California on Friday reported a fifth person nationwide died due to a vaping-related lung illness, marking the third such fatality announced in fewer than 48 hours.

Los Angeles County health officials announced the vaping-related death of an older adult with chronic health issues hours after Indiana reported its first vaping-related fatality.

Oregon health officials said Thursday a second person had died from a severe respiratory illness after vaping.

“Nationwide, we are learning how dangerous these devices may be, and the long-term health impacts remain unknown at this time,” Los Angeles County Health Officer Dr. Muntu Davis said in a written release. “We are compelled to warn our 10 million residents that the risks of using these devices, with or without nicotine, marijuana, CBD or some street concoction, may now include severe lung injury.”

Los Angeles County health officials warned that there are nationwide reports that people are showing up in emergency departments with similar symptoms: coughing, difficulty breathing, fever and possible vomiting and diarrhea.

“The bottom line is everyone should think twice about vaping until more is known about their impacts on the health of their users, and the role they play as a contributor to lung damage leading to death,” Davis said in the release.

The Centers for Disease Control and Prevention on Friday discouraged people from using e-cigarettes as it investigates 450 possible cases of lung disease linked to vaping, more than double the number of cases from last week.

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