A single shipment of shredded iceberg lettuce has triggered one of the largest cyclosporiasis outbreaks in years, and federal health officials say the tally keeps climbing. The outbreak expanded from nine states to fifteen in two weeks, with the CDC and FDA reporting 6,358 confirmed illnesses as of August 5. Six states joined the outbreak in the latest update: Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina.
The lettuce traces back to Taylor Farms de Mexico, grown in central Mexico, and Taco Bell served much of the contaminated product before pulling it from menus. Illness onset dates stretch from June 22 through July 31, meaning some infections predate the July 17 recall by weeks.
Six states joined the outbreak in a single update
Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina all reported confirmed cases tied to the outbreak as of the FDA’s August 5 update. The jump does not necessarily signal fresh contamination. Officials say much of the growth traces back to earlier patient interviews finally getting logged into the federal system.
State and local health departments interviewed additional patients after the recall and matched exposure histories to either Taco Bell or recalled retail lettuce, feeding new names into the count. Many of the newly added illnesses actually began before Taylor Farms issued its July 17 recall, the FDA said, a detail that shows testing lags well behind actual infection.
The case count has nearly quadrupled in three weeks
When the CDC first flagged the outbreak on July 16, the agency tied 1,644 illnesses to five states. A week later, that figure reached 1,947 across nine states. By August 5, the total stood at 6,358, according to FDA outbreak data, marking close to a fourfold jump in three weeks.
Officials expect the number to keep rising. Confirming a Cyclospora case can take as long as six weeks, so illnesses reported to state health departments today may not appear in the federal tally until September. Nationally, the CDC counted more than 6,700 domestically acquired cyclosporiasis cases since May 1, a total that includes this outbreak alongside unrelated infections tracked separately by the agency.
Michigan carries the heaviest toll and both confirmed deaths
Michigan has absorbed the brunt of the outbreak. The state Department of Health and Human Services reported 11,234 cyclosporiasis cases and 193 hospitalizations as of August 3, a broader count that extends beyond the illnesses tied specifically to the recalled lettuce. Two deaths connected to the outbreak have been confirmed, both in Michigan.
Both patients had significant underlying health conditions that dehydration from the parasite may have worsened, and both fell ill before the July 17 recall. Natasha Bagdasarian, the state’s chief medical executive, indicated in late July that case numbers appeared to be leveling off, while stopping short of calling the outbreak over.
Ohio has logged more than 4,000 cases and Indiana close to 1,349, per state figures, though those totals include cases beyond the federal outbreak count.
Traceback data converged on one grower in central Mexico
FDA investigators traced the contamination to Taylor Farms de Mexico, a supplier of shredded iceberg lettuce grown in Guanajuato. The company voluntarily pulled all iceberg lettuce sourced from central Mexico from the US market on July 17 and initiated a recall covering both restaurant supply chains and retail shelves. Taco Bell said it stopped using lettuce from the supplier that same day.
A border sample initially flagged as positive for Cyclospora on July 18 was later ruled a false positive after FDA lab experts re-reviewed the results. The agency said the finding did not undercut the broader epidemiological case against the supplier.
The recall footprint reached far more states than the illness count
Recalled lettuce moved through the supply chain between June 29 and July 16, landing in 27 states plus Washington DC, spanning as far as Texas, New York and Connecticut, per the FDA’s distribution map. Marketside-brand packages sold at Walmart carried best-by dates of July 18 through August 3, meaning some recalled product may have still sat in refrigerators when the recall reached stores.
That wide distribution footprint helps explain why officials expect the confirmed case list to keep growing even after new contamination has stopped. Product already sold does not disappear once a recall notice goes out.
A surveillance change complicates comparisons with past years
The outbreak lands amid a shift in how the country tracks Cyclospora infections. In July 2025, the CDC’s foodborne surveillance network made testing for the parasite optional rather than required, a change infectious disease specialist William Schaffner said could be affecting how the response has unfolded. Federal health officials have denied that the surveillance shift is skewing outbreak data.
Independent of that debate, CDC’s own case data show domestically acquired cyclosporiasis running higher this year than the same stretch in 2025, a pattern the agency flagged even before the Taco Bell cases surfaced. Cyclosporiasis is a nationally notifiable disease, reportable in 47 states, the District of Columbia, and New York City, which gives health departments a consistent baseline even as testing practices shift underneath it.
The parasite spreads through contaminated produce not close contact
Cyclospora cayetanensis causes illness when people swallow contaminated food or water, and the CDC says the parasite does not spread directly between people the way norovirus does. Someone typically becomes ill about a week after exposure, though symptoms can appear anywhere from two days to two weeks later.
Watery diarrhea, fatigue, loss of appetite, bloating and stomach cramps top the symptom list, alongside nausea and occasional fever. Untreated illness can drag on for a month or longer, with symptoms sometimes fading and then returning in relapse. Vomiting, body aches and headache round out the range of complaints doctors have logged among patients tied to this outbreak.
Doctors warn immunocompromised patients face the greatest risk
Cyclosporiasis rarely kills healthy adults, but the FDA warns immunocompromised patients can develop more severe illness that lasts longer and needs closer medical attention. Routine stool tests do not automatically screen for Cyclospora, so people with prolonged diarrhea after eating shredded lettuce need to specifically request the test from a doctor.
The CDC recommends anyone holding recalled lettuce to:
- Throw it away,
- Wash any surfaces or containers it touched with hot soapy water and
- Stay hydrated once symptoms appear.
Consumers who bought the product at Walmart under the Marketside brand can also return it for a full refund rather than simply discarding it.
The outbreak keeps growing even though the recall already happened
Health officials stress that a completed recall does not end an active outbreak. The six-week reporting lag means new cases tied to lettuce eaten in July could still surface through September. FDA and CDC say they will keep updating state counts as interviews continue.
Anyone who ate at Taco Bell locations in the affected states before July 17 and later developed diarrhea should contact a healthcare provider and mention the exposure.
