Iowa state officials on Tuesday said they have received reports of nine more cases of Cyclospora infections, bringing the total number affected by the outbreak in the state to 127 and to 267 total in six Midwestern states, according to the latest count by Food Safety News. A source has still not been identified for the outbreak, which centers in Iowa, Nebraska and Texas, but also involves a handful of victims in Wisconson, Illinois, and Kansas. The most recent case count, based on a tally from officials in each state is as follows: Iowa (127 illnesses), Nebraska (68), Texas (65), Wisconsin (4), Illinois (2), Kansas (1). The Iowa Department of Public Health said Tuesday that that the number of cases reported is decreasing and that the state plans to release another case count Wednesday at approximately 10 a.m. The Centers for Disease Control and Prevention has the official outbreak count at 250 cases, but said “it is not yet clear whether the cases from all of the states are part of the same outbreak.” According to CDC, the cases in Kansas and Illinois may have been acquired out of state and “additional cases are currently under investigation and will be included on this page as states confirm them.” In all, at least 10 people have been hospitalized. Cyclospora is a parasite and it could have been passed onto fresh food via contaminated water, but officials have not named any particular food, but have said they do believe it was foodborne and that it likely not a fruit but a fresh vegetable. “This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life,” IDPH said in its most recent update. “At no time was an Iowa-grown fruit of vegetable suspected to be the cause of the outbreak. IDPH also said it recommended eating fresh fruits and vegetables, but suggested washing produce “thoroughly” before eating. Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated, according to IDPH. Most of the illnesses in the current outbreak began in mid to late June. Many people report still being ill and some have had relapses, according to the update. Anyone experiencing diarrhea, or have recently had a long bout with diarrhea, should contact their health care provider and see if they should be tested for Cyclospora infection. Photo courtesy of flickr Creative Commons.