The number of confirmed cases of a parasitic illness linked to recalled iceberg lettuce has now reached 20 states, with federal health officials announcing new cases in Georgia, Tennessee, and Texas.

The latest figures show the total number of people sickened by the parasite has risen to 11,458, an increase from approximately 10,900 reported the previous week. The outbreak is the largest of its kind in the United States.

Scientists from the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), in conjunction with state health departments, have been investigating lettuce from a farm in central Mexico operated by Taylor Farms, a major U.S. produce supplier.

The FDA stated that its personnel are continuing to inspect and test produce at the farm, collaborating with Mexican government officials. The agency expressed confidence that all iceberg lettuce connected to this specific outbreak has been removed from the market.

Cyclospora is a microscopic parasite that typically causes watery diarrhea, characterized by frequent and sometimes urgent bowel movements, according to the CDC. Outbreaks of this illness are most common during the late spring and summer months.

The parasite, which thrives in warmer temperatures, infects the intestines and can spread through feces. Cyclosporiasis, the illness it causes, is less common than foodborne illnesses caused by other pathogens like salmonella and E. coli. Many cases of cyclospora infection are never traced back to a specific food source or other origin.

Earlier this week, the CDC reported that the U.S. has seen about 29,000 confirmed or suspected cyclospora cases this year, with 922 hospitalizations. The previous record for infections in the U.S. was in 2019, when approximately 4,700 illnesses were reported nationwide.