Some 226 of those cases have occurred since May 1. None of those individuals reported having traveled outside the United States.
Federal health officials from the CDC and FDA are working with local and state health officials to investigate clusters of this illness
in Texas and Georgia. Clusters have also been identified in Wisconsin.
According to the Centers of Disease Control and Prevention, investigations in Wisconsin and Texas preliminarily identified cilantro as the possible source of the outbreak. Some of the sick individuals ate at restaurants that used cilantro from Puebla state, Mexico, according to the Food and Drug Administration. They caution that the investigations are ongoing and not conclusive.
A 2012 outbreak of cyclosporiasis found cilantro from this state was one of many possible sources.
According to the FDA, outbreaks of cyclosporiasis in the United States associated with cilantro from the Puebla, Mexico, have occurred every year since 2012. The FDA does not believe all of these outbreaks are linked to isolated contamination because of their timing and because they have not been able to identify packing or shipping dates, lot codes or a single supplier that explains all of the cases of illness.
Last week, the FDA issued
an alert banning shipments of fresh cilantro
from Puebla, Mexico, from April 1 through August 31 unless it is from a firm on its approved list.
The move was preceded by FDA and Mexican inspection reports that found "objectionable conditions" at 11 farms and packing houses in Puebla. Among them, human feces and toilet paper in growing fields and restrooms without running water, soap or toilet paper.
Cyclosporiasis is an intestinal infection caused by the cyclospora cayetanensis parasite. The parasite is too small to see without the use of a microscope. Illness is caused by consuming food or drink that contains the parasite and usually takes about a week to make a person sick. The illness is not transmitted from person to person.
Symptoms include watery diarrhea, loss of appetite, weight loss, bloating, abdominal cramping, increased gas, nausea and fatigue. Patients sometimes experience vomiting and a low-grade fever as well.
Healthy people can recover without treatment.
When treated by a physician, the antibiotics Bactrum, Septra or Cotrim are prescribed. Without treatment, symptoms may last several weeks or months and might even resolve and then return again.