Federal and state health officials are investigating whether Taco Bell restaurants played a role in one of the nation’s largest outbreaks of cyclosporiasis, a parasitic illness that has sickened more than 4,000 people nationwide, according to The Washington Post

Symptoms of Cyclosporiasis include prolonged watery diarrhea, fatigue, nausea, stomach cramps and, in some cases, explosive bowel movements, according to the CDC.

Authorities have not identified Taco Bell as the source of the outbreak, nor have they identified a produce grower or supplier responsible. But investigators are examining whether fresh ingredients served at some Taco Bell restaurants may have been linked to the illnesses. 

Texas has been closely watching the outbreak. As Chron previously reported, the state has reported an unusually high number of cyclosporiasis cases this summer, placing it among the states with the highest number of reported infections nationwide.

The investigation intensified after Michigan health officials linked many illnesses there to leafy lettuce and local reports claim some Taco Bell locations temporarily stopped serving lettuce, cilantro, onions, pico de gallo and guacamole while investigators worked to identify the source. 

One person familiar with the investigation told The Washington Post that Taco Bell’s decision to voluntarily stop serving several fresh ingredients was an appropriate precaution. Investigators also noted that while some people who became ill reported eating at Taco Bell, many others had not, suggesting the outbreak extends beyond the chain. 

For Texans, however, the biggest question remains the same one health officials have been trying to answer for weeks: what’s contaminating the produce? So far, investigators say they still don’t know.