmer recently announced the state could be the the first to ban the sale of flavored e-cigarettes. The ban gives sellers 30 days to comply and lasts six months -- though the governor can decide to renew it. This includes sales in brick-and-mortar stores and online.
In July, San Francisco Mayor London Breed signed an ordinance that effectively banned e-cigarette sales in the city -- the first of its kind in the United States.
On behalf of nearly 3,000 local health departments nationwide, the National Association of County and City Health Officials on Friday urged the FDA to take "swift action" and regulate the e-cigarette market.
"The data continue to show what local health officials have been seeing on the ground in far too many communities—vaping is reversing our gains in addressing youth tobacco use and not letting up," Lori Tremmel Freeman, NACCHO chief executive officer, said a written statement.
"In fact, a recent NACCHO survey of rural local health departments notes that 93% of respondents see e-cigarettes as a public health threat in their community. However, our research also notes that there are real barriers to ensuring that cessation and prevention activities are available in all communities," she said. "We urge the administration to work swiftly to adopt this and other measures to address the youth vaping crisis and to support local communities in addressing tobacco use across the board."
CNN's Michael Nedelman contributed to this report.