An outbreak of cyclosporiasis, a diarrheal illness caused by the microscopic cyclospora parasite, has now been confirmed in nine states after Illinois, Kansas, Oklahoma and Pennsylvania joined Indiana, Kentucky, Michigan, Ohio and West Virginia on the list. Federal health officials say the bulk of the illnesses trace back to shredded iceberg lettuce grown by Taylor Farms in central Mexico and served at Taco Bell locations, though investigators have not ruled out additional sources. Nearly 2,000 people who reported eating at Taco Bell across the nine states have tested positive for the parasite since late June, and the outbreak has continued into late July.
Case counts far outpace recent years
State health departments have logged more than 12,000 cyclosporiasis cases this summer, a number that dwarfs the roughly 4,500 cases recorded in all of 2023 and 3,500 in 2024. Michigan alone accounts for more than 8,100 of those cases, making it by far the hardest hit state. Some Michigan officials have said not every patient interviewed could recall eating the implicated lettuce, raising the possibility that more than one source is contributing to the surge. Federal investigators, along with health authorities in Mexico, are still trying to pin down what caused the contamination at the processing level.
Wells thinned by federal cuts
Michigan’s Cyclosporiasis outbreak response has been complicated by a depleted public health workforce. The state has 23 fewer infectious disease specialists and 123 fewer county health workers since the Trump administration canceled roughly $12 billion in COVID era grants to states last year. To keep up with interviews, which can take up to 45 minutes each, health departments have pulled staff from unrelated programs, including hepatitis C surveillance and gun violence prevention work, and in some counties have turned to volunteers. Ingham County, home to Lansing, has investigated only about half of its roughly 700 cases and has begun setting aside older cases to focus on new ones.
Cyclosporiasis communication gaps frustrate local officials
Several county health officials said they have struggled to get timely updates from federal agencies, with one Michigan county reporting it first learned new outbreak details from news coverage rather than from state or federal briefings. A federal health spokesperson disputed that characterization, saying the CDC has been meeting daily with the FDA and state officials nationwide. Other states in the Cyclosporiasis outbreak, including Ohio and West Virginia, said they have maintained regular calls with federal partners, and the CDC dispatched a team of epidemic intelligence officers to Ohio in late July.
What comes next
The FDA linked the outbreak to Taylor Farms lettuce in mid July, prompting Taco Bell to drop the supplier nationwide and Taylor Farms to pull the affected product from central Mexico off shelves. Still, federal officials say the investigation into other possible sources continues, and cases keep appearing weeks after the initial cluster emerged. Symptoms of cyclosporiasis, including watery diarrhea, cramping, fatigue and weight loss, can take up to two weeks to appear after exposure and may persist for weeks afterward. With county health departments already stretched thin and case counts still climbing, officials say the outbreak’s true scope and cause may not be fully understood for some time.
