Cyclospora Outbreak Linked to Lettuce Expands Across U.S. States

Health officials in the United States announced a connection between cases of a parasitic illness and lettuce across 15 states. This year, cyclospora cases have surfaced in at least 47 states. Investigators aim to determine how many originate from a shared contaminated source.

The Centers for Disease Control and Prevention (CDC) reported that the outbreak’s reach increased from nine to 15 states. Newly added are Arkansas, Iowa, Missouri, Nebraska, New Hampshire, and North Carolina, joining an initial list that included Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia.

Investigations initially focused on lettuce served at Taco Bell. Federal officials now target Taylor Farms as the outbreak’s lettuce source. The company has recalled iceberg lettuce grown in central Mexico.

The complexity of investigating and containing cyclospora outbreaks is notable. Dr. Juan Luis Marquez, Medical Director for Washtenaw and Livingston County Health Departments in Michigan, emphasized that symptom onset can occur weeks after exposure. Laboratory analysis of the parasite poses challenges, and extensive interviews to identify common exposures demand significant effort.

There is also a reduction in public health staffing at federal, local, and state levels, resulting in fewer available resources, Marquez pointed out. Cyclospora is a microscopic parasite primarily causing diarrhea with frequent and sometimes explosive bowel movements, as stated by the CDC. Outbreaks mostly arise late in spring and during summer.

The parasite thrives in warm conditions, infecting the intestines, and spreads through feces. Cyclosporiasis is less common than foodborne diseases caused by salmonella or E. coli. Many cyclosporiasis cases never link to a specific food or source. In 2019, the U.S. experienced its worst year with approximately 4,700 cases. This year’s figures have significantly exceeded that number. Michigan alone reported over 12,000 cases, including two deaths. Nationwide cases surpass 25,000.

The U.S. Food and Drug Administration is monitoring five separate cyclospora outbreaks. The 15-state outbreak remains the largest. No product links to the others, which include one affecting 115 people.