Some of the Texas cyclosporiasis cases have been traced back to fresh cilantro from Mexico, according to federal health officials.
The Texas Department of State Health Services said Thursday the its investigation has linked the cases in four restaurants to fresh cilantro from Puebla, Mexico.
Texas DSHS said a total of 21 people got sick and all of them reported eating food containing cilantro within two weeks of becoming ill.
The FDA and DSHS traced the cilantro from all four restaurants to Puebla. While investigators could not find cilantro contaminated with cyclospora they said there's a strong enough "epidemiological link" between the illnesses and the cilantro to draw the conclusion.
Russell Jones, chief epidemiologist for the Tarrant County Health Department, said health officials believe the outbreak is over, but they still don't know exactly how the cilantro was contaminated.
"We don't know if it happened on the farm, processing, somewhere in transit," Jones said. "Cyclospora is usually found in contaminated water. Fecal contaminated water. And it's a human parasite, so it normally doesn't come from an animal, but a person. Maybe it's irrigation water, water used from processing. Somewhere the product came in contact with contaminated water."
State health officials said they are choosing not to release the names of the restaurants, saying it wasn’t their fault the cilantro was bad.
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At Roy Pope Grocery in Fort Worth, owner Robert Vega said he's lucky to only buy local produce. However, he said many larger chains and restaurants don't have that option.
"A lot of it has to do with how things are going in California, whether it could be a drought or too much rain or high demand, and that's usually what brings more produce from Mexico," Vega said. "The only thing I can say is, as a consumer, is that you wash everything and that you thoroughly cook everything. Those are the two biggest keys."
In October 2013, the Centers for Disease Control and Prevention also linked a cyclospora outbreak to cilantro from Puebla.
The Texas DSHS reported a total of 166 confirmed cyclospora cases in the state, but only 126 cases were considered part of the outbreak.
Dallas County reported the majority of this year's cases with 38, 19 cases were confirmed in Tarrant County and 12 in Collin County.
Recent data from the Texas DSHS suggests that the outbreaks have ended.
Cyclosporiasis is an intestinal illness that is caused by the microscopic parasite cyclospora cayetanensis and causes prolonged diarrheal distress. People can become infected with cyclospora by eating or drinking food or water contaminated with the parasite.
NBC 5's Amanda Guerra and Bianca Castro contributed to this report.
