Cyclospora cases in US hit all-time high

The Centers for Disease Control and Prevention (CDC) said it confirmed more than 2,500 additional cases of cyclosporiasis infections across dozens of states, making it the largest outbreak on record.  

Nationwide, CDC said it has confirmed 4,173 cases of cyclosporiasis since May 1, though some states are seeing much higher case numbers than others. The worst year in the U.S. for infections was 2019, when about 4,700 illnesses were reported, according to federal data on confirmed and suspected cases. 

The CDC is investigating more than 7,400 additional cases that are not yet laboratory confirmed. Many of the additional illnesses have been reported by Michigan and Ohio, and health officials and experts have said that the actual number of infections is likely higher. 

The illnesses are caused by cyclospora, a parasite transmitted through contaminated food and water. There are multiple clusters of cyclospora cases, and health authorities do not have a definitive answer to what products are making people sick.     

Still, Health Secretary Robert F. Kennedy Jr. said Tuesday the outbreak was “under control.”  

The Food and Drug Administration has linked one outbreak across five states— Indiana, Kentucky, Michigan, Ohio and West Virginia— to iceberg lettuce from Taylor Farms facilities in Mexico. The lettuce was supplied to Taco Bell locations in those five states, as well as selected Walmart locations across the country. 

The company has since issued a recall of a variety of packaged products containing iceberg lettuce across 27 states that were sourced from central Mexico.  

No samples from the Taylor Farms facility in Mexico have tested positive for cyclospora, though FDA reported one result over the weekend that turned out to be a false positive.

In some states, the cases of cyclosporiasis have not been linked to the ongoing outbreak. 

The U.S. sees cyclospora cases every summer, with a typical season running from the start of May through the end of August. However, case counts are especially high this year.  

CDC’s surveillance updates do not include probable cases, but state data may, resulting in higher case counts than what CDC reports.  

The Michigan Department of Health and Human Services has counted more than 7,000 cases in the state as of Wednesday.  

The agency said on its website that other food items cannot be ruled out as potential sources of the outbreak, and that “no specific type of produce, grower, or supplier has been identified as the source.” 

Kennedy on Tuesday defended the administration’s response amid concerns that CDC was not conducting adequate surveillance on the parasite.  

The CDC stopped routinely reporting data for cyclospora and several other pathogens last July through its FoodNet program, which helps states understand how common foodborne illnesses are outside of outbreak settings.  

“Those criticisms are invalid. We’ve had no cuts in our surveillance program,” Kennedy said. “We did cuts in the FoodNet program, but they were for redundant surveillance, and all the states will tell you that we’re still doing forensics. We’re still doing surveillance in all the states.”  

Experts have said that Food Net cuts did not have an impact on the current outbreak. The program is not designed for real-time outbreak detection or response, but it does provide context in terms of identifiable trends that can be analyzed.  

Cyclospora is a difficult parasite to track, and the incubation period of illness can take up to two weeks after food is consumed, meaning people are being asked to remember what they ate weeks earlier. Lettuce is also a highly perishable food, so by the time a potential source may be identified, consumers have either eaten or thrown away the affected product.

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