The cyclospora outbreak has turned deadly after Michigan health officials confirmed the first two known U.S. deaths connected to the intestinal illness. According to the Michigan Department of Health and Human Services, both people had significant underlying health conditions that may have been affected by cyclosporiasis and dehydration. The department said it would not release additional information about either person. The Associated Press reported that these are the first confirmed deaths in the United States related to the microscopic parasite.
Michigan’s outbreak dashboard listed 11,234 cases as of August 3. The state also reported that 193 infected people had been hospitalized as of July 30. Michigan officials said cyclosporiasis is generally not life threatening and that deaths from the illness remain uncommon in the United States.
The cyclospora outbreak is also exposing how complicated national disease counts can become during a rapidly developing investigation. According to the Associated Press, the CDC has received more than 4,100 confirmed cases since May 1 and is examining more than 7,400 additional likely cases across 41 states. The FDA explains that state totals may include probable and recently reported cases, while federal totals generally focus on cases that have completed confirmation and review.
Federal investigators have connected one major portion of the cyclospora outbreak to iceberg lettuce sourced from central Mexico and recalled by Taylor Farms de Mexico. According to the FDA, 1,947 infected people who reported eating at Taco Bell were identified across Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia. At least 98 people in that group were hospitalized.
The CDC’s August 3 advisory acknowledged the two Michigan deaths while noting that its laboratory confirmed outbreak totals were still being updated. That distinction matters because the two deaths should not automatically be counted within every smaller cluster being investigated by federal officials.
The FDA said Taylor Farms de Mexico recalled all iceberg lettuce sourced from central Mexico on July 17. The recall included certain Marketside iceberg salad and shredded lettuce products sold at Walmart with best if used by dates extending through August 3. Recalled food service lettuce was distributed across at least 27 states, according to the CDC, and Taco Bell told federal regulators that it stopped using lettuce from the supplier on July 17.
However, officials have warned that the investigation may extend beyond one supplier or restaurant chain. According to the Associated Press, federal health officials said other “brands, restaurants, retailers, or distribution channels” could eventually be connected to reported illnesses.
The cyclospora outbreak is caused by Cyclospora cayetanensis, a microscopic parasite that infects the intestines. According to a CDC health advisory, people usually become infected after consuming food or water contaminated with the parasite. The illness does not usually spread directly from one person to another.
Watery diarrhea is the most common symptom. The CDC describes the illness as causing diarrhea “with frequent and sometimes explosive bowel movements.” Other reported symptoms include loss of appetite, weight loss, stomach cramps, bloating, nausea, increased gas, and fatigue. Symptoms typically begin about one week after exposure but may appear anywhere from two days to two weeks or longer.
The CDC says routine stool examinations may not reliably detect Cyclospora, meaning patients may need to specifically request testing. The agency identifies trimethoprim sulfamethoxazole as the preferred treatment and recommends rest and plenty of fluids. People with weakened immune systems or poor overall health may face a greater risk of severe or prolonged illness.
Consumers should not eat recalled lettuce and should clean any surfaces or containers that may have touched it, according to the CDC. Anyone experiencing sudden or persistent watery diarrhea should contact a healthcare provider, request Cyclospora testing, and stay hydrated.
