A source of a widespread outbreak of cyclosporiasis, a parasitic infection known for causing “explosive” diarrhea, in several Midwest states has been officially identified.
Federal health officials said lettuce from Mexico served at Taco Bell locations across five states has been named a source of the rapid spread in cases, though additional sources could still be named.
The Centers for Disease Control and Prevention late Thursday warned consumers not to eat shredded iceberg lettuce from Taco Bell restaurants in Indiana, Kentucky, Michigan, Ohio and West Virginia.
A Food and Drug Administration investigation identified a single supplier of the lettuce. The federal warnings to consumers did not identify the company, but a person familiar with the investigation told NBC News it was Taylor Farms of Salinas, California.
Taylor Farms did not immediately respond to a request for comment. The company also was tied to a 2013 cyclosporiasis outbreak linked to salad mix and a 2024 E. coli outbreak tied to onions served at McDonald’s.
“FDA is working with the supplier of iceberg lettuce to determine if potentially contaminated shredded iceberg lettuce remains on the market,” including in other states, the CDC said. “Taco Bell has committed to stop using any lettuce from the supplier identified by FDA’s traceback investigation.”
In a statement, federal health officials stressed that other “brands, restaurants, retailers, or distribution channels” could be identified as the investigation continues.
Taco Bell said earlier this week that it had “voluntarily and temporarily removed” pulled certain ingredients from some locations amid the outbreak.
“The health and safety of our guests is our top priority,” Taco Bell Corp said in its statement. “Public health officials have not confirmed a link to Taco Bell or any specific ingredient, supplier, restaurant or retailer. While authorities continue their broader review, Taco Bell has voluntarily and temporarily removed limited ingredients at select restaurants as a precautionary measure. We will continue to closely monitor the situation and follow the guidance of public health authorities.”
Last week, local news outlets in the Detroit area reported signs at certain Taco Bell locations indicating the restaurants had pulled lettuce, cilantro, onion, pico de gallo and guacamole.
A record number of cyclospora cases have been reported in more than 30 states, and experts have said not every recent U.S. illness might be caused by a single source.
CDC, FDA and public health officials in several states have been investigating a multistate outbreak that led to thousands of infections.
Michigan has seen the most cases of cyclosporiasis of any state in the U.S. so far — and by a large margin. As of Friday, more than 5,000 cases had been reported in the state.
Health officials there had previously said “current results point to lettuce or salad greens” as the source, but they noted that “other food items cannot be completely ruled out.”
More than 30 states have reported infections this year, and current data from them shows the number of infections surpassing the record U.S. mark of about 4,700 set in 2019.
“This is much, much higher than what we’ve seen last year or the year before,” Gwen Biggerstaff, deputy director of the CDC’s Division of Foodborne, Waterborne, and Environmental Diseases, said. “This is a pretty big shift from what we’ve seen in previous seasons.”
Though not part of the multistate outbreak the CDC has been investigating, Illinois has reported several new infections in recent days. 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 were still under investigation at the time the numbers were released.
“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.
It’s not clear if the contaminated lettuce could be involved in the Illinois cases.
Cyclospora is a microscopic, spherical parasite that commonly causes watery diarrhea “with frequent and sometimes explosive bowel movements,” according to the U.S. Centers for Disease Control and Prevention. Outbreaks tend to occur most often in the late spring and summer.
The heat-loving parasite infects the bowels and spreads through feces. In the past, people have been infected by consuming fruits or vegetables that were exposed to feces-contaminated irrigation water.
The illness, called cyclosporiasis, is less common than foodborne illnesses caused by other germs, including salmonella and E. coli. Many cases are never linked to a specific food or other source and, for years, few U.S. cyclospora outbreaks were reported. But the number started rising about a decade ago, with a particularly notable spike in 2018 and 2019.
Experts say it’s likely that cyclospora cases historically were underreported, in part because some common tests used to check for food poisoning have not been geared to detect cyclospora. They attribute the increasing trend in cases to climate change and better detection.
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.
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