The U.S. Food and Drug Administration (FDA) has expanded its investigation into a multistate Cyclospora outbreak to 9 states, with 1,947 laboratory-confirmed illnesses and at least 98 hospitalizations, making it one of the largest Cyclospora outbreaks investigated in the United States. The outbreak is linked to recalled iceberg lettuce sourced from central Mexico, and no deaths have been reported so far.

What Is Cyclospora and Why Should You Care?

Cyclospora cayetanensis is a parasite that causes cyclosporiasis, a gastrointestinal illness characterized by prolonged watery diarrhea, abdominal cramping, bloating, nausea, fatigue, weight loss, and decreased appetite. Symptoms may persist for weeks or recur if left untreated. The illness onset dates for this outbreak range from June 22 through July 20, 2026, and officials expect the case count to continue rising because it can take up to 6 weeks for investigators to determine whether newly reported illnesses are part of the outbreak.

Immunocompromised patients face particular risk. Those with weakened immune systems, including transplant recipients, oncology patients, and others with compromised immunity, are at increased risk for prolonged illness and complications, making early recognition particularly important in hospitals caring for these vulnerable populations.

Which States Are Affected and Where Did the Contamination Come From?

Illnesses included in this investigation are linked to exposure at Taco Bell restaurants and have been reported in Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia. The investigation prompted Taylor Farms de Mexico to voluntarily remove all iceberg lettuce sourced from central Mexico from the U.S. market on July 17. The recall includes Marketside-brand iceberg salad and shredded lettuce products sold at Walmart, as well as numerous foodservice products distributed to restaurants, institutional kitchens, and other commercial customers. Product distribution has been confirmed across 28 states, underscoring the importance of reviewing food inventories even in states without confirmed illnesses.

The FDA also clarified a laboratory finding that briefly created confusion during the investigation. An iceberg lettuce sample initially reported as positive for Cyclospora cayetanensis was later determined to be a false positive after additional laboratory review. The agency emphasized that this does not change the epidemiologic evidence or traceback investigation, both of which continue to implicate shredded iceberg lettuce supplied by Taylor Farms de Mexico.

How Health Care Facilities Can Protect Patients

• Inventory Review: Work with dietary services, supply chain teams, and environmental health personnel to verify that recalled products have been removed from inventory and that foodservice vendors are aware of the recall.
• Clinical Awareness: Clinicians and infection preventionists should consider Cyclospora infection in patients presenting with persistent diarrheal illness who have recently consumed fresh produce or eaten at establishments receiving recalled products.
• Surface Sanitation: Clean and sanitize surfaces and containers that may have come into contact with recalled products to reduce the risk of cross-contamination.

For hospitals and other health care organizations, infection preventionists play a critical role in recognizing foodborne outbreaks as an important component of infection prevention and public health surveillance. Although Cyclospora is not spread person-to-person through routine patient care, the parasite can contaminate food supplies used in patient meals, cafeterias, and long-term care settings.

A Separate Egg Recall Adds to Food Safety Concerns

While the Cyclospora outbreak dominates headlines, another significant food safety issue emerged this week. Midwest Poultry Services voluntarily recalled nearly 1.6 million dozen eggs, approximately 19 million individual eggs, due to the potential for salmonella contamination. The white shell eggs and brown cage-free shell eggs were produced in Texas and have "sell by" or "best by" dates between July 20, 2026, and August 17, 2026.

The recalled eggs were available at Kroger locations in Texas and Louisiana; Brookshire Grocery stores in Texas, Oklahoma, Arkansas, Louisiana, New Mexico, and Mississippi; and other smaller retail outlets. The eggs were also shipped to foodservice customers in Texas, Oklahoma, and Louisiana. The recalled eggs can be identified by a code number, either P-1950 or 0840962, with a Julian Date between 157 and 184, printed in date-coding ink on the left or right sides of the carton.

Salmonella bacteria cause about 1.35 million infections in the U.S. every year, with contaminated food as the source of most of these illnesses. Symptoms of salmonella, including abdominal pain, fever, headache, watery diarrhea that may also have blood or mucus, loss of appetite, nausea, and vomiting, usually begin six hours to six days after swallowing the bacteria. Most people recover from salmonella without treatment after four to seven days, but some people, particularly children under the age of 5 and adults 65 and older, or those with weakened immune systems, may experience more severe illnesses that require medical treatment or hospitalization.

Midwest Poultry Services stated that it initiated the recall "as a precautionary measure" and is not aware of any illnesses linked to its products. The company said it began diverting eggs to a breaking plant where they would be pasteurized to kill any foodborne pathogens and initiated testing protocols to identify potential sources of salmonella.

As traceback activities continue for the Cyclospora outbreak, the FDA has cautioned that additional brands, retailers, restaurants, or distribution channels may be identified. For infection preventionists and consumers alike, staying informed about evolving food recalls and maintaining vigilance about fresh produce and egg products can help ensure recalled items do not reach vulnerable populations.