Cyclosporiasis cases have been rising in Illinois and the Midwest for weeks, but figuring out what’s causing the increases has been a bit of a challenge.
That search continues even as reported cases surge, with numbers surpassing 3,700 in Michigan as of July 15 according to officials.
Michigan health officials have said no exact source has been identified but that “current results point to lettuce or salad greens.” They 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.”
The Centers for Disease Control and prevention (CDC) says its current case count “is substantially higher than the 249 cases reported nationally by this same time last year.”
And, “because cyclosporiasis is often underdiagnosed and underreported, the true number of illnesses is likely higher than what has been reported to CDC.”
The gastrointestinal illness that’s been grabbing headlines is caused by the parasite Cyclospora. People get infected by consuming contaminated food or water. It’s not spread from person to person, and according to the agency, previous outbreaks have been linked to consuming contaminated, fresh produce.
The CDC said it’s working closely with FDA and state health authorities to investigate multiple clusters of cyclosporiasis.
Although hundreds of cases in at least four states appear to be epidemiologically linked, suggesting that there could be a common source of these infections, that source has so far not been identified.
According to the CDC, cases in Ohio, Michigan, Kentucky and West Virginia are being investigated together as part of a multi-state cluster.
“It’s true that if soil is contaminated, it is contaminated, and that can certainly contaminate the produce,” said Dr. Sharon Welbel, an infectious disease doctor at Cook County Health. “It doesn’t mean that the whole country has the same source.”
Welbel, who chairs the infectious disease department at Cook County Health, points to the size of the outbreak, and how common many of the previously contaminated foods are, as to why it may be difficult to pinpoint one source.
“Ohio, Michigan, some surrounding states, that probably is linked. But the whole country most likely is not linked,” said Welbel.
It’s also more difficult to test parasites compared to bacteria during outbreaks, according to Welbel.
“We don’t have the tools that we have with things like bacteria. So, we can test, say it’s the lettuce, and grow that in the lab, and then we can test a specimen from a patient, and grow that in a lab, and see if they’re the same. And we can do like molecular typing and all sorts of things to say this produce caused this person’s illness. But we can’t do that with a parasite right now.”
Surveillance of the parasite has also recently changed.
The CDC scaled back the Foodborne Diseases Active Surveillance Network (FoodNet) in 2025, which tracks infections caused by multiple pathogens, including cyclospora.
Foodnet narrowed its focus to Salmonella and STEC, but states aren’t precluded from conducting their own surveillance. State health departments are able to report cases through the National Notifiable Diseases Surveillance System.
Anyone experiencing frequent, watery diarrhea is being urged to contact their healthcare provider and “specifically request testing for cyclospora as routine stool tests may miss the parasite,” health officials said.
Treatment for confirmed infections will include antibiotics, but those who contract it should also be prepared to rest and drink fluids to maintain hydration.
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 CDC.
The infections can also last much longer than other foodborne illnesses.
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