Two people in Missouri are among more than 320 people infected by a parasite in the last month in the Midwest, the South and New England.

The parasite is food-borne and contracted by ingesting food or water contaminated with feces, but the cause has not been identified. An infection can result in violent diarrhea, stomach cramping and fatigue. Symptoms begin about a week after exposure and can last for a few days to a month.

This outbreak has resulted in 18 hospitalizations. The two cases in Missouri are in people in the Kansas City and Branson areas.