Map of Cases by State, Foods to Avoid and More

Key Points:

• Health officials have linked a multistate cyclosporiasis outbreak primarily to shredded lettuce supplied to Taco Bell restaurants in Michigan, Ohio, Indiana, West Virginia, and Kentucky, with investigations ongoing for other sources nationwide.
• Over 6,700 confirmed or probable cases have been reported in 2026, a significant increase from 2,700 cases in 2025, with the Midwest, especially Michigan, experiencing the highest number of infections and hospitalizations.
• Cyclosporiasis is caused by the parasite Cyclospora cayetanensis, transmitted through contaminated food or water, leading to severe diarrhea; it is treatable with antibiotics, and person-to-person spread is unlikely.
• Taco Bell is voluntarily removing the implicated shredded lettuce from its supply chain nationwide, while health authorities advise avoiding shredded iceberg lettuce from affected Taco Bell locations and emphasize thorough washing and cooking of produce to reduce risk.
• Due to the parasite’s long incubation period and challenges in tracing outbreaks, multiple unrelated outbreaks may be occurring simultaneously, and health officials continue to investigate other possible contaminated food sources.