The Texas Department of State Health Services (DSHS) is investigating an outbreak of at least 160 cases of Cyclosporiasis, an illness caused by the parasite Cyclospora that can cause prolonged watery diarrhea and other gastrointestinal symptoms. The department has identified at least 160 cases this year, including a surge of reported cases beginning in mid-June. The case breakdown by county can be found here. Though a source has yet to be identified, past outbreaks have been traced to fresh imported produce. DSHS encourages people to wash produce thoroughly, though that may not entirely eliminate the risk because Cyclospora can be difficult to wash off. Nationwide, the Cyclospora case count exceeds 200, according to the U.S. Centers for Disease Control and Prevention (CDC). Besides Texas, other states with Cyclospora cases are: Connecticut, Florida, Georgia, Illinois, Maine, Maryland, Massachusetts, Montana, New Jersey, New York, Oregon and Tennessee. Ill persons are currently being interviewed about international travel, with 19 so far reporting that they had recently traveled internationally, while another 35 had not. Cyclospora is more common in some tropical countries. Symptoms of Cyclosporiasis include watery, sometimes explosive diarrhea, as well as loss of appetite, stomach cramps, nausea, vomiting, fatigue and bloating. If not treated, these symptoms may last anywhere from days to a month or more, with the potential for relapse. Last year, a Cyclosporiasis outbreak linked to imported salad mix and fresh cilantro sickened 631 people in 25 states. Previous Cyclosporiasis outbreaks in the U.S. have been linked to imported fresh produce such as lettuce, salad mix, snow peas, raspberries, cilantro and basil.