U.S. health officials on Thursday reported 18 deaths due to a mysterious lung illness linked to e-cigarettes and other vaping products and said the number of confirmed and probable cases of the condition now exceeds 1,000.

Public health officials are still at a loss to explain the cause of the severe lung illnesses, which have now reached 1,080 cases across 48 states and one U.S. territory so far, up from 805 cases last week.

Dr. Anne Schuchat, the principal deputy director of the U.S. Centers for Disease Control and Prevention (CDC), told reporters on a conference call that the outbreak shows no signs that it has peaked. She said the CDC has sent staff to several states to bolster the response and get the word out to doctors about how to recognize the illness.