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Massachusetts officials are instructing health care professionals to look out for respiratory illnesses that might be related to vaping, after nearly 200 cases of mysterious lung illnesses have surfaced across the country.

The Massachusetts Department of Public Health notified some 25,000 doctors, nurses, and physician assistants Tuesday to watch for respiratory illnesses in patients who said they use e-cigarettes or vaporizers of any kind — and report those cases to the state. Patients with the unexplained illnesses have said they have chest pain, difficulty breathing, vomiting, and fatigue. Some cases have been more serious and can involve permanent lung damage.

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The department also attached information from Centers for Disease Control and Prevention, which has been tracking the illnesses. It’s unclear whether the issues are coming from marijuana products, traditional e-cigarettes, or a contaminated product being sold on the illicit market.

“Even though cases appear similar, it is not clear if these cases have a common cause or if they are different diseases with similar presentations,” the CDC wrote in a notice. The State Departments of Health are investigating the possible cause of the illness by testing patient specimens and e-cigarette products. State-specific epidemiologic investigations are ongoing.”

As of Thursday, the CDC has received reports of more than 193 potential cases of severe lung illnesses in 22 states, including Connecticut and New York. One person in Illinois has died from respiratory problems.

All the cases were reported between June 28 and Aug. 20.

Ann Scales, a spokeswoman for the state’s Department of Public Health, said no cases have been reported in Massachusetts yet, and hospitals aren’t required to report such incidents.

The agency is using an “electronic syndromic surveillance system,” Scales said, which will be used to track and identify cases of respiratory illnesses that could be linked to vaping. All emergency rooms in Massachusetts have access to the system, according to DPH.

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Some states are taking additional action to investigate the illnesses and try to prevent more from occurring. The Wisconsin and Illinois departments of health have asked the CDC to assist them in investigating the incidents, and the New Mexico Department of Health is recommending that people stop using vape cartridges with marijuana as a main ingredient.


Naomi Martin of the Globe Staff contributed to this story. Material from The New York Times was used in this story. Felicia Gans can be reached at felicia.gans@globe.com. Follow her on Twitter @FeliciaGans.