At least 11,458 people across 20 states have fallen ill in a multistate cyclospora outbreak linked to iceberg lettuce from Taylor Farms de Mexico, federal health officials confirmed on August 27.
Two people have died in Michigan and 454 have been hospitalized, making it the largest outbreak of the parasite ever recorded in the country.
The FDA said Thursday that cases have now been identified in three additional states, Georgia, Tennessee and Texas.
Both Michigan deaths were in people with underlying health conditions, according to the Food Poisoning Bulletin outbreak tracker.
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Illness onsets began on June 14 and continued through August 11, 2026. Most people got sick before Taylor Farms recalled all iceberg lettuce sourced from central Mexico on July 17.
Retail product reached shoppers as Marketside-brand items at Walmart with best-if-used-by dates between July 18 and August 3, and food-service lettuce was served at Taco Bell locations and other restaurants.
Where the outbreak came from
The FDA and CDC traceback pointed to a single Taylor Farms facility in central Mexico. The company suspended production at the site on July 17 and says it has removed all potentially implicated product from the market.
Taylor Farms disputes that it is the source, saying no company or federal test on the recalled product has come back positive for the parasite.
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The site has a history. The same central Mexico facility was tied to a 2013 cyclospora outbreak in which FDA inspectors found sanitation problems including the use of recycled wash water, Food Safety News reported.
What cyclospora actually is
Cyclospora cayetanensis is a microscopic single-celled parasite, not a virus or a bacterium.
It spreads through the fecal-oral route, meaning tiny amounts of contaminated feces get into the mouth through water or food. It cannot be passed from person to person.
Fresh produce, especially imported soft leafy greens, herbs and berries, is the vehicle in almost every US outbreak.
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The parasite sticks tightly to the surface of produce and is not reliably removed by ordinary washing, which is one reason large lettuce and salad outbreaks recur despite modern food-safety programs.
Similar patterns have appeared in past US foodborne parasite alerts covered in our earlier outbreak reporting.
Symptoms and why it hits so hard
Symptoms usually start within a week of eating contaminated food. The hallmark is loud, watery, sometimes explosive diarrhea, often with stomach cramps, bloating, nausea, low-grade fever and heavy fatigue. Some infected people have no symptoms at all.
Without treatment, the illness can last a month or longer, and it commonly follows a remitting-relapsing pattern.
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Patients feel better for a few days, then the diarrhea and exhaustion come roaring back.
That long, wave-shaped course is why cyclospora is frequently mistaken for a stubborn stomach bug or ordinary traveler's diarrhea.
Treatment and what to do now
The standard treatment is the antibiotic combination trimethoprim-sulfamethoxazole, a prescription sulfa drug.
For people with a sulfa allergy, doctors may use ciprofloxacin or nitazoxanide. Rest and fluids matter, but no over-the-counter product clears the parasite.
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Anyone who developed watery diarrhea after eating iceberg lettuce or a fast-food salad this summer, especially if symptoms have lasted more than a few days or keep returning, should contact a health care provider and mention the outbreak.
Cyclospora requires a specific stool test, so the diagnosis is easy to miss unless it is asked for.
The FDA says all recalled Taylor Farms de Mexico iceberg lettuce is now past its best-by date and should no longer be in stores or restaurants.
The federal investigation, including onsite work at the Mexican farm, remains open.
This article is made and published by Mie Hermansen, who may have used AI in the preparation.