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Health officials expanded a foodborne illness investigation after they linked more cases of cyclosporiasis to recalled shredded iceberg lettuce. The U.S. Food and Drug Administration said the outbreak now involves 15 states, adding six more states since the previous update. Investigators continue to examine the source of the contamination and work with state health departments to identify additional cases.

Federal investigators connected the outbreak to recalled iceberg lettuce supplied by Taylor Farms de Mexico. The company removed the affected products from the market after officials identified a possible link between the lettuce and the growing number of illnesses. The recall includes certain shredded lettuce and salad products with specific use-by dates. Consumers should avoid eating recalled products and should throw them away or return them to the store.

Cyclosporiasis develops after people consume food or water contaminated with the Cyclospora parasite. The illness often causes diarrhea, stomach cramps, nausea, fatigue, and loss of appetite. Symptoms may not appear for several days, which can make it difficult for investigators to identify the source of an outbreak. Doctors can treat the infection with medication, and most people recover with proper medical care.

The Centers for Disease Control and Prevention and the FDA continue to work with state officials to trace the contaminated food and prevent additional illnesses. Investigators have interviewed patients, reviewed purchase records, and tracked food distribution to determine where the contaminated lettuce reached stores and restaurants. Officials expect the investigation to continue as they gather more information from affected states.