An intestinal infection has almost 50 people in The Lone Star State doubling over in acute discomfort that could linger for quite some time if not treated.

As of Thursday morning, there have been 48 reported cases of cyclosporiasis in Texas in the last week, most in north Texas. By comparison, there were 44 cases in all of 2012, 14 in 2011, and nine in 2010.  

The foodborne illness, caused by the parasite Cyclospora cayetanensisw, is transmitted through food and water contaminated with fecal matter. Symptoms include watery diarrhea, loss of appetite, nausea, fatigue, bloating, cramping, and weight loss, according to the Centers for Disease Control and Prevention. A low fever can also be a warning sign.

Symptoms can appear as soon as two days after infection, and while the cyclosporiasis is not life threatening, it can stay in the body for a long time if left untreated. What's worse is that tests cannot confirm the parasite 100 percent of the time, and the most effective treatment is hard to administer.

"What a lot of us have decided to do so far is just kind of basically treat this clinically, so if you have a lot of fatigue, a lot of the other symptoms, a lot of us will still test to go ahead and treat as well," Dr. Blaine Bachim at Texas Health Southwest told NBC 5 News.

"It's a Catch-22 for sure," Dr. Shawn Mitchell, medical director of Premier Urgent Care in Colleyville, added. "It's effective -- it's the only effective antibiotic that we know of right now for cyclosporiasis. The hitch with it is, many people are allergic to it."

Officials have not yet determined the origin of the outbreak and advise Texas residents to be extra vigilant in washing down food items, especially produce.

"To decrease the risk of eating fresh produce it is important to thoroughly rinse your fruits and vegetables several times," said Dr. Christopher Perkins, Dallas Country Department of Health and Human Services medical director and health authority. "Even when cooking vegetables it is critical to clean them beforehand."