WILMINGTON, Del. (AP) - Delaware health officials are investigating three possible cases of severe lung disease related to the use of electronic cigarettes and vaping.

News outlets report the state health department is urging residents to stop vaping as cases of lung disease possibly linked to e-cigarettes pop up across the country. The Centers for Disease Control and Prevention says there have been 450 possible cases of lung disease related to vaping reported in 33 states. As many as five cases have ended in death.

The agency says no evidence of infectious diseases have been identified, meaning the illnesses are likely associated with chemical exposure. It says no specific substance or product has been linked to all cases, though many cases involve people who reported vaping THC, marijuana’s high-inducing chemical.

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