DETROIT — Michigan health officials are urging consumers to take precautions to help ward off cyclosporiasis and limit its spread as thousands of state residents have been sickened by the parasitic illness.

Through Monday, the Michigan Department of Health and Human Services has received more than 2,600 reports of the illness since June 22.

Cyclosporiasis usually causes symptoms including prolonged watery diarrhea, loss of appetite, weight loss, stomach cramps, bloating, nausea, fatigue and, in some cases, low-grade fever. The symptoms usually begin about a week after exposure, though they can appear anywhere from about two days to two weeks later.

On Monday, state health officials said they believe the outbreak originated from infected lettuce or salad greens. But they also warned that "other food items cannot be completely ruled out."

They are recommending that consumers take these steps to help prevent the spread of the outbreak:

How to handle lettuce and salad greens

•Buy whole heads of lettuce. Throw away the outer two to three layers of leaves and wash the inner leaves under running water.

•Avoid buying prewashed, bagged lettuce or salad mixes.

When preparing food

•Wash hands with soap and water before and after handling or preparing raw fruits and vegetables

•Wash fresh produce thoroughly under clean, running water, even if you plan to peel it. Fruits and vegetables labeled "prewashed" do not need to be washed again at home.

•Cut away damaged or bruised areas on fruits and vegetables before preparing and eating

•Cook foods whenever possible

After preparing food

•Wash all food prep surfaces, dishes and utensils with soap and hot water.

•Refrigerate any cut, peeled or cooked fruits and vegetables as soon as possible, ideally within two hours.

•Cilantro, basil: Wash thoroughly under running water, separating leaves.

•Green onions: Trim the root end and remove outer layer.

•Raspberries: Clean carefully as their bumpy surface makes them especially hard to clean; the parasite can hide in the tiny crevices. Consider frozen raspberries as an alternative

•Avoid drinking untreated water or using it to cook.

If you have symptoms

•Contact a health care provider if you have several bouts of watery diarrhea per day. Contact the provider again if the symptoms return or worsen after finishing a full course of antibiotics.

•Visit an emergency room if you have a weakened immune system and have symptoms of the infectious disease. Also visit an ER if you have signs of severe dehydration, including confusion, dizziness or dark-colored urine, or if you’re not urinating as much as you should.

•Avoid swimming for at least two weeks if you have diarrhea.

If you have cyclosporiasis

•Get fluids, including water, sports drinks or broth.

•Avoid caffeine and alcohol.

•Eat food, even if it's small bites.

•Take antibiotics as prescribed, even if symptoms improve.

How the parasitic illness is spread

Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis.

The illness spreads when people consume food or water contaminated with the parasite. Food or water can become contaminated when it comes into contact with feces containing the parasite. Outbreaks are most often linked to contaminated fresh produce.

It is not spread directly from person to person.

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