Cases of cyclosporiasis continued to climb in Illinois, with several new infections reported in recent days as health officials investigate a potential source for the outbreak known for causing “explosive” diarrhea.
According to numbers released by the Illinois Department of Public Health Tuesday, the state has recorded at least 216 cases of the parasitic infection so far. Of those, 18 were hospitalized, health officials said.
Chicago made up as many as 50 of the reported cases, though three remain under investigation.
“At this time, no single source or cause of Chicago cases has been identified, and there is still no evidence of a large outbreak accounting for all or most of these Chicago cases,” the Chicago Department of Public Health said in a statement.
The numbers are some of the highest of the 31 states currently reporting cases, according to the Centers for Disease Control and Prevention.
Michigan remains the highest by far, with cases continuing to rapidly rise, reaching over 3,300 Tuesday morning, up from 2,640 in a single day.
As of July 9, the CDC said 843 cases were confirmed to have been acquired in the U.S. since May 1, with another 1,500 requiring further analysis.
“So far this year, multiple states have reported an increase in cases in the last two weeks compared to the same period in 2025,” the CDC reported, adding that due to a six-week “reporting lag,” the agency anticipates “case counts will continue to rise as data are received.”
Public health officials are investigating what the CDC said are “several clusters of cases in more than one state.” An update on the outbreak is set to be held Tuesday.
As of Monday, health officials in Michigan said “current results point to lettuce or salad greens” as a potential source. That finding only applies to Michigan, and health officials noted that “other food items cannot be completely ruled out” and “no specific type of produce, grower or supplier has been identified as the source.”
“Although we do not have a definite product identified as the source of the outbreak, we want to let Michiganders know what we have learned so far so they can take steps to protect their families,” Dr. Natasha Bagdasarian, chief medical executive for MDHSS, said in a statement. “Early information has shown lettuce as a common product that regularly comes up during the investigation. We will continue to provide updates as we learn more.”
While the infections can be contracted from swimming in contaminated waters, such transmission is uncommon and Michigan health officials said it is “not a recognized risk factor” and “there is currently no evidence linking recreational water activities to this outbreak.”
Instead, they have said foodborne exposure remains the primary focus for the latest outbreak.
What is cyclosporiasis?
Known for causing watery diarrhea, nausea and stomach pains, cyclosporiasis is an infection caused by a parasite often linked to contaminated food and water.
What can you do to prevent infection?
While lettuces are being investigated as a potential source, and have been the source for previous cyclosporiasis outbreaks, officials urged anyone eating or preparing lettuce or salad greens in areas where cases have been reported to take added precautions.
That includes:
Purchase whole heads: Buy whole heads of lettuce rather than pre-washed, bagged lettuce or pre-mixed salad kits. Discard outer layers: Before preparation, throw away the outer two to three layers of leaves. Wash inner leaves: Thoroughly wash the remaining inner leaves under clean running water. Prioritize cooking: For any greens that can be cooked, cooking to a temperature of at least 158 F (70 C) is the safest option, as the parasite is resistant to routine chemical disinfection and washing alone cannot guarantee its removal.Other recommendations include:
Cook produce when possible: Heating food to 158 F (70 C) or higher kills cyclospora. Peel produce: Peeling is highly effective for food items with removable skin as the parasite sits on the outer surface. Wash all fresh produce: Wash under clean running water, even if you plan to peel it. “Pre-washed” does not guarantee safety and rewashing bagged lettuce is unlikely to remove cyclospora. While washing alone may not fully eliminate cyclospora, it enhances protection when combined with cooking or peeling.Produce items linked to previous outbreaks
Food items that have been linked to previous cyclospora outbreaks in the U.S. and Canada include:
Bagged salad mixes and kits Fresh cilantro (coriander leaves) Fresh basil Raspberries Snow peas Green onions (scallions)What are the symptoms of cyclosporiasis?
While the most common and notable symptom of the infection is known as “explosive diarrhea,” there are numerous other signs of infection.
“[The diarrhea] can be really frequent, pretty severe. People talk about explosive diarrhea,” said Dr. Kiran Joshi with the Cook County Department of Public Health. “You can get all kinds of other abdominal symptoms as well, including loss of appetite, nausea, vomiting, sometimes a low grade fever. Now, those symptoms can certainly cause quite a bit of distress. The good news is that this is typically not a life-threatening illness, though if untreated, it can last for a month or longer, so it’s really important.”
Experts say diarrhea itself isn’t a distinctive symptom, but knowing the outbreak is growing could lead more practitioners to testing for cyclosporiasis.
“There are a lot of different causes of diarrhea, and cyclosporiasis is not one of the higher causes of infectious diarrhea. But when cases do surge in the way that they are, it’s important to pay attention to it,” Mayer said.
One of the larger indications of cyclosporiasis is likely the timing of infection and symptoms.
While many other foodborne illnesses will show symptoms within hours, cyclosporiasis can take days or even up to two weeks to appear. The most common time frame is around one week, according to the Centers for Disease Control and Prevention.
“The first thing is explosive diarrhea, bloating, cramping, loss of appetite,” Dr. Sharon Welbel, chair of infectious diseases for Cook County Health, said. “Some people have a low-grade fever but that’s pretty uncommon.”
The infections can also last much longer than other foodborne illnesses.
“The symptoms are a bit less, but they go on longer. Noroviruses kind of hits you hard and then it’s done. This kind of just drags on for a longer period of time,” Dr. Irfan Hafiz, an infectious disease physician at Northwestern Medicine, told NBC Chicago.
The CDC notes that the illness can last anywhere from a few days to over a month and, in some cases, may even seem to go away but then return one or more times.
Here’s a look at how it compares to other illnesses.
What to do if you become ill
People experiencing frequent, watery diarrhea are being urged to contact their healthcare provider and “specifically request testing for cyclospora as routine stool tests may miss the parasite,” MDHSS stated.
Treatment for confirmed infections will include antibiotics, but those who contract it should also be prepared to rest and drink fluids to maintain hydration.
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