Thursday, 6 August 2026, 13:36
The cyclosporiasis outbreak continues to grow. Federal officials now count more than 22,700 cases and 517 hospitalizations across 15 states, with two deaths reported. Most cases have been tied to contaminated shredded iceberg lettuce at Taco Bell. The CDC has implemented a level 3 emergency response to the outbreak, according to a source briefed on the agency’s actions.
Six states were added in the most recent update: New Hampshire, Arkansas, Iowa, Missouri, Nebraska, and North Carolina. They join Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia, according to a federal source cited by Telemundo stations. The additions bring the total to 15 states.
Missouri has seen a particularly sharp rise. The Missouri Department of Health and Senior Services reported 1,095 cases as of Sunday, more than double the number it reported the previous week.
Health officials caution that the addition of new states does not necessarily mean the outbreak is still spreading. Dr. Stephen Ostroff, former acting commissioner of the FDA, said the newly reported cases may involve people who consumed the recalled lettuce weeks ago and were only recently diagnosed.
Lab testing by the CDC showed that the illnesses in the six newer states were probably caused by the same strain of the cyclospora parasite, which burrows into the lining of the small intestine and can cause weeks of explosive diarrhea if left untreated.
The CDC has implemented a level 3 emergency response, according to a source briefed on the agency’s actions. Level 3, the lowest level of emergency response, means the agency is actively monitoring and working on a situation, although the risk to the general public is low. It gives the CDC the flexibility to repurpose staff to assist in the outbreak investigation.
In its latest update, the CDC identified more than 22,700 cases of domestic cyclosporiasis this season; 10,468 cases are confirmed, and more than 12,200 others are undergoing further laboratory testing. Among the more than 6,000 cases tied specifically to the outbreak, nearly 300 have been hospitalized, and two people have died. By Bill Marler’s tally, states have reported nearly 25,000 cases so far this season. Because many people may skip seeing the doctor for diarrhea, officials believe that many more cases haven’t been counted. The current count 'is a floor and not an estimate,' Marler said. The true number of Americans sickened by cyclosporiasis this summer may be as high as 1 million, according to a multiplier published by the CDC in 2011.
Investigators have tied most cases to shredded iceberg lettuce served at Taco Bell and supplied by Taylor Farms. The lettuce came from central Mexico, according to the reports. The company issued a recall, and health officials removed the product from market shelves. Taco Bell says it has removed affected shredded iceberg lettuce supplied by Taylor Farms from its restaurants in certain states.
On July 17, Taylor Farms de Mexico recalled all iceberg lettuce grown in central Mexico, including in salad kits sold in grocery stores, out of an abundance of caution. The company said it conducted a broad recall and is conducting a 'top-to-bottom' review of all safety processes and protocols. The recalled lettuce was distributed to restaurants and retail stores in 27 states. The FDA has not identified other potential sources beyond Taylor Farms, and the recalled lettuce should no longer be available in the U.S.; its use-by dates ended in August.
"We may have solved the Taylor Farms shredded lettuce problem, but that's unlikely to explain everything we're seeing," Ostroff said.
The delayed onset of cyclosporiasis symptoms means that some patients may have been exposed weeks before their cases were counted. Ostroff pointed out that if people were exposed after the recall date, investigators may need to look for another source. "It's unlikely that explains everything," he added.
Experts believe that because lettuce is perishable, the product that made people sick was consumed or thrown away long ago. In addition, some people who became ill did not report eating lettuce, and state health officials have said they cannot rule out other contaminated sources as contributors.
"With an incubation period up to two weeks, there should no longer be people newly getting sick from that product," Ostroff said. "But it takes a while for people to seek health care after onset, get tested and diagnosed, reported to state health departments and then to CDC. Think of it like solving a jigsaw puzzle. You have all these pieces sitting there and the longer you work on it, the more likely it is you’ll figure out where each piece fits into the puzzle."
Taylor Farms is a major produce supplier with operations in California, making this outbreak highly relevant to the state's agricultural industry. While the contaminated lettuce originated in central Mexico, the company's connection has put California produce handling under renewed scrutiny. California residents who ate Taco Bell salads or bowls with shredded iceberg lettuce should monitor for symptoms.
Cyclospora cayetanensis is a microscopic parasite that burrows into the lining of the small intestine and can be found in human feces. It can contaminate fresh produce and causes cyclosporiasis, an intestinal illness marked by watery diarrhea, often explosive, which can last for weeks if left untreated. The illness is sometimes nicknamed the "explosive diarrhea parasite." Past outbreaks have been linked to imported vegetables and berries. The CDC recommends washing produce thoroughly and seeking medical care for persistent diarrhea.
Anyone who ate recalled shredded iceberg lettuce from Taco Bell and developed diarrhea, cramps, or nausea should contact a healthcare provider. Cyclosporiasis can be treated with antibiotics. The investigation remains active, and officials have not ruled out additional sources of contamination.
