FDA Expands Cyclospora Outbreak Investigation to 15 States

The U.S. Food and Drug Administration (FDA) has expanded its Cyclospora outbreak investigation linked to recalled Taylor Farms de Mexico iceberg lettuce, adding six states and broadening the outbreak to include people who reported eating either at Taco Bell or the recalled lettuce. The investigation now includes 6,358 laboratory-confirmed cases across 15 states as of Aug. 5.

Since FDA’s last update on July 24, health officials have continued interviewing additional people with cyclosporiasis, and the U.S. Centers for Disease Control and Prevention (CDC) has added them to the multistate outbreak. Due to additional interview data, the outbreak now includes people who reported exposure to Taco Bell or recalled Taylor Farms de Mexico iceberg lettuce. Many of these illnesses began before the Taylor Farms de Mexico iceberg lettuce recall on July 17, said FDA.

Six states have been added to the outbreak since the last update: Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina. 

FDA said it expects to see the number of confirmed cases continue to rise, as it can take up to six weeks for CDC and state officials to determine whether a sick person is part of the outbreak.

The true number of sick people in the multistate outbreak is likely higher than the number reported, said FDA, and the outbreak may not be limited to the states with known illnesses. FDA's outbreak total includes only laboratory-confirmed illnesses that investigators have linked to this multistate outbreak. Some people recover without medical care and are not tested for Cyclospora, the agency said.

Several states, including Michigan and Ohio, are reporting substantially higher numbers of cyclosporiasis cases because their totals include all reported cases under investigation or cases not yet linked to a specific outbreak.

Illnesses linked to the outbreak began on June 22, and onset dates have continued through July 31, said FDA. There have been at least 278 hospitalizations, and two deaths have been reported in Michigan. Both individuals had significant underlying health conditions that may have been adversely impacted by cyclosporiasis and dehydration, said FDA. Based on information provided to FDA by the state of Michigan, both of these individuals had illness onset dates prior to Taylor Farms de Mexico’s voluntary recall. 

FDA said it will continue to work with federal and state partners to investigate the outbreak and help ensure products linked to it have been removed from the market.  

Other Cyclospora Investigations.

The iceberg lettuce investigation is one of seven active Cyclospora outbreaks currently being tracked by FDA.

In its latest CORE Outbreak Investigation Table update, the agency added a new Cyclospora investigation involving an unidentified food that has sickened 10 people and increased the case counts for two other outbreaks linked to unidentified products to 115 and 25 cases, respectively.

FDA also continues to investigate several additional Cyclospora outbreaks for which a food source has not yet been identified.