A second case of severe lung illness believed to be caused by vaping has been reported in Mahoning county. 

The Ohio Department of Health released an update Thursday afternoon, with the number of cases of vaping-related illnesses across the state rising to 64, including the second Mahoning county case. 

The age ranges of those diagnosed with the illness run from 15 on up to 65. 

According to the health department, there are still currently 31 cases under review across the state. 

Earlier in November, the CDC released the results of a study that isolated vitamin E acetate as the one common factor in every case of vaping-related pulmonary disease studied. That study cautioned that more work still needs to be done to determine if other chemicals are also to blame for the issue. 

Vitamin E acetate is often used in the black market, homemade vaping products, particularly those which contain THC. Its thick appearance is sometimes used as an additive due to it's visual similarity to THC oil. 

21 News spoke in October to Dr. Nick Proia, who treated the first Mahoning county case. At that time, Dr. Proia described the illness as causing blood in the lungs. Proia said as he washed that patient's lungs, the blood became more and more prominent. 

No cases have been reported in Trumbull or Columbiana counties so far.