Michigan’s Cyclosporiasis Outbreak Has Surpassed 9,000 Cases. What Residents Need to Know

Michigan had reported 9,253 cyclosporiasis cases as of July 27, according to state data cited by CBS Detroit. The illness had been recorded in nearly every Michigan county, and 160 residents had received hospital treatment as of July 23.

The total is more than 180 times Michigan’s typical annual count of roughly 40 to 50 cases. Health officials are still investigating, so the number may change as testing, interviews and case reviews continue.

Michigan’s count is broader than the federal recall-linked total

Michigan’s state-reported total should not be combined with the smaller federal outbreak count. The FDA said its July 24 investigation covered 1,947 illnesses in nine states among people who reported eating at Taco Bell, including Michigan. At least 98 people had been hospitalized in that federal investigation, and no deaths had been reported.

The FDA said those illnesses are only a subset of Cyclospora infections identified nationwide. Michigan’s count reflects the state’s broader outbreak investigation and may include cases that have not yet been matched to the narrower federal criteria or fully reviewed at the federal level.

Federal confirmation can also lag behind illness reports because agencies must review laboratory results, interviews and exposure histories. The FDA said it could take as long as six weeks to determine whether some sick people belong to the recall-linked outbreak.

What investigators know about lettuce

Michigan health officials said July 13 that lettuce or salad greens repeatedly appeared in interviews as a possible source, although other foods could not be ruled out. At that point, MDHHS said no specific product, grower or supplier had been identified.

Separately, FDA traceback work converged on shredded iceberg lettuce supplied by Taylor Farms de Mexico to Taco Bell locations where people later became ill. Taylor Farms announced the voluntary removal and recall of affected iceberg lettuce on July 17. FDA said the recalled food-service products were distributed to Michigan customers from June 29 through July 16.

The recall also covers certain Marketside-brand iceberg salad and shredded lettuce products sold at selected Walmart stores. FDA’s listed retail distribution states did not include Michigan. Residents should check the specific product, brand, dates and distribution channel rather than assume that every grocery-store lettuce product is recalled.

What residents, restaurants and retailers should do

Do not eat recalled Taylor Farms iceberg lettuce. Discard it or return it for a refund according to the recall instructions. Clean and sanitize refrigerators, counters, cutting boards, containers and other surfaces the product touched.

Michigan restaurants and commercial kitchens should check food-service inventory and recall records, remove affected products and follow FDA food-safety instructions. The investigation remains ongoing, and additional products, restaurants or distribution channels could be identified.

For other lettuce and salad greens, MDHHS recommends buying whole heads instead of pre-washed bagged lettuce or premixed salad kits when possible. Remove the outer two or three leaves, wash the inner leaves under clean running water and cook greens when practical. MDHHS says heating greens to at least 158 degrees Fahrenheit is the safest option because washing alone cannot guarantee removal of the parasite.

MDHHS has said there is no evidence linking swimming in Michigan lakes or other recreational-water activity to this outbreak.

Symptoms can last and return

Cyclosporiasis commonly causes watery diarrhea and frequent bowel movements. Other symptoms can include nausea, stomach cramps or pain, bloating, increased gas, loss of appetite, weight loss and fatigue. Vomiting, fever, headache and body aches may also occur.

Symptoms can begin days after exposure, last for weeks if untreated and disappear before returning. Prolonged diarrhea can cause dehydration, and illness may be more severe or persistent for people who are immunocompromised.

Anyone with persistent or recurring diarrhea should contact a health care provider and mention possible exposure to recalled shredded iceberg lettuce or other food connected to the investigation. The Michigan provider bulletin warns that a routine ova-and-parasite order may not include a specific Cyclospora test, so patients and clinicians may need to confirm that testing targets the parasite.

What happens next

MDHHS, local health departments and federal agencies are continuing interviews, laboratory testing and food traceback. Michigan case totals, hospital-treatment figures and product advisories may change as those investigations progress.

Sources

• Michigan health department outbreak guidance
• FDA investigation of the nine-state lettuce-linked outbreak
• CBS Detroit report on Michigan’s July 27 case count

Look for updates to this story

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