The Hawaii Department of Health on Wednesday said it is investigating a sixth case of cyclosporiasis in the islands. This time, the case is not travel-related.

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Health officials said an Oahu resident became ill at the end of July, and did not travel outside of Hawaii during the period when they were likely exposed, which is usually in the previous two weeks.

DOH investigators are reviewing how the infection may have been acquired locally, either through food or other potential exposures. They have not yet identified a suspected contaminated food source, officials said.

“A single locally acquired case does not change the overall risk assessment for the general public, which remains low,” health officials said in a news release. “DOH will continue to update the public on investigation findings as they become available.”

The five cases previously reported in Hawaii involved individuals who had traveled outside of the state during their likely exposure periods. The first case in July involved a nonresident visitor whose infection was acquired outside of Hawaii, officials said.

The second and third cases involved Hawaii residents from the same household who traveled internationally. The fourth and fifth cases involved separate military members based in Hawaii who had traveled internationally before becoming ill.

The latest discovery comes as the number of cyclosporiasis cases nationally surpassed 17,000, according to the U.S. Centers for Disease Control and Prevention. As of Monday, the CDC had confirmed 17,180 cases across 48 stats plus the District of Columbia, with 922 hospitalizations and two deaths.

More than 11,000 additional cases require further investigation and analysis, officials said.

The number includes a multistate outbreak that was linked to iceberg lettuce processed by Taylor Farms de Mexico, which on July 17 recalled all iceberg lettuce sourced from central Mexico.

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Hawaii health officials said no recalled iceberg lettuce was distributed or sold in Hawaii, and that it continues to work with CDC to determine whether local cases have any connection to other multistate outbreaks.

Cyclosporiasis is a gastrointestinal illness caused by the microscopic parasite Cyclospora cayetanensis. People can get sick from eating food or water contaminated with human excrement containing Cyclospora, according to CDC. Symptoms usually begin about a week after exposure, but can appear anywhere from two days to two weeks later.

The most common symptoms include frequent, watery diarrhea, loss of appetite, stomach cramps and bloating. Other possible symptoms include nausea, fatigue and, less commonly, vomiting or low-grade fever.

Anyone experiencing diarrhea lasting longer than a few days should contact their doctor. Cyclosporiasis is treatable with prescription antibiotics. Without treatment, symptoms may last for more than a month, and come and go several times, health officials say.

DOH officials said residents can reduce risk of cyclosporiasis by:

— Washing hands with soap and water before preparing or eating food and after using the restroom.

— Washing fresh fruits and vegetables under running water before eating, cutting or cooking them.

— Seeking medical care if experiencing severe diarrhea or diarrhea lasting longer than a few days.

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