Sorting through the mixed messages on cyclosporiasis

Lettuce has probably never made you so nervous.

The news about cyclosporiasis, an illness people can contract by eating raw produce contaminated with a diarrhea-causing parasite, keeps evolving. U.S. cases are the highest on record with 41 states reporting more than 4,000 lab-confirmed cases.

That number is expected to keep rising and even the U.S. Centers for Disease Control and Prevention’s finalized data will likely be an undercount because some people recover without getting tested or treated for the parasite.

On July 16, health officials announced that some of the cases were linked to shredded iceberg lettuce from a single producer, which recalled several products. In the days that followed, the U.S. Food and Drug Administration announced a lettuce sample had tested positive for cyclospora, then walked that back, saying the test result was flawed.

“We do have the outbreak under control,” said Health Secretary Robert F. Kennedy Jr. on July 21. “We’ve identified the source of the outbreak and the companies that are involved have implemented a recall.”

The next day, the FDA opened an investigation into another ongoing cyclospora-related outbreak.

It’s been a confusing whirlwind of events.

So, what does all of this mean for you and what’s the outlook on cyclosporiasis?

Q: What is the best advice right now for avoiding this?

A: Continue to steer clear of recalled shredded iceberg lettuce from the supplier Taylor Farms de Mexico, which public health officials say is linked to the cyclosporiasis cases in nine states.

Beyond that, cook your produce. Cooking food to at least 158 degrees Fahrenheit kills cyclospora, so that’s the best way to avoid illness after eating something contaminated.

The parasite can cling to fresh produce, so thoroughly washing your produce and herbs under running water might reduce your chances of getting sick, but it won’t eliminate the risk entirely.

Q: What products and states are affected by this outbreak?

A: Taylor Farms’ July 17 recall involved shredded iceberg lettuce products distributed June 29 through July 16 in more than 25 states.

That included lettuce in products sold at numerous Taco Bell locations and Marketside-brand products sold at Walmart stores in 15 states, some of which had “best by” dates through Aug. 3. Check the produce in your fridge against the recall details and throw it away if you have it.

Taylor Farms lettuce was clearly linked to cyclosporiasis in nine states: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania and West Virginia. Cyclosporiasis cases have also been reported in another 32 states.

Q: I got the memo on iceberg lettuce. But should I steer clear of all lettuce? 

A: That depends on your risk tolerance.

For some people, even the smallest threat of a violent bout of gastrointestinal distress could outweigh the joy of a fresh salad. For others, it might be worth taking a chance.

Since there are multiple outbreaks, other foods in addition to lettuce could be contributing to different case clusters. Sometimes, officials can’t successfully pinpoint a cyclosporiasis outbreak’s source. That’s because these investigations typically rely on people accurately self-reporting the things they’ve eaten, and people struggle to remember everything they ate days earlier.

Some experts said they were taking steps to temper the risk. Jill Roberts, a professor of environmental health microbiology at the University of South Florida College of Public Health, said because cases have been linked to foreign produce, she is eating domestically grown produce for the time being.

Meanwhile, Don Schaffner, a food science specialist at Rutgers University, said he hasn’t changed his behavior. Most fresh produce in this country is not linked to foodborne disease, he said: “I’ve had a salad for dinner most nights, and will definitely be having a salad for dinner tonight.”

Q: Is the outbreak “under control” as Kennedy said?

Health Secretary Robert F. Kennedy Jr. answers questions about rising cyclosporiasis cases July 21, 2026. (C-SPAN)

A: It’s hard to say precisely because there are several outbreaks and data on cyclosporiasis cases is slow and limited. Schaffner said the CDC has been particularly slow to report information on symptomatic people and new cases.One day after Kennedy made the comment on July 21, the FDA opened an investigation into its sixth cyclospora-related outbreak. Of the currently active cyclospora investigations, the FDA says four outbreaks are ongoing. Only one active investigation has linked an outbreak to a product — the iceberg lettuce.

If the other outbreaks are linked to common sources, more recalls could follow.

Three days after Kennedy made the comment on July 21, the CDC said the number of states with reported cyclosporiasis cases linked to Taylor Farms’ iceberg lettuce had increased from five to nine. And reported cyclosporiasis case numbers have continued to rise.

The CDC said July 24 the outbreak could be even larger and involve more states than reported so far because not every case is reported.

That cases are rising doesn’t necessarily mean people are being newly exposed. It can take up to two weeks for symptoms to develop.

Although cyclosporiasis hasn’t made these kinds of news-leading headlines in recent years, it is not new. Public health officials are used to seasonal outbreaks from May 1 to Aug. 31 because it thrives in warm temperatures.

Q: I’ve found it difficult to understand how and where this is spreading. Is it just me? 

A: It’s not just you. Some of the confusion stems from the nature of the illness — it takes a while to develop symptoms and therefore track cases — but other factors have also muddied the picture.

News that the FDA had gotten a false positive test result on a Taylor Farms lettuce sample introduced uncertainty about what was and wasn’t causing cases to spread.

We don’t know all the details, but to detect cyclospora in a lab setting, scientists have to create chemical reactions to amplify the presence of the parasite’s DNA. Sometimes the amplification process can create false positives. The FDA stayed firm on its recommendation to avoid Taylor Farms’ recalled products, saying other signs still pointed to the company’s lettuce as the most likely culprit.

 

View this post on Instagram

 

A post shared by Well Informed (@wellinformedfacts)

Bloomberg reported that the false-positive incident came after Taylor Farms had delayed issuing a product recall until after an FDA deadline, all of which may have contributed to communication lags and further spread.

Food safety experts say the Trump administration’s cuts to the federal workforce and public health and research funding have also hindered the government’s response and communication.

Public health laboratories work on food-related disease outbreaks and recalls, and those labs were “decimated in the last year,” Roberts said.

Kennedy said July 21 that only “redundant” food safety surveillance programs were cut.

Food Fix, a newsletter about federal food policy, pointed out that the federal government cut billions in funding for state and local health officials, who are critical to foodborne illness surveillance. It also cut CDC lab staff specialized in cyclospora and USAID funding that supported domestic cyclospora research.

PolitiFact Staff Staff Writer Grace Abels and PolitiFact Staff Researcher Caryn Baird contributed to this report.

RELATED: What is cyclosporiasis and how can you avoid catching this, uh, ‘explosive’ GI illness?