The Michigan Department of Health and Human Services confirmed two deaths linked to a cyclosporiasis outbreak on August 3, marking the first fatalities associated with the ongoing outbreak in the United States.
Health officials stated that both individuals had significant underlying health conditions that may have been exacerbated by dehydration and cyclosporiasis, a parasitic infection causing severe diarrhea and vomiting. No additional details about the deceased were provided.
The announcement comes as Michigan reports 11,234 confirmed cases of cyclosporiasis since early May, including 193 hospitalizations, according to state health data. The outbreak has affected 45 states, with federal health agencies linking the surge to contaminated iceberg lettuce supplied by Taylor Farms from central Mexico.
Public health response
State and federal agencies have taken multiple steps to address the outbreak. On July 17, Taco Bell removed shredded iceberg lettuce from its U.S. restaurants after the company was linked to the outbreak. Taylor Farms, the produce supplier, issued a voluntary recall of iceberg lettuce grown in central Mexico and shipped to 27 states.
The U.S. Centers for Disease Control and Prevention (CDC) has reported 6,707 laboratory-confirmed cases nationwide as of July 28, with 423 hospitalizations. An additional 11,500 suspected cases remain under investigation. The CDC noted that its updates do not include probable cases, and state data may reflect higher totals due to varying reporting standards.
Symptoms and transmission
Cyclosporiasis is caused by the Cyclospora cayetanensis parasite, which infects the small intestine and typically leads to watery diarrhea, frequent bowel movements, and dehydration. Symptoms may appear 2 to 14 days after exposure and can persist for weeks or months if untreated. The illness is often treated with Bactrim, an antibiotic, though healthy individuals may recover without medical intervention.
The parasite spreads through contaminated food or water, with outbreaks historically linked to fresh produce such as salad greens, raspberries, and cilantro. Health authorities recommend washing produce thoroughly, cooking when possible, and maintaining hygiene to reduce risk.
Geographic spread and investigations
Michigan has reported the highest number of cases, followed by New York City, which recorded 511 cases as of July 27. The outbreak has been traced to shredded lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio, and West Virginia, with additional cases linked to other states including Illinois, Kansas, Oklahoma, and Pennsylvania.
Federal officials continue to investigate multiple clusters of cases, emphasizing that other brands, restaurants, or distribution channels may be involved. The U.S. Food and Drug Administration (FDA) is coordinating with state health departments to identify the source of contamination.
Preventive measures
Public health agencies have issued guidelines to mitigate further spread:
- Wash hands with soap before handling food and after using the restroom.
- Wash firm fruits and vegetables with a produce brush and sanitize surfaces and utensils.
- Cook produce when possible to reduce risk.
- Avoid consuming raw produce of unknown origin.
Health officials stress that while cyclosporiasis is not typically life-threatening, individuals with compromised immune systems or underlying conditions are at higher risk of severe complications.