The outbreak sickened thousands of people across multiple states and territories, making it the largest recorded U.S. outbreak of cyclosporiasis. Despite extensive epidemiological and traceback investigations, officials have not identified a single food, producer or other source responsible for the infections.

Cyclospora is a parasite that causes intestinal illness when people consume food or water contaminated with the organism. Symptoms commonly include prolonged diarrhea, abdominal cramps, nausea, fatigue and loss of appetite.

Outbreak investigation ends without a confirmed source

The Centers for Disease Control and Prevention and the U.S. Food and Drug Administration coordinated the investigation with state and local health authorities.

Investigators interviewed patients, examined exposure histories and conducted traceback work involving foods consumed by people who became sick.

The investigation did not produce enough evidence to establish a common contaminated food or supplier.

That leaves the central question of the outbreak unresolved: how the parasite entered the food supply and where the contamination occurred.

The end of the outbreak designation does not mean officials have determined what caused the infections. Rather, it reflects the absence of continuing evidence indicating that the outbreak remains active.

Cyclospora can cause prolonged illness

Cyclospora infection, known as cyclosporiasis, is caused by the microscopic parasite Cyclospora cayetanensis.

People generally become infected by consuming food or water contaminated with the parasite. Unlike some foodborne pathogens, Cyclospora requires time outside the human body before it becomes infectious, which can complicate efforts to identify how contamination occurred.

Illness can last for weeks if untreated and may recur in some patients.

Common symptoms include watery diarrhea, frequent bowel movements, stomach cramps, nausea, vomiting, loss of appetite, weight loss and fatigue.

The infection is generally treatable with prescription medication, although diagnosis can be difficult because routine stool testing does not always detect the parasite.

Food-safety investigations can be difficult to trace

Identifying the source of a Cyclospora outbreak can be particularly challenging because people may become sick days or weeks after consuming contaminated food.

Patients may also have eaten many different foods during the exposure period, making it difficult for investigators to establish a statistically meaningful common exposure.

Fresh produce has been associated with previous Cyclospora outbreaks in the United States. Investigators have previously identified contaminated cilantro, basil, fresh vegetables and other produce as outbreak vehicles.

But those previous findings do not establish the source of the latest outbreak.

Officials therefore continue to distinguish between known risk factors for Cyclospora infection and evidence directly linking a particular product to the current outbreak.

Record outbreak raises continuing questions

The scale of the outbreak has increased pressure to determine how contamination occurred.

A confirmed source could help public-health agencies identify weaknesses in the food-supply chain and determine whether additional interventions are needed to prevent similar outbreaks.

Without a source, investigators cannot conclusively identify the point at which contamination entered the supply chain.

That does not mean the outbreak is expected to continue. Health authorities’ decision to close the active investigation indicates that available evidence no longer supports treating the event as an ongoing outbreak.

Investigation may continue after outbreak declaration

The conclusion of the outbreak does not necessarily end all public-health work related to Cyclospora.

Health authorities continue to monitor reported infections and may investigate new clusters if cases begin to show a common geographic, food or exposure pattern.

The FDA and other agencies can also pursue food-safety investigations when new evidence emerges.

For consumers, the outbreak highlights the continuing difficulty of preventing and tracing parasitic contamination in fresh foods.

For investigators, however, the most important unanswered question remains the same: where the contamination originated and how it reached the people who became infected.

Reporting Credit: U.S. Centers for Disease Control and Prevention — outbreak and cyclosporiasis surveillance information; U.S. Food and Drug Administration — food-safety investigation and traceback information; state and local public-health authorities — case and epidemiological information.

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According to the U.S. Centers for Disease Control and Prevention (CDC), 6,358 confirmed illnesses, 278 hospitalizations, and two deaths have been reported across 15 states. The investigation is being conducted jointly by the CDC, the U.S. Food and Drug Administration (FDA), and state and local public health agencies.

Investigators traced the outbreak to iceberg lettuce supplied by Taylor Farms de Mexico, which announced a voluntary recall on July 17, 2026, covering all iceberg lettuce sourced from central Mexico.

The recalled products were distributed to restaurants, retailers and consumers in at least 27 states, including Marketside-brand packaged lettuce sold at select Walmart stores and iceberg lettuce supplied to Taco Bell restaurants.

Consumers urged to discard recalled lettuce

The CDC advises consumers not to eat recalled iceberg lettuce from Taylor Farms de Mexico.

Anyone who still has the affected products should throw them away or return them to the place of purchase. Although the recalled lettuce has passed its best-by dates and should no longer be available for sale, health officials recommend checking refrigerators and freezers for any remaining products.

Consumers should also thoroughly wash cutting boards, knives, storage containers and any surfaces that came into contact with the recalled lettuce using hot, soapy water or a dishwasher to reduce the risk of contamination.

Investigation remains active

Federal officials said the investigation into the recalled lettuce remains ongoing.

The CDC also noted that it is investigating several other unrelated Cyclospora outbreaks involving different sources of exposure elsewhere in the United States.

Investigators continue interviewing patients, reviewing food distribution records and tracing supply chains to determine the full extent of illnesses linked to the recalled products.

Cyclospora illness can last for weeks

Cyclospora is a microscopic parasite that causes cyclosporiasis, an intestinal illness that typically develops about one week after consuming contaminated food or water, although symptoms may begin as early as two days or more than two weeks after exposure.

Common symptoms include:

• Watery diarrhea
• Fatigue
• Loss of appetite
• Weight loss
• Stomach cramps
• Bloating
• Excessive gas
• Nausea

Without treatment, symptoms can continue for several weeks or even longer.

The CDC advises anyone experiencing symptoms to stay hydrated and seek medical care. Because routine stool testing does not always include Cyclospora, healthcare providers may need to order specific laboratory tests.

Public health officials seek consumer cooperation

State and local health departments may contact people diagnosed with cyclosporiasis to ask about foods consumed during the two weeks before symptoms developed.

The CDC said these interviews are an important part of identifying contaminated foods, tracing distribution networks and preventing additional illnesses during foodborne outbreak investigations.

Healthcare providers are encouraged to test patients with compatible symptoms and report confirmed cases to public health authorities.

Reducing the risk of infection

Although this outbreak has been linked to recalled iceberg lettuce, the CDC noted that Cyclospora can contaminate a variety of fresh fruits and vegetables.

To reduce the risk of infection, the agency recommends:

• Wash hands before preparing food.
• Rinse fresh produce thoroughly under running water.
• Follow all food recall notices.
• Cook foods when appropriate, as heating produce to at least 158°F (70°C) can kill the parasite.

Health officials emphasized that washing produce alone may not completely eliminate Cyclospora.

Investigation continues

The CDC, FDA and state public health agencies continue monitoring for additional illnesses while tracing products connected to the outbreak.

Officials urged consumers to follow recall guidance, dispose of recalled lettuce if found, and seek medical attention if symptoms consistent with cyclosporiasis develop.

This report is based on reporting by the U.S. Centers for Disease Control and Prevention (CDC).

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The U.S. Department of Health and Human Services (HHS) said Thursday that the investigation remains active and that federal agencies are working to determine the source of the outbreak. Officials have not disclosed where the illnesses have been reported, and the U.S. Food and Drug Administration (FDA) has not identified any specific food products linked to the infections.

“This is an active investigation, and officials are working together to determine the specific cause of illnesses in this cluster,” HHS said in an emailed statement.

Cyclospora is a microscopic parasite that spreads when people consume food or water contaminated with human feces. In the United States, outbreaks are most commonly linked to fresh produce contaminated during growing, harvesting or processing. The parasite causes an intestinal illness known as cyclosporiasis, which typically produces watery diarrhea, loss of appetite, stomach cramps, bloating, nausea, fatigue and weight loss. Symptoms generally begin about one week after exposure and, if left untreated, can persist for several weeks or longer and may recur.

Federal officials said the latest investigation is separate from another multistate cyclospora outbreak that public health authorities are also examining.

Separate Investigation Focuses on Recalled Lettuce

Earlier this week, federal officials said they continue to investigate shredded iceberg lettuce supplied by Taylor Farms as the suspected source of a separate cyclospora outbreak.

The company announced a voluntary recall of certain iceberg lettuce products grown in central Mexico after epidemiological evidence linked them to illnesses, although the FDA later said an earlier laboratory finding detecting the parasite in one lettuce sample was a false positive. Officials said the traceback investigation nevertheless continues to support the lettuce as the likely source of that separate outbreak.

Health authorities have not indicated whether the newly reported illnesses are connected to that recall or involve a different food source.

Because the investigation remains ongoing, officials have not released additional information about affected states, patient demographics or potential exposure locations.

CDC Advises Prompt Diagnosis and Treatment

The Centers for Disease Control and Prevention (CDC) says healthcare providers should consider cyclospora infection in patients experiencing prolonged diarrheal illness, particularly because routine laboratory testing does not always include the parasite. Providers may need to specifically request testing for Cyclospora cayetanensis.

According to the CDC, the recommended treatment is the antibiotic trimethoprim-sulfamethoxazole (TMP-SMX), sold under brand names including Bactrim and Septra. Most healthy people eventually recover even without treatment, but illness can last from several days to more than a month and symptoms may return if left untreated. No vaccine is currently available.

Public Health Guidance

The CDC advises consumers to practice good hand hygiene after using the bathroom and before handling food. While washing fresh produce is an important food safety practice, routine rinsing alone may not completely remove Cyclospora parasites from contaminated produce. Cooking food to an internal temperature of at least 158°F (70°C) can destroy the parasite.

Federal and state investigators said the investigation will continue as they work to identify the contaminated food source, trace its distribution and determine how the latest outbreak occurred.

This report is based on reporting by The Associated Press.

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