The number of lung disease cases related to people using e-cigarettes in Utah has quadrupled in the past week, the state's health department confirmed. The news comes on the heels of nearly 200 cases of severe lung illnesses among e-cigarette users nationwide.

On Tuesday, the Utah Department of Health confirmed there are now 21 cases of lung disease with connections to vaping. One week ago, the total was five.

CBS News affiliate KUTV reported last month that vaping rates in Utah have nearly doubled since 2013. The FDA has said there was a 78% increase in vaping nationally between 2017 and 2018.

Get Breaking News Delivered to Your Inbox

In a statement released on August 19, the Utah Department of Health said the five patients experienced serious breathing problems after vaping or using other drugs that are inhaled. The people experienced shortness of breath, fatigue, chest pain and coughing.

The patients' conditions worsened for days and weeks before they were admitted to the hospital, according to the release. Even though their conditions have improved with medical treatment, it is unknown if there will be long-term effects.

On Monday, the Utah Department of Health took to Twitter to provide an update on additional vaping lung disease cases.

We will be posting weekly updates on Mondays as we continue to investigate cases of lung disease among people who report vaping nicotine or THC products. As of today, we are reporting 21 such cases. — Utah Dept. of Health (@UtahDepOfHealth) August 26, 2019

The Utah Department of Health said it is working with national partners, local health departments and clinicians to try and identity the cause of these severe illnesses. These cases are similar to cases reported nationally in other states, including Illinois, Minnesota and Wisconsin.

Federal health officials are investigating nearly 200 cases of severe lung illnesses among vapers. An adult in Illinois, who recently used e-cigarettes, died this week from an unexplained pulmonary illness.

In Texas, a 17-year-old teen spent 10 days on a ventilator after his lungs failed. Doctors believe the teen's vaping habit was the cause of his health failure, and one doctor, pulmonologist Karen Schultz, said the teen had caused enough irritation and damage to scar his lungs.

Some states are ready to take action. In Illinois, The Lake County State's Attorney's Office filed a lawsuit this month against Juul Labs that accuses the e-cigarette giant of violating the Illinois Consumer Fraud and Deceptive Business Practices Act for allegedly using deceptive marketing aimed at teens. The State's Attorney's Office is also seeking punitive damages. Juul holds more than 75% of the e-cigarette market.

In response to the lawsuit, Juul issued a statement saying the company has "never marketed to youth and do not want non-nicotine users, especially youth, to ever try our product." Juul pointed to its exit from Facebook and Instagram as part of its effort to "remove inappropriate social media content generated by others."