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Health officials in Marin County are advising residents to stop vaping until more is known about the cases of lung injury being reported across the United States.

A public health alert has been issued by Marin County Health and Human Services asking local health care providers to be watchful for unexplained respiratory illnesses.

There have been at least 57 severe respiratory illness cases related to vaping recently reported in California, with the first death in the state reported earlier this month in Los Angeles, though no cases had been reported in Marin County.

“Until we know what’s causing this, the only way to be sure we’re protected is to avoid using e-cigarettes. It’s just not safe to vape,” Marin County Public Health Officer Dr. Matt Willis said in a statement.

Nationally, there have been at least 450 illness cases reported in 33 states since July, most involving products containing cannabis and many striking teenagers or young people.

Figures show nearly one-in-three 11th graders in Marin County reported using e-cigarettes on a regular basis, more than double the number two years ago.