(NYT) – Public health experts said there were more cases than usual of the disease caused by cyclospora, which is spread through contaminated food and drink.

More than 400 people across 18 states have been infected with cyclospora, a parasite that is transmitted through food and water contaminated with feces and causes stomach cramps, nausea, vomiting and severe diarrhea. At least 20 people have been hospitalized, according to the Centers for Disease Control and Prevention, and no deaths have been reported.

New York, Texas, Illinois and Michigan have the most cases so far, according to the C.D.C. and state health officials. (Read More)