YAKIMA, Wash. (AP) — Health officials in Washington state have announced the first case of vaping-related illness in Yakima County increasing the number of cases in the state to 20. The Yakima Herald-Republic reported Tuesday that the young adult patient was not identified. Health officials say the common product in all patients has been the use of e-cigarettes or vapor products. Officials say e-cigarettes and vapor products are not safe and have urged people not to start using products if they are not already using them. The Center for Disease Control and Prevention have confirmed 2,291 cases nationwide, including 48 deaths.