Health officials have now linked the cyclosporiasis outbreak that causes “explosive diarrhea” to six more states as the first deaths have been reported. Also, according to the U.S. Centers for Disease Control and Prevention (CDC), once a backlog of cases is investigated and confirmed, the number of people infected could rise to as many as 22,700.
Michigan, where the outbreak is the worst, has now reported two deaths related to the wave of parasitic infections that has affected more than 11,000 people in the state. They are the first fatalities reported in the U.S. this year from the cyclosporiasis outbreak.
On Tuesday, Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina joined the list of states with residents who have been diagnosed with the gastrointestinal illness caused by the microscopic parasite Cyclospora. The Missouri Department of Health and Senior Services has reported 1,095 cases as of Sunday, nearly double the number it reported a week ago.
All but three states have now reported cases of cyclosporiasis
47 states have now reported 10,468 people with laboratory-confirmed domestically acquired cyclosporiasis since May 1, 2026, according to the CDC. The only three states that have not reported any laboratory-confirmed cases of cyclosporiasis are Delaware, Hawaii, and Montana. Health officials in those states have, however, reported several possible cases: one in Delaware, two in Montana, and four in Hawaii.
However, the CDC also notes that it “is aware of more than 12,255 additional cases of cyclosporiasis that are not laboratory confirmed or require further investigation and analysis. Many of the additional cases continue to be reported by Michigan. CDC is working closely with states to update surveillance data as additional cases are confirmed.”
The CDC also added, “Cyclosporiasis cases may not be limited to these states with known cases. The true number of people sick with cyclosporiasis was likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.”
Most of the cases have been linked to Taco Bell’s use of lettuce from central Mexico supplied by Taylor Farms, a Salinas, California-based producer of lettuce, salad mixes, and other fresh goods. The company voluntarily recalled all iceberg lettuce that came from central Mexico last month.
Also, Sysco, the world’s largest broadline food distributor, announced it will no longer be purchasing iceberg lettuce from Mexico due to the cyclosporiasis outbreak.