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Texas is among 17 states reporting cases of cyclosporiasis, an intestinal illness caused by the microscopic Cyclospora parasite, as federal health officials investigate possible sources of infection.
The Centers for Disease Control and Prevention reported 145 domestically acquired cases of cyclosporiasis as of June 16.
The cases involved people who became sick between May 1 and June 16 after eating food in the United States and who did not report international travel in the 14 days before becoming ill.
Of the 145 people with available information, 20 were hospitalized. No deaths have been reported, according to the CDC.
Federal health officials said there is no evidence that all cases are connected to a single multistate outbreak.
Instead, the CDC described the numbers as a surveillance count while local, state and federal agencies investigate possible clusters and sources of illness.
Cyclosporiasis is caused by consuming food or water contaminated with feces containing the Cyclospora parasite, according to the Texas Department of State Health Services.
The illness is not believed to spread directly from person to person.
Symptoms usually begin two to 14 days after a person consumes contaminated food or water.
The most common symptom is watery diarrhea that can last several days to several months and may return after improving.
Other symptoms can include fatigue, loss of appetite, weight loss, stomach cramps, bloating, gas, nausea, vomiting and low-grade fever.
Past U.S. outbreaks have been linked to fresh produce, including cilantro, prepackaged salad mix, raspberries, basil, snow peas and mesclun lettuce, according to Texas health officials.
The CDC said case counts typically rise during spring and summer, with cyclosporiasis season running from May 1 through Aug. 31.
Health officials said the true number of illnesses is likely higher because some people recover without medical care or are not tested for Cyclospora.
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