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(NEXSTAR) – Thousands of confirmed and probable cases of cyclosporiasis have been added to what is considered to be the largest outbreak of the “explosive” diarrhea-causing parasite in the U.S. Additional states have also reportedly been linked to the outbreak.
According to the Centers for Disease Control and Prevention, all but three states have reported at least one case of cyclosporiasis that has been traced back to recalled iceberg lettuce.
In an update Tuesday, the CDC said it has, so far, received reports of 10,468 laboratory-confirmed cases of domestically acquired cyclosporiasis, with 47 states reporting infections. Another 12,255 cases have not yet been laboratory-confirmed or fully investigated.
Should they be confirmed, the U.S. tally would rise to more than 22,700.
The U.S. this week also saw what appear to be its first deaths related to the ongoing outbreak. Two patients in Michigan died after becoming ill prior to the lettuce recall, though state health officials warned that “both individuals had significant underlying health conditions.”
Michigan, where more than 12,200 cases have been reported as of Wednesday, remains the state that has been hardest hit by the outbreak.
It’s one of nine states that have been linked to the federal cyclosporiasis outbreak investigation, along with Illinois, Indiana, Kansas, Kentucky, Ohio, Oklahoma, Pennsylvania, and West Virginia.
Another six states may soon be formally added to the list. Individuals familiar with the investigation told NBC News and The Washington Post that Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina are being linked to the outbreak.
The CDC and the Food and Drug Administration did not immediately respond to Nexstar’s request for comment regarding these states.
As of Wednesday, Missouri alone has reported 1,095 cases so far this year. That’s up from just under 600 in late July, tracking by Nexstar shows. North Carolina has recorded over 860 cases since May.
A review of CDC and state health data, as well as local reporting, shows that every state has reported at least one case of cyclosporiasis this year. However, not all are linked to ongoing outbreak investigations.
Only three states — Delaware, Hawaii, and Montana — have not reported any laboratory-confirmed cases of cyclosporiasis linked to the CDC’s ongoing investigation.
Health officials in those states have, however, have reported possible cases. Delaware reported a case in mid-July, while at least two have been reported in Montana. Four cases have been reported in Hawaii: a non-resident who became infected outside the state, two residents who traveled internationally, and a member of the military based in the state.
The true number of people who have been infected by the cyclospora parasite this year may be higher than the aforementioned tallies suggest. Not everyone who becomes infected experiences symptoms, requires hospitalization or undergoes testing to confirm their diagnoses.
If you are experiencing symptoms, especially diarrhea that lasts more than a week or two, health care experts encourage you to seek medical care.
Left untreated, cyclosporiasis can stick around for a month or longer. Treatment can include antibiotics, antidiarrheal medications and hydration, according to the Cleveland Clinic.
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