CDC Expands Cyclospora Outbreak Investigation to 15 States as Lettuce Link Grows

The U.S. Centers for Disease Control and Prevention (CDC) is expanding its investigation into the nationwide cyclospora outbreak, adding six more states to the list of those linked to contaminated iceberg lettuce imported from Mexico, according to a Washington Post report citing sources familiar with the probe.

The newly added states are Arkansas, Iowa, Missouri, Nebraska, New Hampshire, and North Carolina, bringing the total number of affected states to 15. Health officials continue to investigate the outbreak, which is now among the largest foodborne illness events in recent U.S. history.

CDC data shows the outbreak has resulted in more than 10,468 laboratory-confirmed cases and 12,255 suspected infections across the United States. Because the agency’s national surveillance system trails state reporting by several weeks, the actual number of cases may be higher.

The U.S. Food and Drug Administration (FDA) previously linked the outbreak in nine states to iceberg lettuce served at Taco Bell restaurants and supplied by privately owned Taylor Farms operations in central Mexico. Investigators are still working to determine whether additional food sources contributed to the spread.

Missouri, one of the newly added states, has reported 1,095 cases. According to state health officials, many infected individuals told investigators they had eaten at Taco Bell before developing symptoms, reinforcing the suspected connection.

Cyclospora infection, also known as cyclosporiasis, is caused by the parasite Cyclospora cayetanensis. Common symptoms include prolonged diarrhea, nausea, stomach cramps, fatigue, and other gastrointestinal issues. While most healthy individuals recover with treatment, the illness can be more severe for people with weakened immune systems or other underlying medical conditions.

Michigan remains the hardest-hit state, reporting 11,508 cases, an increase of more than 200 from the previous update. The state has also confirmed the first two deaths associated with the outbreak. Health officials said both patients had significant pre-existing health conditions.

Federal and state authorities continue tracing the source of the contaminated lettuce while urging consumers and food service operators to remain alert as the investigation develops.