Cyclospora in salad: The diarrhea parasite outbreak has now sickened over 10,000 nationwide — see the hotspots
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- The number of confirmed cyclosporiasis cases in the US has topped 10,400, health officials said Tuesday.
- People got sick after eating lettuce sold in several states — Michigan and Ohio were especially hard-hit.
- Two maps show the states with the most reported cases and where food has been recalled.
The Midwest remains the hotspot of a major outbreak of cyclosporiasis, a parasitic infection that can trigger weeks of watery diarrhea.
On Tuesday, federal health officials at the Centers for Disease Control and Prevention said that 10,468 people across the US have developed laboratory-confirmed cases of cyclosporiasis this summer. Another 12,255 cases are still under investigation. Most of the cases are clustered in a group of states bunched together in the Midwest and mid-Atlantic.
What was previously a five-state outbreak, with most cases reported in Michigan and Ohio, now involves at least nine states: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia. Missouri is also reporting an unusually high number of cyclosporiasis cases this week, though Michigan and Ohio are still leading in case counts.
The CDC said in July that 1,947 cyclosporiasis cases were linked to a specific type of iceberg lettuce distributed by Taylor Farms to Taco Bell locations in the nine states, but that is far from the full extent of the outbreak.
Overall, more than 517 people are known to have been hospitalized this summer with the parasite, which causes watery diarrhea and severe stomach cramps that can last for several weeks.
The first two deaths in the outbreak were reported in Michigan on Monday. The parasite is not usually deadly, but it can lead to severe dehydration, which can be fatal in older adults or people with compromised immune systems.
Cyclospora season in the US typically runs between the beginning of May and the end of August.
Katelyn Jetelina, assistant professor adjunct of epidemiology at Yale School of Public Health, wrote in her public health newsletter, Your Local Epidemiologist, on August 4 that the share of tests coming back positive is "in a nosedive, which is a great sign."
"It looks like things are slowing down," Jetelina said, though she added the caveat that "the true number of cases and direction remain nearly impossible to know given our fragmented data infrastructure in the US."
It's possible that the US has had several outbreaks running at once, including one suspected to be caused by cilantro in New York.
On July 17, Taylor Farms voluntarily recalled iceberg lettuce from the US that was sourced from central Mexico, as shown below.
Taylor Farms told shoppers who had bought iceberg lettuce distributed June 29th through July 16th in the following states to throw it out: Alabama, Arkansas, Connecticut, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Missouri, Mississippi, North Carolina, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.
However, other foods can't be ruled out.
(As Business Insider's Dan DeFrancesco explained in an edition of the Business Insider Today newsletter, the situation is a little more complex than we get into here.)
Jetelina said iceberg lettuce was recalled in 27 states "due to a combination of the complexity of food distribution networks and continued uncertainty around where people are most impacted."
Already, there are signs that this outbreak is past its peak, with new case numbers dwindling.
"Either the contaminated food works its way out of circulation, or it takes a few weeks, the temperatures get cool, and the parasites no longer mature on produce," Jetelina said.
Why states and the CDC have different case counts
There are a number of potential sources of confusion in this outbreak, including differing state and federal case counts, and how the FDA and Taylor Farms have shared information on the suspected source of infections.
As of July 21, at least 11,276 cases of cyclosporiasis had been reported across 46 states in 2026, according to Georgetown University's Health Security Operations Center, which is tracking state and national-level data. Some state health departments are tallying cases as part of the ongoing outbreak, while others include all cases reported in 2026 in their figures.
How to avoid cyclospora
Cyclospora spreads through contaminated food and water, and symptoms, including watery diarrhea, nausea, and stomach cramps, can take up to two weeks to show, making it difficult to trace back to a definitive source. The parasite is resistant to disinfectants, and washing food doesn't guarantee its removal, as it is particularly good at sticking to produce.
Health authorities say in order to definitively kill the parasite, consumers should cook foods to at least 158 degrees Fahrenheit. Buying whole heads of lettuce and peeling back the outer layer of leaves rather than choosing pre-washed, bagged, or pre-mixed salads is also a good move, if you are more risk-tolerant.
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