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Cases of a parasitic disease that causes “explosive diarrhea” are continuing to rise in over 40 states this week.

Cyclosporiasis infections are rarely fatal but can lead to an uncomfortable illness lasting for weeks, with symptoms also including vomiting and fever.

The nasty stomach bug is spread by eating fresh produce or drinking water contaminated with the cyclospora parasite but officials have yet to find the source of the current outbreaks.

The East Coast and Midwest have seen large numbers of cases.

The U.S. Centers for Disease Control and Prevention previously said that 400 cases reported in Michigan, West Virginia, Kentucky and Ohio are likely linked.

The map below shows where cases are located, state by state. The states colored in light green have the lowest numbers and increase to dark blue with the most cases. Roll over the map for specific counts.

There are 6,571 total cases in Michigan – the hardest hit state – and over 12,000 nationwide, according to The Independent’s latest analysis of state and federal data, though the real count is likely much higher.

Case counts could continue to rise through August, Dr. Gwen Biggerstaff, Deputy Director of CDC’s Division of Foodborne, Waterborne and Environmental Diseases, previously told reporters.

Past outbreaks have been traced to bagged salad mixes, popular herbs, snow peas, green onions and raspberries.

This time, iceberg lettuce from central Mexico has been subject to a voluntary recall by California salad-maker Taylor Farms.

However, there’s been some confusion surrounding a false positive test on some of the company’s lettuces.

“It’s important to note that the reevaluation of the sample does not alter the data supporting the outbreak advisory that prompted the current voluntary recall,” Donald Prater, the Acting Deputy Commissioner for Food, said Monday.

The hardest hit states appear to be in the eastern U.S. but case data is incomplete.

On Tuesday, the CDC said it had received reports of 4,173 confirmed domestic cases and was aware of more than 7,400 requiring further analysis.

“We assume a 6-week reporting lag between illness onset and case reporting to CDC; therefore, we anticipate that case counts will continue to rise as data are received,” the CDC says on its website tracking cases.

Under the second Trump administration, FoodNet, the foodborne illness surveillance arm of the CDC, made tracking cyclospora optional. That change had no impact to tracking this season, according to the CDC.

“The data that we have for cyclosporiasis for this outbreak is the same as we’ve had for all of the other seasons,” said Biggerstaff. “We use the same systems and the same processes. So that is unchanged.”

But even without firm case counts, people can still take action to protect themselves. The best way to reduce exposure to cyclospora is to avoid any potentially-contaminated sources, as well as to cook and thoroughly clean food. Heating food to 158 degrees Fahrenheit kills cyclospora.

Symptoms of infection typically appear a week after consuming the contaminated food or water but can take as little as two days or up to two weeks to appear, according to New York health officials.

Some people may not experience any symptoms.

“If you’re having symptoms that don’t seem to want to go away, or you’ve got several people around you that are sick with a similar illness after eating the same food or having the same exposure, those are the clues you want to put together,” primary care provider Dr. Austin Williams told Ohio hospital non-profit Kettering Health.

Doctors recommend that people who have cyclosporiasis get treated with antibiotics.