The South Heartland District Health Department (SHDHD) is reporting 18 confirmed cases of cyclosporiasis within its health district, which includes Adams, Clay, Nuckolls and Webster counties. SHDHD Executive Director Michele Bever said the department has recorded 18 confirmed cases since July 10. Case investigations are continuing, and health officials have interviewed eight community members who contracted the illness. SHDHD is working with state health officials to determine whether the local cases are connected to a larger national outbreak. As of Aug. 5, the outbreak had resulted in 6,358 confirmed cases, 278 hospitalizations and two deaths in the United States.