Five cases of the diarrhea-causing disease cyclosporiasis have been confirmed in Mississippi, the Department of Health reported Friday. 

State Epidemiologist Dr. Renia Dotson temporarily declared cyclosporiasis a reportable disease Thursday due to the nationwide spike in cases, she told reporters at a Friday press conference. Mississippi was previously one of three states that did not require health professionals and laboratories to report the disease to the Health Department.

“We have not been tracking these illnesses,” Dotson said. “So, I cannot with confidence say that the five cases we have now are outside of our norm, or outside of our range, because we don’t have a good handle on what the range of cases we normally see is.” 

Cases were reported in four of the state’s nine public health regions. These regions cover central and southern Mississippi, the Delta and the Gulf Coast. Dotson said the Health Department has not yet identified any commonalities among the cases. 

Cyclosporiasis is a gastrointestinal disease caused by a microscopic parasite. Infections have surged across the nation in recent weeks. As of Monday,  more than 1,600 confirmed cases since May 1 in 30 states, according to the Centers for Disease Control and Prevention. The agency said more than 5,000 additional cases required further analysis. No deaths have been reported in connection with the illness.

The disease’s symptoms include watery diarrhea with “frequent and sometimes explosive bowel movements,” according to the CDC. It can take between two days and two weeks for an infected person to become sick, and it is typically treated with antibiotics. Young children, older adults and people with weakened immune systems are at risk of more severe or prolonged illness, Dotson said. 

The disease spreads when people eat food or drink water contaminated with feces. It is typically not transmitted from person to person. Previous outbreaks have been linked to fresh produce, including leafy greens, herbs and berries. 

Health officials have not identified a single cause of the wave of U.S. infections.

On Thursday, the CDC, Food and Drug Administration and public health officials in several states announced they are investigating infections connected to shredded iceberg lettuce served at Taco Bell locations in five states — Indiana, Kentucky, Michigan, Ohio and West Virginia. The federal agencies have identified a single supplier of iceberg lettuce from Mexico in the investigation. Cases in Mississippi have not been linked to this outbreak, Dotson said. 

The CDC is also investigating other clusters of cyclosporiasis cases unrelated to this outbreak.

The true number of sick people is likely higher than the number reported, because some people recover without treatment and were not tested, and it can take as long as six weeks to determine if a sick person’s illness is related to cyclospora. 

The Health Department has asked laboratories across the state to retroactively review cases from the past year to determine a normal caseload as a point of comparison, Dotson said. 

To protect against cyclosporiasis, Dotson said she recommends washing hands and produce before preparing food, including scrubbing fruits and vegetables and removing any bruised areas. She also recommended refrigerating cut or peeled fruits and vegetables as soon as possible and noted that cooking food thoroughly kills the parasite. 

Dotson said people experiencing diarrhea lasting longer than a few days, severe dehydration, bloody diarrhea, persistent vomiting or high fever should contact a health professional.