Health officials said Friday that another cyclosporiasis infection was reported this week, bringing the total number of people affected by the outbreak to 135.

The Wake County Health Department told WRAL News on Wednesday that Since May, 134 cases of cyclosporiasis have been reported. Of these, about 22 cases were linked to three restaurants in the area. Health authorities declined to name the restaurants but said they had been inspected and no improper food handling was found.

“The reason we don’t name them is because when a patient names them to us, we go to the restaurant and do an inspection there. Those inspections have taken place but have turned up nothing,” said Rebecca Kaufman, Wake County’s health director. “We believe the cause is really the vegetables or herbs and not something the restaurant did.”

“We have identified 135 confirmed cases of cyclosporiasis in Wake County this year, of which only 22 have been linked to outbreaks. Additional cases linked to Cyclospora clusters are being investigated in various areas of the state, as is common practice when outbreaks are identified through routine surveillance. Therefore, the number of reported cases linked to an outbreak will likely change,” the North Carolina Department of Health and Human Services (DHHS) said in a statement to WRAL.

“Cyclosporiasis is a reportable disease in North Carolina. Similar clusters of cyclosporiasis cases associated with herbs and vegetables have been reported in other states this summer, and the case numbers are not limited to North Carolina. CDC is working with all states to determine possible links between the cases. If a link is found, the state will focus on traditional epidemiological methods to identify common strains.”

Cyclosporiasis is spread when people consume food or water contaminated with feces.

Cyclospora can cause a variety of symptoms, including frequent diarrhea, stomach cramps, and body aches. According to the CDC, the time between infection and onset of illness can range from a few days to two weeks or longer.

Humans can become infected with Cyclospora more than once, but direct transmission from person to person is unlikely.

The typical symptoms of a cyclosporiasis infection include diarrhea, stomach cramps and aching limbs, as well as nausea, weight loss, loss of appetite, flatulence, persistent fatigue, mild fever and other flu-like symptoms.