SALT LAKE CITY (AP) — Utah health officials say they have confirmed 35 cases of lung damage linked to vaping and are investigating 12 more potential cases.

The state Department of Health announced the new number Monday, a jump from the 28 cases reported last week.

The department says the cases stem from the use of a mix of nicotine and marijuana electronic cigarette products. It hasn’t found one specific product linked to all the cases.

Symptoms of the disease include coughing, shortness of breath, chest pain, fatigue, nausea and vomiting. Nearly all the people have had to get medical care.

U.S. government health officials said Friday they had identified about 450 possible cases of breathing ailments linked the devices, including as many as five deaths, in 33 states.