Health officials report that an ongoing cyclosporiasis outbreak in Central Florida has grown to 58 cases since May, up sharply from 36 cases reported last week.
- Hardest-Hit Area: Orange County currently leads the region with 21 confirmed infections.
- Suspected Source: Investigators have linked the outbreak to lettuce imported from Mexico, though the investigation remains ongoing.
- The Cause: The illness is triggered by the parasite Cyclospora cayetanensis, which causes severe gastrointestinal distress, including prolonged diarrhea, stomach cramps, and nausea.
Prevention & Advice
- Seek Care: Anyone experiencing persistent digestive issues—particularly after consuming fresh produce—should consult a healthcare provider.
- Practice Safety: Experts recommend thoroughly washing all fruits and vegetables and maintaining strict food safety habits to minimize infection risks.
Michigan’s Cyclosporiasis Outbreak:
Michigan is in the midst of the largest cyclosporiasis outbreak on record, with about 1 in every 1,000 residents affected over the past three months. More than 10,000 cases have been reported in the state, which has a population of roughly 10.1 million, according to the state health department. Cyclosporiasis is caused by a microscopic parasite that contaminates fresh food or water and causes severe diarrhea in those infected. Iceberg lettuce supplied by Taylor Farms has been recalled, and health officials believe contaminated products have largely already been eaten or removed from shelves. “We do have the outbreak under control,” US Health and Human Services Secretary Robert F. Kennedy Jr. said last week, pointing to the recall. Still, because symptoms can take time to appear, thousands of new cases were reported nationwide over the past week. Health officials are racing to trace the details of cases in an ongoing investigation, but the parasite is notoriously difficult to find, and testing produce can be challenging. People who are sick may be asked to recall what they ate weeks earlier to help identify a common thread. Cyclosporiasis cases typically rise in the US during spring and summer, with a season that usually runs from the start of May through the end of August, according to the Centers for Disease Control and Prevention. This year’s case counts, however, are particularly high. Here is what is known about the situation so far.
How Big Is the Outbreak?
The CDC has identified more than 18,000 cases of domestic cyclosporiasis this season. Of those, 6,707 are confirmed, while about 11,500 others are still undergoing laboratory testing and analysis to determine whether the illness was acquired in the US. The FDA is investigating multiple clusters of cyclosporiasis cases this year in collaboration with the CDC and state partners, including the particularly large multistate outbreak centered in the Midwest, to which the CDC has linked 1,947 cases as of last week. However, CDC figures include only confirmed cases, and data from individual states shows much higher case counts.
What States Are Part of the Outbreak?
The CDC has identified nine states with cases linked to the ongoing outbreak: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania and West Virginia. Michigan has reported more cases than any other state, with at least 10,077 since May 1, according to the Michigan Department of Health and Human Services. The state health department has said it “cannot say with certainty that every illness is linked to the same source of exposure,” but that the concentrated, sharp increase in cases “strongly suggests that the vast majority of these illnesses are associated with the same outbreak.” As of Wednesday, the eight other affected states had reported more than 5,000 cases combined: Ohio has reported at least 2,574 cases, Indiana 1,092, Illinois 532, Kentucky 468, Kansas 461, Oklahoma 303, West Virginia 245, and Pennsylvania 82. Some states update their case counts daily, while others do so weekly or a few times a week. According to a CDC update, the true number of sick people in this multistate outbreak is likely higher than what has been reported, and the outbreak may not be limited to the states with known illnesses. Overall, 45 states have reported at least one domestically acquired cyclosporiasis case this season, though some, including California and New Jersey, say their case counts this year are in line with typical seasonal trends.
What Foods Are Affected in the Large Outbreak?
With questions swirling about whether cilantro, tomatoes or romaine lettuce are safe to eat, Michigan health officials have completed more than 2,000 interviews of people sick with cyclosporiasis. They say there is “very strong” evidence linking the outbreak to one product in particular: shredded iceberg lettuce supplied by Taylor Farms, which was served at some Taco Bell locations. The CDC recommends avoiding shredded iceberg lettuce from Taylor Farms de Mexico served at Taco Bell locations in the states with cases linked to the outbreak—Indiana, Kentucky, Michigan, Ohio and West Virginia—while the FDA works to determine whether the contaminated lettuce reached other places. Taco Bell has said it removed Taylor Farms lettuce from its restaurants and its nationwide supply chain, and supplier Taylor Fresh Foods said it is removing all of its iceberg lettuce from central Mexico from the US market. In a LinkedIn post last week, Taco Bell CEO Sean Tresvant thanked the chain’s customers for their support and pledged to strengthen the company’s food safety practices, saying, “We aren’t entitled to your loyalty. We earn it one meal at a time… There is a better way forward, and we are going to lead the way.” Taylor Farms has also recalled iceberg lettuce shipped to 27 states, some of which went to Walmart and Jack in the Box and other food service outlets. The investigation is ongoing, and no other foods have so far been identified as part of this outbreak, though basil, cilantro, berries and snap peas have historically been the foods most commonly linked to cyclospora outbreaks. Federal health officials say there have been multiple cyclospora investigations this year—some tied to the large Midwest outbreak, some involving single states, and some involving cases not yet tied to any cluster.
How Long Does It Take to Get Sick?
Illnesses associated with the current outbreak began in mid-May, and new cases have continued to emerge as recently as last week, according to the CDC. Symptoms of cyclosporiasis can take days, or up to two weeks, to appear after a person consumes contaminated food or water. They include watery diarrhea, loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue, and people who become ill may experience symptoms for weeks.
How Severe Is It?
At least 98 people have been hospitalized in connection with the current outbreak, according to the CDC, while hundreds of other cyclospora hospitalizations have been reported this year overall. States specifically linked to the outbreak have reported dozens of hospitalizations each, including at least 160 in Michigan and at least 134 in Ohio. No deaths have been reported.
How Does This Compare to Other Outbreaks?
According to a 2023 report from the US Department of Agriculture’s Food Safety Inspection Service, the largest cyclospora outbreak on record in the US involved raspberries and led to about 1,500 cases; other large outbreaks have typically not surpassed 1,000 cases. With nearly 2,000 cases now linked to the current Midwest-centered outbreak, it has become the largest known cyclospora outbreak in the US to date. The total number of cyclosporiasis cases reported nationwide this year is also higher than usual: there were more than 4,500 cases in 2023 and more than 3,500 in 2024, according to federal officials, but this year’s total has already more than doubled those figures with at least a month still left in the season.
What Else Could Be Causing Stomach Issues?
The French biotech company bioMérieux tracks trends in gastrointestinal pathogens by collecting test results from a network of laboratories. Its data shows that the prevalence of cyclospora and other parasites has surged in the US over the past month, rising from less than 3% of tests in the second week of June to more than 15% in mid-July. Even so, E. coli remains a more common cause of stomach issues in the US right now, present in more than 19% of tests, while viruses accounted for more than 14% of positive tests between July 26 and July 29.
