INDIANAPOLIS (WISH) — The first death linked to a history of e-cigarette use has been confirmed in Indiana, according to the Indiana State Department of Health.

The agency reports the death was confirmed Sept. 5 as part of an investigation involving health officials at the local and federal levels and in surrounding states.

Indiana is currently investigating 30 cases involving severe lung injury linked to vaping, eight of which have occurred among people ages 16-29.

The exact cause of the illnesses has left state health officials perplexed.

“Nothing is known for certain what is causing these injuries,” said Pam Pontones, deputy state health commissioner and state epidemiologist.

What’s actually in the vaping devices is a key point of concern.

“In general, we do know that we have a significant percentage of our cases that individuals have used other substances in their e-cigarette products rather than just the nicotine that comes from a manufactured e-cigarette,” said State Health Commissioner Kris Box.

Symptoms of severe lung injury can include:

• shortness of breath
• cough
• chest pain
• fatigue
• fever
• weight loss
• nausea
• abdominal pain
• diarrhea

More than 215 cases of severe lung injuries related to vaping have been reported nationwide, according to the Centers for Disease Control.

Health officials are working with individuals and families affected to gather products used by the patients and send them to the U.S. Food and Drug Administration for testing.

No common substance has been linked to the Indiana cases.

“Right now we’re just asking everyone follow the CDC’s recommendation. Folks really should consider not using these products and not vaping until more is known about what is causing these lung injuries,” Pontones said.

Last week Box and Gov. Eric Holcomb announced a $2 million plan to combat youth vaping. The plan focuses on training, education and a statewide vaping awareness campaign.