Another 14 cases of vaping-related illness have been reported in New York since state health officials earlier this month first warned that 11 people using vaping devices had to be hospitalized.

The new tally of 25 cases in New York comes after the first vaping-linked death was suspected in Illinois and nearly 200 vaping-related lung diseases are being investigated across the country.

Some public health experts say the illnesses are connected to vaping marijuana oil rather than nicotine, prompting criticism of federal health officials for failing to clearly alert people about the health risk being linked to tetrahydrocannabinol, known as THC, the chemical in marijuana that causes psychological effects.

While many of the 25 cases in New York involved THC, state health officials noted none of them reported using products sold by the medical marijuana companies licensed in New York.

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"At this time, there are no concerns over the safety of approved New York State medical marijuana products," said Jill Montag, a Department of Health spokeswoman.

Meanwhile, some public health experts were raising alarms about the THC connections between many of the cases nationally.

Boston University public health professor Michael Siegel said the Centers for Disease Control and Prevention is being “unnecessarily vague” about describing the injuries as simply vaping-related when many people might have been injured by vaping THC oil, USA TODAY Network reported.

“Based on what we know now, I think there’s enough to tell people: Don’t vape THC oils — especially products that are bought off the street,” said Siegel. "There are certain things the agency could be recommending right now that could potentially save lives and prevent this from happening by being much more specific.”

CDC, the Food and Drug Administration and state health agencies say they are completing the painstaking work of tracing common factors that may have triggered the vaping-related lung illnesses mainly harming young adults.

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In New York, state health officials are obtaining and testing samples from vaping products involved in the cases to help determine the potential cause.

Health Department officials declined to provide answers to questions about the specific locations and vaping products involved in the cases in New York, citing the ongoing investigation and interviews of patients. They noted 10 of the cases were in western New York.

Some of the unanswered questions included whether the vaping devices were used as intended.

At this point, state Health Department officials didn't have any information suggesting that the brand or model of the vape device had any relationship to the illness, according to Montag.

Most nicotine-laced liquids in e-cigarettes are alcohol-based and can't cause "lipoid pneumonia," the type cited in many of the lung cases nationally, according to Siegel. The oil used when marijuana is vaped can, he said.

New York University public health professor Ray Niaura said the recent spate of lung illness means "it is unlikely it is e-cigarettes that have been on the market for a long time" unless "something was either changed or a new product was introduced into marketplaces."

"If it’s nicotine, it’s like a bad batch or a new player that is unknown," said Niaura, a former science director at the anti-tobacco Truth Initiative.

"More likely, it’s what others are saying and people are vaping a lot of other things besides nicotine, such as synthetic cannabis or contaminated THC that is making an appearance and leading to these bad consequences," he said.

Some patients have likened onset of the illness to a heart attack, and others to the flu. Symptoms included headache, fatigue, nausea, cough, chest pain, shortness of breath, fever and diarrhea, health officials said.

Some patients in New York have had progressive respiratory problems requiring supportive care including intubation and systemic steroids, health officials said. Other cases have self-resolved with close clinical monitoring and minimal supportive care over several days.

Dr. Brian King of the CDC's Office on Smoking and Health also told reporters that harmful ingredients in traditional nicotine vape liquid had been identified that included ultrafine particulates, heavy metals such as lead, cancer causing chemicals, and flavoring used in e-cigarettes to give it a buttery flavor.

Those ingredients had been related to severe respiratory illness, he said. While they haven't been linked to the current cases, "we know that e-cigarette aerosol is not harmless," said King.

And despite the THC links, public health investigators across the country have noted they need to gather more information about each case to determine what triggered the lung illnesses, USA TODAY Network reported.

DROBINSON@lohud.com