KENDALLVILLE (WLKI)- Northeast Indiana continues to account for a significant share of Indiana's reported cyclosporiasis cases as health officials investigate a multistate outbreak linked to contaminated iceberg lettuce.
Cyclosporiasis is an intestinal illness caused by a microscopic parasite. People can become infected by consuming food or water contaminated with fecal matter containing the parasite.
The illness can cause watery diarrhea, stomach cramps, nausea, loss of appetite, bloating, gas, vomiting, body aches, headache and other flu-like symptoms.
According to the Indiana Department of Health, Allen County has reported the highest number of confirmed cases in Indiana, with 399 as of Wednesday afternoon.
Other northeast Indiana counties also rank among the state's highest.
Noble County had 123 confirmed cases, while Steuben County reported 119 and DeKalb County had 117.
Whitley County had 26 cases and LaGrange County had 17.
By comparison, 45 Indiana counties had reported 10 or fewer cases.
Statewide, the Indiana Department of Health had reported 1,705 cases as of Wednesday afternoon.
The cases cover an investigation period that began May 1.
Federal health officials initially investigated lettuce served at Taco Bell locations as a possible source of illness.
Investigators later focused on Taylor Farms as a source of iceberg lettuce associated with the outbreak.
The company recalled potentially contaminated iceberg lettuce grown in central Mexico and removed affected product from the market.
The Centers for Disease Control and Prevention said the outbreak had been reported in at least 15 states, although cyclosporiasis cases have been reported in at least 47 states this year.
Previous cyclosporiasis outbreaks have been associated with a variety of fresh produce, including salad mixes, herbs, raspberries and green onions.
Person-to-person transmission is considered unlikely.
Symptoms of cyclosporiasis may not begin immediately.
Health officials say symptoms can develop anywhere from two to 14 days after exposure.
Noble County Health Officer Dr. Gerald Warrener said most otherwise healthy people are expected to recover, although some patients may require antibiotic treatment.
He expressed particular concern for people with underlying health conditions.
Warrener recommends people seek medical attention if symptoms persist for more than two or three days.
Fresh produce should be washed before it is eaten, although Warrener cautioned that washing may not completely remove this particular parasite.
The Indiana Department of Health recommends frequent handwashing with warm, soapy water, particularly after using the bathroom, changing diapers and preparing food.
Officials also recommend avoiding untreated water, separating raw and cooked foods and washing produce before eating it.
Local health departments are contacting people who test positive in an effort to determine where they may have been exposed.
Noble County Public Health Nurse Carrie Ryan said the local health department has been extremely busy responding to the outbreak.
Officials say cooperation from people who test positive is important because investigators use information from individual cases to determine whether there are common sources of exposure.
Although the illness is rarely fatal, health officials say people who are older, have underlying health conditions or otherwise have weakened health should take symptoms seriously.
For now, public health officials continue to monitor the number of cases while federal investigators work to determine the full scope and source of the outbreak.
The high number of cases in northeast Indiana has made the region one of the state's most affected areas.