cyclosporiasis

July 17 (UPI) — Taylor Farms announced Friday it is removing all iceberg lettuce sourced from central Mexico from the U.S. market, after federal officials said they traced the cyclosporiasis outbreak that’s caused illness in thousands of people to lettuce supplied to Taco Bell restaurants in five states.

The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration said their investigators found the shredded iceberg lettuce came from Taylor Farms, a supplier that also sells salad kits in grocery stores.

In a statement, the company said it is voluntarily removing all of its Mexico-sourced iceberg lettuce, adding the outbreak is not associated with any of its salad kits.

“While the FDA traceback is indicating a specific independent farm that represents less than 1% of the U.S.’s iceberg lettuce supply as the potential source of the outbreak, we have removed all iceberg lettuce from the region indefinitely,” the company statement said.

The CDC’s website says not to eat “shredded iceberg lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio and West Virginia.”

More than 1,600 people have been confirmed ill with the bug.

The agencies did not name a supplier, but two people familiar with the inquiry told The Washington Post that investigators have identified Taylor Farms as the supplier.

“The investigation remains active, and additional states, restaurants, retailers or products may be identified as more information becomes available,” said Emily Hilliard, a spokesperson for the Health and Human Services Department.

“The signal we have gotten is that there is a very high percentage of people who got sick at Taco Bell, and when investigators asked what their menu items were in common, lettuce came up frequently,” one person familiar with the investigation said.

“Based on ongoing conversations with public health officials, and out of an abundance of caution, Taco Bell has taken immediate action to voluntarily remove potentially impacted lettuce from a supplier in select states,” Taco Bell Corp. said in a statement. “The affected ingredient from our supplier is being indefinitely removed from our supply chain nationwide and will be replaced within 24 hours in select states.”

Taylor Farms is a leading global producer of salads and healthy fresh foods, with production facilities across the United States, Canada, Mexico and Western Europe. The company has been linked to several outbreaks.

In November 2024, onions from Taylor Farms were tainted with E.Coli and sold at McDonald’s stores via Quarter Pounders burgers. About 100 people in 14 states were sickened. In December 2015, 19 people in 18 states were sickened with E. Coli after eating tainted celery supplied by the company to grocery stores. In August 2013, salad kits from Taylor Farms grown in Mexico were recalled after more than 360 people in Texas, Iowa and Nebraska became ill with cyclosporiasis. In February 2013, Taylor Farms recalled organic baby spinach products sold in 39 states for potential E. coli contamination, though there were no reports of illness.

July 15 (UPI) — The U.S. Centers for Disease Control and Prevention has confirmed the multistate outbreak of cyclosporiasis, the parasite-based illness, in at least four states.

The four states are Michigan, which has seen the highest rate of illness; Ohio; Kentucky; and West Virginia. But cases have been identified in 34 states, the CDC said.

The CDC had said that there was “no evidence of a single, multistate” outbreak, The Hill reported, but on Tuesday said that the hundreds of cases in the region appeared to link to a common source. The source hasn’t been confirmed, said Dr. Gwen Biggerstaff, deputy director of the CDC’s Foodbourne, Waterbourne and Environmental Diseases division. Biggerstaff hosted a call with reporters on Tuesday.

Michigan health officials have reported more than 3,700 cases of the illness and believe lettuce or salad greens could be the culprit. Dr. Donald Prater, FDA acting deputy commissioner for food, said the agency is continuing to investigate “multiple produce items, including lettuce.”

As of Wednesday, the CDC has gotten reports of at least 1,645 lab-confirmed cases of domestically acquired cyclospora since May 1, which is the start of the typical cyclosporiasis season. Biggerstaff said the agency is aware of more than 5,100 additional reports that require further analysis.

Cyclosporiasis is an intestinal illness caused by a microscopic parasite called cyclospora. It’s spread when people consume food or water contaminated with the parasite, typically fresh produce that has not been adequately washed or cooked, Biggerstaff said.

Symptoms include watery diarrhea — sometimes frequent — along with cramping, nausea, loss of appetite, fatigue and low-grade fever. Symptoms generally begin about one to two weeks after exposure, she said.

“I want to underscore an important point: This illness does not spread directly from person to person. The source of this outbreak is what we eat or drink — not casual contact with someone who’s sick,” Biggerstaff said on the call.

Biggerstaff emphasized that “the true number of infections is almost certainly higher than what’s reflected in these numbers, because many people with mild illness recover without seeking medical care and are never tested.”

Cyclospora can only be diagnosed by stool sample, the CDC said. The agency urged medical professionals to “specifically request cyclospora laboratory testing on stool specimens” to be sure of the diagnosis.

In the past, cyclosporiasis was associated with travel abroad, but in the past few years has been tied to domestic and imported produce.

The CDC said the reason cyclosporiasis investigations take longer is because people show symptoms up to two weeks after exposure to the parasite. Also, there is no whole genome sequencing of the parasite, which makes it more difficult to match the food product to the people made sick by it.

Instead, labs use genotyping, which is not as fast or precise, Biggerstaff said. In some cases, the source may never be identified.

July 8 (UPI) — Cases of cyclosporiasis, an infection that causes “explosive” diarrhea, are on the rise in regions throughout the United States, health officials said Wednesday.

The intestinal illness, which is caused by the Cyclospora cayetanensis parasite, often surges through the summer, but this year has been marked by larger-than-usual spikes in some states.

Reported cases in Michigan are nearing 1,000 since June 22, a representative from the state’s Department of Health and Human Services told ABC News. The state usually has about 50 reported cases a year.

Authorities in Ohio, North Carolina, New York, Texas and Illinois are also dealing with more cases than usual. However, a spokesperson for the U.S. Centers for Disease Control and Prevention said there is “no evidence of a single, multistate Cyclospora outbreak” right now. It can take weeks or more for local authorities to report confirmed cases to the CDC.

The parasite spreads through food or water contaminated by feces from an infected person, and person-to-person spread is unlikely. ABC News reports that the Michigan health department’s working hypothesis is that the outbreak is connected to contaminated produce.

Past outbreaks have been connected to fresh produce such as raspberries, salad greens, basil, cilantro and snow peas.

The illness is not usually life-threatening, but if not treated, it can last a few days to over a month, the CDC said. Multiple relapses are possible. The CDC also notes that the true number of those infected with Cyclospora is likely higher than reported.

In addition to the most well-known symptom of sudden, watery diarrhea, symptoms of cyclosporiasis include vomiting, nausea, severe stomach cramps, loss of appetite and fatigue. It can take up to two weeks after eating contaminated food for symptoms to show themselves.

To avoid cyclosporiasis, people should avoid food and water that may be contaminated.

They also should take basic food safety precautions, such as washing hands with soap and water before and after handling raw fruits or vegetables, thoroughly washing all fresh produce under running water before eating or preparing, cutting away any damaged areas on fresh produce and refrigerating prepared produce as soon as possible.