Cyclospora outbreak: What to know about recalled lettuce and symptoms

Michigan health officials reported two deaths associated with the current Cyclospora outbreak on August 3, 2026, adding a serious new development as federal investigators continue tracing illnesses linked to recalled shredded iceberg lettuce.

According to state officials, both people had underlying health conditions that may have been worsened by Cyclospora illness and dehydration. The deaths were reported after the Food and Drug Administration’s July 24 outbreak update, which listed zero deaths at that time. The different totals reflect different reporting dates, and the investigation remains ongoing. The deaths should not be interpreted as evidence that Cyclospora is commonly fatal.

Two different counts describe the problem

The FDA’s July 24 investigation focused on a nine-state outbreak involving people who reported Taco Bell exposure: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania and West Virginia. At that point, the agency reported 1,947 confirmed illnesses and at least 98 hospitalizations, with no deaths reported in that update.

Investigators found that the illnesses converged epidemiologically and through traceback work on recalled shredded iceberg lettuce sourced from central Mexico by Taylor Farms de Mexico. The FDA said there were no confirmed positive product samples as of July 19. The lettuce connection was based on epidemiologic and traceback evidence, and the investigation continues.

The Centers for Disease Control and Prevention’s July 28 surveillance update covered a broader picture: 6,707 laboratory-confirmed domestically acquired cyclosporiasis cases, 423 hospitalizations and zero deaths reported nationwide from May 1 through July 27. Those figures cover domestic Cyclospora infections beyond the recalled-lettuce outbreak and included cases reported from 45 states.

The CDC also reported more than 11,500 additional cases that were not laboratory confirmed or still required investigation, with many reported by Michigan and Ohio. The figures are preliminary and may change. CDC estimates that reporting can lag illness by about six weeks, so the national total may continue to rise even after the recall.

What Cyclospora does

Cyclospora is a microscopic parasite that can cause cyclosporiasis, an intestinal illness. Common symptoms include watery diarrhea and frequent bowel movements, along with loss of appetite, weight loss, stomach cramps or pain, bloating, gas, nausea and fatigue. Vomiting, body aches, headache and fever can also occur, and some infected people have no symptoms.

Symptoms often begin about a week after exposure, but timing can vary. The illness may last for weeks or longer, and symptoms can improve and then return. Untreated illness can cause dehydration and complications that require medical care.

Seek medical attention for diarrhea lasting more than three days, diarrhea that returns after improving, or signs of dehydration such as very little urination, dizziness, unusual weakness, dry mouth or an inability to keep fluids down. Children, older adults, people with weakened immune systems and people with other conditions that make fluid loss more dangerous should contact a health care provider promptly if symptoms develop.

Tell the clinician about recent shredded-lettuce or restaurant exposure. Cyclospora may require a specific stool test, and health departments may need additional information or specimens to confirm and investigate a case.

What consumers should do with recalled lettuce

Consumers should check the FDA recall notice before eating or serving affected shredded iceberg lettuce. Recalled retail products included certain Walmart Marketside packages: 12- and 24-ounce Iceberg Salad products with best-if-used-by dates from July 18 through August 3, 2026, and 8- and 16-ounce Shredded Lettuce products with dates from July 18 through August 3, 2026. The recall also covered other products distributed to food-service customers.

The FDA identified confirmed product distribution across multiple states, and additional distribution may have occurred. Not all iceberg lettuce, all Taco Bell food or all restaurant locations are implicated. Check the specific recall information rather than relying only on the store, restaurant or brand name.

Do not try to wash or salvage recalled lettuce. Discard it, then clean and sanitize refrigerators, counters, containers and other surfaces it touched. Seek a refund where applicable. Taco Bell said it stopped using lettuce from Taylor Farms de Mexico as of July 17, 2026, but that statement does not mean every Taco Bell product or location was involved.

Why washing produce is not a guarantee

Cyclospora spreads when food or water is contaminated with human fecal matter. Direct person-to-person spread is considered unlikely because the parasite generally needs time outside the body before it becomes infectious.

Rinsing fresh produce under running water can reduce some contamination, but it is not a guarantee against Cyclospora. Do not wash produce with soap or bleach. For recalled food, disposal is the key safety step.

Testing and treatment

Doctors can treat cyclosporiasis with prescription medication, commonly trimethoprim-sulfamethoxazole. A clinician should determine whether testing and treatment are appropriate, especially for people who are dehydrated, have prolonged or relapsing diarrhea, or have conditions that increase the risk of complications.

The FDA, CDC and state health departments are continuing to investigate the outbreak. Official counts may change as delayed reports are reviewed, probable cases are separated from laboratory-confirmed cases and additional testing is completed.

Sources

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