The Centers for Disease Control and Prevention now reports 47 deaths and 2,290 lung injuries associated with the use of e-cigarette or vaping products across the U.S.

"And these cases have occurred in every state but Alaska," said Alaska State Epidemiologist Dr. Joe McLaughlin.

McLaughlin says outside health officials have asked why Alaska has not seen a single reported case. McLaughlin says there are possible reasons for that.

"One answer is that actually cases have occurred in Alaska, but either they haven't been diagnosed or suspected by clinicians or they haven't been reported to the health department," said McLaughlin.

McLaughlin says the Alaska Department of Health and Social Services has done a lot of work to raise awareness about the national outbreak, including media interviews, social media posts and monitoring emergency rooms for possible cases.

"The other possibility is no cases have occurred in Alaska," McLaughlin said.

He says Alaska has a lower population compared to other states and it may be just "random chance" that Alaska hasn't seen any cases.

Local health officials also wonder if Alaska's regulated industry has something to do with no reported cases. Health officials say vitamin E acetate has been found in many of the vaping related cases.

State Marijuana Education Program Manager Eliza Muse says the Marijuana Control Board is responsible for approving vaping products before they go to market here.

"The board got a chance to take a look at all of the approved products, vapor products and their ingredients lists and found that in those ingredients lists vitamin E acetate was not found in the products sold here in Alaska," Muse said.

However, McLaughlin says because officials have not pinpointed an exact cause of deaths and injuries, the health department still urges people to follow the CDC recommendation of not using any vaping products.

Copyright 2019 KTVA. All rights reserved.