The North Dakota Department of Health has received the state's first report of a severe respiratory illness associated with the use of a vaping device or other products known as electronic nicotine delivery systems.

North Dakota joins 25 others states that have reported more than 200 potential cases of severe respiratory illness from e-cigarettes among teenagers and adults, the Health Department said Wednesday.

Reported symptoms of severe respiratory illness include cough, fatigue, dizziness, headache, diarrhea, vomiting, chest pain, and difficulty breathing. Some patients have required medical treatment and supplemental oxygen, according to the Centers for Disease Control and Prevention.

"As people call in with these reports, we will continue to gather data in an effort to find answers and linkages," State Epidemiologist Tracy Miller said. "We're working closely with the CDC on the national outbreak."

In all reported cases nationwide, patients have reported e-cigarette use, according to the CDC. Some patients have reported using e-cigarettes containing cannabinoid products, such as Tetrahydrocannabinol, or THC. To date, no single substance or e-cigarette product has been linked to the outbreak.

State health officials are asking health care providers to watch for cases of severe respiratory illness and ask patients about e-cigarette use. People with symptoms should seek medical care promptly.

"Individuals are discouraged from using vaping and e-cigarette products of any kind as the long-term health impacts are unknown," said Neil Charvat, director of the state Tobacco Prevention and Control Program.

People experiencing symptoms can call the Health Department at 866-207-2880 or visit ndhealth.gov to take a confidential survey.

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(Reach Blair Emerson at 701-250-8251 or Blair.Emerson@bismarcktribune.com)