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Infections with cyclospora — what’s become known as the “explosive diarrhea” parasite — have been reported in almost every state in the U.S. as of early August. Health officials are still racing to find the illness
On Tuesday, the U.S. Centers for Disease Control and Prevention shared the latest national numbers: 10,468 laboratory-confirmed cases in the U.S. since May 1, and 12,255 probable cases that are under investigation
Cases have been reported in 47 states so far. There have been 517 hospitalizations and two deaths in this timeframe
The two deaths occurred in Michigan in people with “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,” the state’s health department said. Death from cyclosporiasis is rare in the U.S
It’s unclear which clusters of cases across the country may be connected, officials have said. The U.S. Food and Drug Administration is currently investigating six separate cyclospora outbreaks, according to its foodborne illness tracker
The biggest one spans 15 states, including Michigan, Ohio, Missouri, Illinois and Indiana, NBC News reported. It’s been linked to shredded iceberg lettuce served at Taco Bell and supplied by Taylor Farms from central Mexico. Taco Bell has since removed all the implicated lettuce from its supply chain, and Taylor Farms has issued a recall
The FDA has not specified where the other five outbreaks are located, nor any possible
Public health officials are still looking into whether lettuce may be driving cases in other parts of the country beyond those 15 states, as well as other possible or from before the Taylor Farms recall
Food safety experts have said there are likely multiplecases could continue to rise through the end of August
“There may be multiple unrelated outbreaks going on at the same time,” Donald Schaffner, Ph.D., professor of food microbiology in the Department of Food Science at Rutgers University, tells TODAY.com
Here’s where cyclosporiasis is surging in the U.S., what to know about the stomach-churning infection and how to stay safe during peak fresh produce season
What Is the ‘Diarrhea Parasite’ Going Around?
Cyclosporiasis is an intestinal infection caused by Cyclospora cayetanensis, a microscopic parasite carried in human feces. The parasite is not new, and cases normally increase in the summer in the U.S
People become infected with cyclospora by consuming food or water contaminated with particles of feces from an infected person, Kali Kniel, Ph.D., professor of microbial food safety at the University of Delaware, tells TODAY.com
The parasite infects the small intestine, causing severe bowel upset. The hallmark symptom of cyclosporiasis is watery and sometimes “explosive” diarrhea, per the CDC. Other signs include abdominal cramping, bloating and fatigue
If left untreated, the diarrhea can last for weeks, but cyclosporiasis isn’t usually life-threatening, says Kniel. Doctors can treat the infection with a combination antibiotic
Person-to-person spread is very unlikely. That’s because after the parasite is shed in feces, it takes one to two weeks living outside the body to mature and become infectious, says Kniel
Cyclospora can get into produce if it’s grown in soil or washed with water contaminated with feces; fresh fruits and vegetables are common culprits, says Kniel
Where Are Cyclosporiasis Cases Surging?
Almost 23,000 confirmed and probable cases of cyclosporiasis have been reported in 47 states since May 1, per the latest CDC data as of Aug. 4
Of these, the CDC has confirmed 10,468 cases and another 12,255 are under investigation, the agency said
The true number of cyclospora infections in the U.S. is likely higher than the numbers currently being reported — that’s because many people recover on their own and never get tested for cyclospora, per the CDC
Most of the cases are tied to a massive outbreak primarily in the Midwest and South spanning 15 states,of these.)
- Indiana
- Kentucky
- Ohio
- Michigan
- West Virginia
- Illinois
- Kansas
- Oklahoma
- Pennsylvania
- Arkansas
- Iowa
- Missouri
- Nebraska
- New Hampshire
- North Carolina
Only three states have reported zero cases since May 1: New Mexico, Montana and Hawaii
Here’s which states are reporting the most cases:
Michigan
Michigan is being hit the hardest. As of Aug. 5, the state has reported 12,218 cyclosporiasis cases and 193 hospitalizations, per per the Michigan Department of Health and Human Services
There are some promising signs that cases may be peaking in Michigan, but the outbreak is still not over, Dr. Natasha Bagdasarian, the state’s chief medical executive, told NBC News in late July
Ohio has reported over 4,000 cases, per the state health department
Indiana
Indiana has recorded nearly 1,349 so far, according to the state health department
Missouri
Missouri has had 1,095 infections since the start of the year, per the state health department
Illinois
Illinois reported 995 confirmed and probable cyclosporiasis cases as of Tuesday, state health officials said
North Carolina
North Carolina’s case count is 867 since May, according to the state health department
New York
There have been 753 cyclosporiasis cases since May 1, according to the state health department
Kansas
Kansas is reporting between 200-499 cases, per the CDC tally
Kentucky
Kentucky is also reporting between 200-499 cases
Oklahoma
Oklahoma is also in the 200-499 range for cyclosporiasis cases, according to the CDC
What Food Is Driving the Rise in Cyclospora Cases?
So far, the FDA and CDC have identified one possible and nearby states: shredded iceberg lettuce served at Taco Bell
Health officials zeroed in on the fast-food chain after interviewing over 1,900 people sickened in these states who reported eating at Taco Bell in June or July, the FDA said
Taco Bell has removed all affected lettuce from its supply chain. The supplier, Taylor Fresh Foods, issued a voluntary recall of all of its iceberg lettuce products
However, it’s possible that another in the U.S. Officials in North Carolina have said that fresh parsley and cilantro may be behind the increase in cases in the state
Investigations are ongoing. “Additional implicated brands, restaurants, retailers, or distribution channels may be identified, reaching additional states,” the FDA said in late July
Schaffner and Kniel both suspect there’s more than one food or water
Past cyclosporiasis outbreaks in the U.S. have been linked to the following foods:
- Salad greens
- Cilantro
- Basil
- Raspberries
- Green onions
- Snow peas
Tracking Cyclospora Outbreaks
Cyclospora is a particularly challenging parasite to track, food safety experts tell TODAY.com
The incubation period for cyclosporiasis is long, and symptoms may not appear for up to 14 days. Then, confirming a diagnosis through testing and being interviewed by an epidemiologist can take weeks or longer, says Schaffner. By that point, the person isn’t likely to remember what they ate that could’ve caused their symptoms
As a result, only a small portion of cyclosporiasis cases every year get traced back to a particular food item
It’s also worth noting that, in July 2025, the CDC’s foodborne surveillance network made testing for cyclospora optional, which could be impacting the response, Schaffner says. Federal health authorities have denied that changes to surveillance are affecting the investigation
Foods to Avoid Due to the Cyclosporiasis Outbreak
The only way to prevent cyclosporiasis is to avoid food and water that may be contaminated with feces
So far, only one recall has been issued due cyclospora concerns: Taylor Farms iceberg lettuce from central Mexico
In the recall, 33 out of the 35 affected products were sent to food service locations. Two were provided to Walmart and sold under the brand Marketside:
- Iceberg Salad: 12 oz., 24 oz.; best if used by July 18–Aug. 3, 2026
- Shredded Lettuce: 8 oz., 16 oz.; best if used by July 18–Aug. 3, 2026
The recalled products were distributed to 27 states: 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
The FDA is urging consumers not to eat any of the recalled lettuce, including at Taco Bell or other restaurants. It encourages consumers to ask about the
Still, experts are urging people not to panic
“Almost all servings of fresh fruits and vegetables that you can buy on the market today are not linked to this outbreak, and are not any more likely to cause illness because of the outbreak,” says Schaffner
“We know that fresh (produce is) part of a healthy diet, and I certainly don’t want to discourage that,” adds Schaffner, who still plans to enjoy his favorite fruits and vegetables this summer
Dr. Bruce Vanderhoff, director of public health in Ohio, one of the hardest-hit states, said in a press conference Tuesday that it’s not necessary to avoid fresh fruits and vegetables, and instead to wash produce and inspect it for signs of damage
The experts encourage people to stay up to date on recalls and food safety alerts
How to Prevent Cyclospora
Cooking food to least 158 degrees Fahrenheit is the best way to protect yourself, as heat destroys the parasite. Freezing can also inactivate cyclospora, but it’s not a guarantee
Washing produce thoroughly can reduce the risk of foodborne illness, but it won’t eliminate cyclospora entirely
Health authorities have offered a few more tips to prevent cyclospora infection:
- Wash your hands well with soap and hot water before and after handling raw produce.
- Scrub all fresh vegetables and fruits with a produce brush under clean, running water. Do not use soap.
- Remove the outer layer of leaves or the peel, if possible. Run the inner leaves under running water.
- Cut or peel off damaged areas of produce before eating.
People with weakened immune systems may need to take extra precautions and should consult their doctor about how to avoid foodborne illness, says Kniel
“We are seeing hospitalizations, so if you do get sick, good hydration is critical, and so is getting clinical care because this can be treated,” Kniel adds
If you develop symptoms of cyclosporiasis, contact your doctor
