HASTINGS — The South Heartland District Health Department (SHDHD) reports 18 confirmed cases of cyclospora in the health district serving Adams, Clay, Nuckolls and Webster counties. SHDHD executive director Michele Bever reported the health department has logged 18 confirmed cases of cyclosporiasis since July 10. Case investigations are ongoing and the health department has conducted eight case interviews with community members who have contracted the illness; all of these cases were acquired in the United States. The health department is working with state officials to determine if local cases are part of the large national outbreak. Fresh vegetables and fruit are usually associated with cyclospora outbreaks.