A cyclospora outbreak has sickened at least 81 people in Iowa and 53 in Nebraska, as well as an unknown number of people in neighboring Midwestern states, according to the state health departments in Iowa and Nebraska. Nebraska state epidemiologist Dr. Tom Safranek told Food Safety News he knew of additional Cyclospora infections in Wisconsin, Illinois and Texas. Investigators are still working to determine where those infections were contracted and whether they are part of this outbreak or isolated incidences. News reports out of Texas say 37 people there have been sickened with Cyclospora, but they have not yet been confirmed to be part of the Iowa-Nebraska outbreak. (Update, 7:00 p.m. EST: The number ill in the past week in Texas has risen to 37, according to the Texas Department of State Health Services. At press time the number was 25.) “The illnesses in Nebraska and Iowa are carbon copies,” Safranek said. “There’s no difference on either side of the border.” Investigators are still working to identify the outbreak source, though they are suspecting a raw vegetable product that is no longer on the market, according to Iowa state epidemiologist Patricia Quinlisk. The illnesses began in early June and have not continued to appear past mid-June, suggesting the outbreak vehicle was a finite shipment of some food type that has since aged past its shelf life. Since very little fresh fruit and vegetables grow in Iowa in early June, Quinlisk said the pathogen likely came in from another area. “There are still several vegetables we’re investigating,” Quinlisk said. “We’re looking for something that could have exposed people in a multitude of settings, so we’re doing a lot of food traceback. Whatever it was, it’s not still on the market in Iowa.” Safranek added that the product was widely distributed and likely not grown by a local mom-and-pop establishment. In an email to Food Safety News, a spokeswoman for the U.S. Centers for Disease Control and Prevention said the agency was aware of the outbreak and working with state officials leading the investigation. In the U.S., Cyclospora outbreaks have predominantly been linked to imported fresh produce, including raspberries, basil, snow peas and mesclun lettuce. Cyclospora, a single-celled parasite, is considered an “emerging pathogen” with no culture system.