Cyclospora Outbreak Reaches 20 States as FDA Links Illnesses to Recalled Iceberg Lettuce

A major Cyclospora outbreak in the United States has expanded to 20 states, with federal health officials continuing to investigate a suspected connection to recalled iceberg lettuce imported from Mexico.

The Food and Drug Administration (FDA) reported Thursday that Georgia, Tennessee, and Texas had joined the list of states with confirmed cases. The number of reported illnesses has also increased to 11,458, making the outbreak the largest recorded U.S. outbreak of cyclosporiasis, according to federal health authorities.

The investigation has focused on iceberg lettuce grown in central Mexico and supplied by Taylor Farms de Mexico. The company voluntarily recalled iceberg lettuce connected to the investigation on July 17 and removed the affected products from the U.S. market.

FDA Investigation Focuses on Recalled Lettuce

Federal and state health agencies, including the FDA and Centers for Disease Control and Prevention (CDC), have been investigating the source of the outbreak.

Investigators have identified iceberg lettuce grown at a farm operated by Taylor Farms de Mexico in central Mexico as a key focus of the investigation. The lettuce was distributed through retail and food-service channels in the United States.

Some recalled products were sold under Walmart's Marketside brand. These included iceberg salad and shredded iceberg lettuce in several package sizes, with best-by dates ranging from July 18 through August 3, 2026.

The recalled lettuce also reached food-service customers. Taco Bell previously said it had stopped using lettuce supplied by Taylor Farms de Mexico beginning July 17.

The FDA said its personnel are continuing inspections and product sampling at the Mexican growing and processing facilities in cooperation with Mexican authorities.

According to the agency, it remains confident that lettuce associated with this particular Cyclospora outbreak has been removed from the U.S. market.

Illnesses Reported Across 20 States

The outbreak has now been identified in 20 states:

• Arkansas
• Georgia
• Iowa
• Illinois
• Indiana
• Kansas
• Kentucky
• Massachusetts
• Maine
• Michigan
• Missouri
• Nebraska
• New Hampshire
• North Carolina
• Ohio
• Oklahoma
• Pennsylvania
• Tennessee
• Texas
• West Virginia

Health officials have reported 11,458 illnesses connected to the outbreak investigation. Among those patients, 495 have required hospitalization, while two deaths have been reported.

The latest reported illness onset occurred on August 15. Officials have emphasized that many of the infections began before the lettuce recall was announced in July.

This timing is important because Cyclospora infections can take time to develop and may not immediately be linked to the food that caused exposure.

What Is Cyclospora?

Cyclospora, scientifically known as Cyclospora cayetanensis, is a microscopic parasite that infects the intestinal tract.

The resulting illness, called cyclosporiasis, is a foodborne intestinal infection. It is generally associated with contaminated food or water and can cause prolonged gastrointestinal symptoms.

One of the most recognizable symptoms is watery diarrhea. People can experience frequent bowel movements, sometimes accompanied by other digestive symptoms.

Symptoms can also include abdominal cramps, nausea, fatigue, loss of appetite, weight loss, and other gastrointestinal problems. The severity and duration of illness can vary from person to person.

People who develop persistent diarrhea or other symptoms after potentially consuming recalled food should contact a health care professional. Medical advice is particularly important for people whose symptoms are severe, prolonged, or worsening.

Why Cyclospora Cases Can Be Difficult to Trace

Cyclospora outbreaks can be challenging for public health investigators because individual infections are not always connected to a particular food source.

The parasite is transmitted through fecal contamination, and outbreaks can occur when contaminated food or water enters the food supply.

Cyclospora infections are also relatively uncommon compared with some other foodborne illnesses, including infections caused by Salmonella and E. coli. As a result, individual cases may not always be immediately recognized as part of a larger outbreak.

Warm-weather conditions can also contribute to the seasonal pattern of Cyclospora infections. Cases in the United States often increase during late spring and summer.

CDC Reports an Unusually High Number of Cases

The outbreak linked to the recalled lettuce is part of a much larger increase in Cyclospora infections reported across the United States this year.

Earlier in August, the CDC reported approximately 29,000 confirmed or suspected Cyclospora cases nationwide in 2026, along with 922 hospitalizations.

That figure substantially exceeds the previous record year. In 2019, approximately 4,700 Cyclospora illnesses were reported in the United States.

The significant increase has prompted continued monitoring by federal, state, and local health authorities.

It is important to distinguish between the nationwide number of Cyclospora illnesses and the 11,458 illnesses associated with the specific lettuce outbreak investigation. Not every Cyclospora infection reported nationally has been linked to the recalled iceberg lettuce.

What Consumers Should Do

Consumers who purchased or received food containing recalled iceberg lettuce should follow official recall instructions and avoid eating affected products.

Health authorities have also advised consumers to thoroughly clean and sanitize surfaces, containers, and other items that may have come into contact with recalled lettuce.

People who develop symptoms after eating potentially affected shredded iceberg lettuce, particularly within the relevant exposure period, should consider contacting a health care provider.

Consumers should not rely solely on appearance or smell to determine whether potentially contaminated food is safe. Food contaminated with a microscopic parasite may not look, smell, or taste unusual.

Anyone who is unsure whether a particular package or food item was included in the recall should consult the latest information from the FDA or another official public health authority.

What Happens Next?

The FDA continues to investigate the source and distribution of the contaminated lettuce while working with Mexican authorities and other U.S. public health agencies.

Investigators are inspecting growing and processing operations and collecting samples as they work to understand how Cyclospora entered the food supply.

Although the FDA has said it believes lettuce connected to this specific outbreak has been removed from the market, public health agencies will continue monitoring new cases and investigating potential exposures.

The situation also highlights the importance of food safety controls throughout the supply chain, particularly for fresh produce that may be consumed without cooking.

Frequently Asked Questions

What is causing the 2026 Cyclospora outbreak?

Federal investigators have linked the record outbreak to iceberg lettuce grown in central Mexico and supplied by Taylor Farms de Mexico. The company recalled affected iceberg lettuce in July.

How many states are affected?

Cases associated with the outbreak have been reported in 20 states, including Arkansas, Georgia, Texas, Tennessee, Ohio, Pennsylvania, Michigan, and others.

What are the main symptoms of Cyclospora infection?

The most common symptom is watery diarrhea. Other symptoms can include abdominal cramps, nausea, fatigue, loss of appetite, and weight loss.

Is recalled lettuce still on the market?

The FDA has stated that it remains confident that recalled iceberg lettuce connected to this specific outbreak has been removed from the U.S. market. Consumers should nevertheless check current official recall information before consuming products they believe may be affected.

When should someone seek medical care?

Anyone experiencing persistent or severe diarrhea or other concerning symptoms should contact a health care professional. People who believe they may have been exposed to recalled food should tell their provider about that potential exposure.

Source: NTD News, information attributed to the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the Associated Press.

Disclaimer: This article is provided for general informational purposes only and is not medical advice. Information about food recalls, case counts, symptoms, and public health investigations can change as authorities receive new data. If you believe you may have consumed recalled food or are experiencing symptoms, consult a qualified health care professional and follow guidance from official public health agencies.