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Record cyclospora outbreak spreads to 34 US states, 141 hospitalized
The largest cyclospora outbreak on record in the US has confirmed 1,645 cases, with 141 people hospitalized. Officials determined that lettuce consumption was a common factor after interviewing more than 1,000 patients.
The cyclospora outbreak in the US has reached an unprecedented scale, with 1,645 laboratory-confirmed cases across 34 states as of July 16, 2026, according to the CDC. Of the patients, aged 2 to 95, 141 have been hospitalized, and no deaths have been reported.
This figure represents a dramatic increase compared to the 249 cases recorded during the same period last year. The journal Nature described the outbreak as the largest of its kind in US history. In Michigan, the state hardest hit, health officials reported 2,640 suspected cases on July 13. The surge in a state that normally sees only 40-50 cases per year has accelerated investigations.
Lettuce Suspected as Common Source
Interviews with more than 1,000 patients revealed that consumption of lettuce or salad greens was a common factor. However, no specific type of lettuce, farm, supplier, or brand has been identified as the source so far. The CDC is also investigating a cluster of over 400 cases in at least four states, which likely points to a common source.
What is Cyclospora?
Cyclospora (Cyclospora cayetanensis) is a microscopic, single-celled parasite that infects the intestines. It is typically transmitted through consumption of food or water contaminated with feces from an infected person. It does not spread directly from person to person. Outbreaks usually increase in spring and summer; past cases have been linked to salad mixes, cilantro, basil, raspberries, peas, and green onions.
Symptoms and Treatment
- The most common symptom is watery and recurrent diarrhea.
- Loss of appetite and weight, bloating, gas, abdominal cramps, nausea, and extreme fatigue accompany it.
- Some patients may experience vomiting, body aches, or low-grade fever.
- Symptoms may subside for a few days and then return; if untreated, they can last for weeks.
Routine stool tests may not detect cyclospora. Therefore, the CDC recommends requesting specific testing for cyclospora in patients with prolonged or recurrent watery diarrhea, especially between May and August. Treatment involves the antibiotic combination trimethoprim-sulfamethoxazole.
Washing Vegetables Is Not Enough
Washing vegetables under clean running water reduces the risk of transmission but does not completely eliminate cyclospora. Chemical disinfectants may not inactivate the parasite. Michigan health officials advised residents in affected areas to buy whole heads of lettuce instead of packaged mixes, discard the outer two or three leaves, and thoroughly wash the inner leaves. If possible, cooking vegetables to at least 70 degrees Celsius is a more reliable method to kill the parasite.
Investigation Continues
Officials are working to identify the source of the outbreak through patient interviews, analysis of food histories, and tracing the supply chain back to farms. However, the long incubation period, the rapid spoilage of fresh produce, and the complexity of distribution networks make the investigation challenging. Until the responsible product is identified, experts advise that there is no need to stop eating vegetables entirely, but to practice food hygiene and follow local health advisories.
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