Just like last summer, illnesses involving prolonged watery diarrhea and other gastrointestinal symptoms caused by the parasite Cyclospora cayetanensis are spreading across the country from Texas. Public health officials suspect the parasite is riding into the United States on contaminated fresh produce grown in Mexico for the U.S. market. They just don’t yet know the exact source, where it’s grown, and how it’s being distributed here. During the past week, the outbreak has expanded by several states, with the number of confirmed cases growing to 202, up from the 61 illnesses reported nationally as recently as July 23. With 110 illnesses, the Lone Star State accounts for more than half of the nation’s current cases, with illnesses being reported in 29 of the 254 counties in Texas. “Though a source has yet to be identified, past outbreaks have been traced to fresh imported produce,” the Texas Department of State Health Services said. “DSHS encourages people to wash produce thoroughly, though that may not entirely eliminate the risk because Cyclospora can be difficult to wash off.” Last summer, a June-peaking national outbreak of Cyclosporiasis ultimately saw 631 people sickened in 25 states. Last year’s Cyclospora outbreak caused some confusion and contention among the state’s investigating it. Iowa and Nebraska thought the infections were caused by bagged mixed salads served by restaurants, while Texas officials named fresh cilantro grown in Puebla, Mexico. This year, interviews conducted by the U.S. Centers for Disease Control and Prevention (CDC) have attributed about 25 illnesses to foreign travel. Before last summer, Cyclospora outbreaks from food or water sources in the U.S. have been sporadic since imported raspberries arrived here two decades ago. Carried by food or water contaminated by feces, the illness is cause by a parasite that’s common in tropical or subtropical counties. The onset of illness typically occurs within two to 14 days after the oocytes are consumed. It results in profuse diarrhea that can last for a couple weeks to several months. Other symptoms are a low-grade fever, nausea and vomiting, bloating and gas, anorexia and fatigue.