The Iowa Department of Public Health is warning Iowans to wash their hands and keep their sick children at home and out of the pool in light of a second diarrhea-causing illness that has sickened more than 200 people since June 1.  A Thursday release said the department has received an increasing number of reports of Cryptosporidiosis, which causes watery diarrhea, nausea, vomiting, stomach cramps and a low-grade fever. The release said 358 cases have been reported to the department this year, and 272 of them have occurred since June 1.

Patricia Quinlisk, state epidemiologist and medical director at the Iowa Department of Public Health, said Thursday that the parasite first began to crop up in Polk County, and has since spread to other counties in the state in recent weeks, prompting the warning.

The cases have been reported in about half of Iowa’s 99 counties and an additional 138 remain under investigation — meaning they have been reported, but the department has not been able to follow up with the patient. In 2012, a total of 328 cases of cryptosporidium were reported total.

Many of the people who contracted cryptosporidium reported swimming in pools, lakes and rivers or being around animals.

People who think they have cryptosporidium can be tested for it, and an anti-parasitic medication is available, Quinlisk said.

The department is advising people not to swim if they are experiencing diarrhea, and not to allow children wearing diapers with diarrhea to swim, not swallowing water in your mouth while swimming, washing hands after using the bathroom or changing a diaper, showering before swimming, changing diapers in a bathroom rather than poolside, and taking children on bathroom breaks often. People with diarrhea should wait until two weeks after it has stopped before swimming.

The release also says people should wash hands frequently — particularly when preparing food, after using the bathroom, after changing diapers and before and after taking care of someone sick with diarrhea. Children with diarrhea should also not go to childcare settings until it has stopped, according to the release.

Quinlisk added that the department has also previously found cryptosporidium is easily transmitted through kiddie pools, which are filled with tap water and therefore not chlorinated. She said parents should opt to use a sprinkler instead, especially if a child is experiencing diarrhea, because it can prevent the spread of cryptosporidium from person to person.