As of August 17, federal officials are reporting more than 15, 716 cases, hundreds of hospitalizations, and nearly all US states have been affected.
The Centers for Disease Control and Prevention (CDC) is now reporting there are 15,716 domestically acquired cases of cyclosporiasis. Of these cases, 828 people have been hospitalized, and 2 deaths have occurred (in Michigan).1
According to the CDC, cases have been identified in 47 states, Washington DC, and Puerto Rico. The only states not reporting cases are Delaware, New Mexico, and Hawaii (Figure). All affected individuals reported eating food in the US without international travel during the 14 days before illness onset.1
As of August 13, the state of Michigan is reporting 13,909 cases of cyclosporiasis, 314 hospitalizations, and the 2 aforementioned deaths. The state continues to experience the greatest impact.
CDC says individual states may report higher case counts than the federal agency because they may include cases that do not meet CDC’s formal reporting criteria.1-2 And there is a lag in confirmed cases as coordination efforts work between state health and federal officials and the onset of illness.1 Additionally, cases are often underreported as some people do not seek out medical care or do not get tested for it.1
Patients range in age from 1 to 99 years, with a median age of 46 years, and 57% were female. The median illness onset date was July 7, 2026 (range from May 1 to August 13).
Federal investigators, including the CDC and FDA, are working with state and local health departments to continue to investigate several multistate clusters.
According to CDC, on July 17, Taylor Farms de Mexico issued a recall covering all iceberg lettuce sourced from central Mexico. The
The outbreak has grown to 15,716 cases across 47 states, DC, and Puerto Rico, with Michigan bearing the brunt (13,909 cases and both deaths).
The true case count is likely higher than reported due to inconsistent state/federal criteria, underdiagnosis, and reporting lags.
Cases span all ages (1–99 years) with a median age of 46, skew slightly female (57%), and illness onset has ranged from May 1 to August 13, with a median date of July 7, 2026.
Cyclospora infection can cause a range of gastrointestinal symptoms, although some people may have no symptoms at all. The parasite infects the small intestine and most commonly causes watery diarrhea, often accompanied by frequent and sometimes explosive bowel movements. Without treatment, the illness can last anywhere from a few days to more than a month, and symptoms may resolve only to return one or more times in a pattern of relapse. Symptoms typically develop about one week after infection but can appear anywhere from two days to more than two weeks after exposure.4
People are at greater risk of infection when living in or traveling to tropical and subtropical regions where cyclosporiasis is endemic. In the United States, however, outbreaks have most often been associated with contaminated fresh produce. Because previous infection does not provide lasting immunity, people can become infected with Cyclospora multiple times.4
Cyclospora is transmitted when people consume food or water contaminated with feces containing the parasite. Unlike many other gastrointestinal pathogens, Cyclospora is not immediately infectious after it is shed in stool. Instead, it requires at least 1 to 2 weeks in the environment before it becomes capable of causing infection. As a result, direct person-to-person transmission is considered unlikely.4
Fresh produce can carry germs that cause foodborne illness, but a few simple steps can help reduce the risk. Wash your hands with soap and water before and after handling fresh fruits and vegetables, and rinse all produce thoroughly under running water before eating, cutting, or cooking. Produce labeled "prewashed" does not need to be washed again. Scrub firm produce such as melons and cucumbers with a clean produce brush, remove any bruised or damaged areas before eating, and refrigerate cut, peeled, or cooked fruits and vegetables within two hours.5
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