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The Hawaii Department of Health has confirmed two additional travel-related cyclosporiasis cases in Hawaii residents, bringing the state's total this year to three.
The two people, who live in the same household, traveled together internationally and to a U.S. state reporting an outbreak. Health officials determined both infections were acquired outside Hawaii.
The department said there is no evidence of locally acquired infections or community transmission in the state.
Cyclosporiasis is an intestinal illness caused by a parasite and is usually spread through contaminated food or water. Symptoms can include watery diarrhea, stomach cramps, nausea, fatigue and loss of appetite.
Residents are advised to wash fresh produce, practice good hand hygiene and seek medical care for prolonged diarrhea, particularly after travel.