Health officials reported a massive surge in cyclosporiasis cases across 18 US states on Monday, driven by an abnormally large outbreak in Michigan.
The Centers for Disease Control and Prevention is investigating the clusters alongside the Food and Drug Administration.
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Michigan health data showed nearly 700 confirmed infections by Monday, a steep rise from 170 cases recorded just six days prior.
This total represents almost 14 times the state's typical annual average of 50 cases, with heavy concentrations in southeastern areas like Detroit.
Ohio also documented a significant increase, logging 177 cases by July 2, with 171 of those infections emerging after June 20.
The CDC noted that the true impact is likely underreported because many individuals recover without formal testing or seeking care.
"The true number of people sick with cyclosporiasis was likely higher than the number reported," said the CDC in an official bulletin.
The agency clarified that while summer traditionally brings a seasonal rise between May 1 and August 31, there is no evidence linking state clusters to a single nationwide source.
Twenty hospitalizations have been recorded nationally, but no deaths have resulted from the current spike.
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"Watery diarrhea with frequent and sometimes explosive bowel movements" is the most commonly reported symptom, according to the CDC.
The illness spreads when people ingest water or raw agricultural produce contaminated with human feces, though it does not typically transmit from person to person.
Michigan medical experts anticipate case tallies will continue climbing as heightened awareness prompts more symptomatic individuals to seek screening.
"There is a significant lag time between exposure to contaminated produce or contaminated materials and development of symptoms," said Dr. Natasha Bagdasarian, Michigan’s chief medical executive, to ABC.
The average incubation period lasts about one week but can range from two days to two weeks.
Health authorities advise washing all fresh produce thoroughly under running water or cooking it completely to reduce transmission risks.
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Bagdasarian described the outbreak as "a moving target," regarding the 678 cases reported in her state by Monday.
