Illinois has been added to the list of states being investigated as part of a cluster of cyclosporiasis cases stemming from what investigators believe was contaminated lettuce.
The Centers for Disease Control and Prevention on Friday updated the number of states included in the outbreak from four to nine, adding Illinois, Indiana, Kansas, Oklahoma and Pennsylvania. Previously, only Michigan, Ohio, Kentucky and West Virginia were being investigated over the diarrhea-causing parasite.
The Food and Drug Administration warned residents in those locations not to eat recalled lettuce from Taylor Farms de Mexico, a supplier for Taco Bell, amid an ongoing investigation. Taylor Farms had previously been labeled a potential source for the outbreak, but officials later said a positive test result was actually a false positive.
Still, public health officials said “cases with Taco Bell exposure” have been reported in each of the nine states.
Here’s what to know:
Where was the recalled lettuce sold?
Taylor Farms de Mexico initiated a voluntary recall of all iceberg lettuce from central Mexico on July 17, including products that were sent to grocery stores and restaurants in more than a dozen states.
According to the recall notice, iceberg lettuce from Taylor Fresh Foods was distributed to food service locations from June 29 through July 16 in the following states:
Alabama, Arkansas, Connecticut, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Mississippi, Missouri, North Carolina, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin.
“Taco Bell has indicated they are no longer using lettuce from Taylor Farms de Mexico,” the FDA reported Friday.
The recalled lettuce was also sold at select Walmart stores in:
Alabama Arkansas Florida Georgia Indiana Kansas Kentucky Louisiana Missour Mississippi Oklahoma Tennessee Texas Virginia West VirginiaWhich states are included in the latest outbreak investigation?
Illinois
Indiana
Kansas
Kentucky
Michigan
Ohio
Oklahoma
Pennsylvania
West Virginia
Federal health officials are also investigating a separate outbreak involving the diarrhea-causing parasite, which included 72 people as of Wednesday.
The Food and Drug Administration has not yet identified which products are linked to the illnesses. Officials also have not said where the cases are located.
“This is an active investigation, and officials are working together to determine the specific cause of illnesses in this cluster,” the Department of Health and Human Services said in an email Thursday.
How many cases are there?
According to its latest update, the CDC reported at least 1,947 infections associated with the nine states, all of whom “reported exposure to Taco Bell.” At least 98 of those cases have required hospitalization but no deaths have been reported.
“This increase in cases is, in part, due to the identification and addition of four new states that are now considered part of this outbreak. We also expect to continue to see the number of confirmed cases rise, despite the recall, due to the fact that it can take as long as six weeks for CDC and state officials to determine if a sick person is part of this outbreak,” the CDC reported.
In Illinois, health officials reported 513 confirmed and probable cases as of July 23, but the health department said it is now “intensifying its investigation” after the state was added to the CDC’s investigation.
“IDPH has been closely monitoring the Cyclospora multi-state outbreak that has been happening across the United States and in Illinois,” Dr. Sameer Vohra, director of the Illinois Department of Public Health, said in a statement. “July case reports are rising at a level we have not seen since 2018.
Meanwhile, cases in Michigan have topped 8,000 as of Friday.
What can you do if you live in one of the affected states?
Health experts have stressed proper food hygiene practices as the outbreak continues to expand, but urged anyone in the impacted states not to eat the recalled lettuce.
Beyond that, Illinois experts said anyone experiencing symptoms should reach out to their healthcare providers right away.
“It is important our residents are aware of how to keep themselves and their loved ones safe. We recommend Illinois residents, but especially our elderly, infants and those with weaker immune systems, reach out to their health care provider if they experience sudden, ongoing diarrhea,” Vohra said. “Important preventive measures include washing your hands before preparing or eating food, thoroughly washing produce, and when appropriate, cooking produce to a temperature of at least 158 degrees.”
The FDA offered the following advice:
Consumers, restaurants, and retailers who purchased or received recalled iceberg lettuce distributed by Taylor Fresh Foods should discard it immediately and not consume it. Full refunds are also available at the location of purchase. If you have symptoms of cyclosporiasis, contact your health care provider to report symptoms and receive care, especially if you ate shredded iceberg lettuce in the two weeks before you got sick. If you purchased or received recalled iceberg lettuce from Taylor Farms de Mexico, carefully clean and sanitize any surfaces or containers that it touched. Consumers should follow FDA’s safe handling and cleaning advice to reduce the risk of cross-contamination. Restaurants and retailers should follow FDA’s Food Safety Tips.Is it safe to eat lettuce?
Brian Schaneberg, executive director of IIT’s Institute for Food Safety and Health, joined The Takeaway with Alex podcast to talk about what is safe to eat. He said the CDC and FDA, have centered their investigation on certain types of bagged, cut or mixed lettuce. In North Carolina, health officials have linked parsley and cilantro to outbreaks there.
“I still eat [lettuce] with the caveat that it’s…going to be more local at the farmers market and getting those things and washing those at home,” said Schaneberg.
He said most people won’t be cooking lettuce to 158 degrees Fahrenheit — a proven way to kill the intestinal parasite — so he recommended washing lettuce instead.
“If you do buy bagged lettuce of any form today, you should clean it again,” said Schaneberg. “Even…if it has one-wash, two-wash, three-wash [on the label], do it again.”
The FDA and CDC have yet to identify an exact source of the outbreak.
Still, weeks into the outbreak, the lack of a cause “boggles all of our minds” in the food safety community, but Schaneberg has a hypothesis for the contamination source.
“It’s got to be water,” said Schaneberg. “But right now there’s no data pointing to whether it is Mexico or not, because we don’t know what it was a week ago.”
Schaneberg said he believes the contaminated water is coming from washing source or irrigation source because the outbreak has infected thousands of people. He said cyclospora isn’t spread person to person, but people can spread it to contaminated surfaces like hands and food. While he doubted cyclospora can survive in a pool due to chlorine and dilution in the water, he said it can survive in ice.
When washing lettuce, Shaneberg said it’s important to be thorough.
“You have to get into those nooks and crannies,” said Schaneberg. “Then spin it down hard with a salad spinner.”
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.This story uses functionality that may not work in our app. Click here to open the story in your web browser.
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