Nine people have confirmed cases of cyclospora infection after eating lettuce at the cafeteria in Cheshire Medical Center in Keene, according to the New Hampshire Department of Health and Human Services.

The health department says the lettuce was later recalled by Taylor Farms and is no longer being served.

In a statement Thursday afternoon, Dartmouth Health said Cheshire Medical Center has identified 16 total patients, including 10 employees, who were exposed to cyclosporiasis, though only nine of them had “confirmed” cases. Dartmouth Health said, as of Thursday afternoon, no inpatients have contracted the illness while at Cheshire Medical Center.

The state health department says anyone who has eaten lettuce products from early June to July 20 and has severe or persistent diarrhea should consider getting tested for a cyclospora infection.

Low-grade fever, nausea, stomach cramps and fatigue are also symptoms of the parasite.

Without treatment, symptoms can last longer and may relapse, though most people with normal immune function will get better on their own.