Michigan reports 2 deaths in cyclosporiasis outbreak

Michigan reports 2 deaths in cyclosporiasis outbreak

Two people in Michigan have died in connection with a widespread cyclosporiasis outbreak, marking the first fatalities in the largest U.S. Outbreak of the intestinal illness. The Michigan Department of Health and Human Services (MDHHS) announced the deaths on Monday, August 3, 2026.

Medical records indicate that both individuals who died had significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration, according to state health officials. While the MDHHS noted that cyclosporiasis is generally not considered a life-threatening illness and deaths are uncommon in the United States, the agency will not release additional information regarding these two cases.

The outbreak has hit Michigan harder than any other state. As of August 3, the MDHHS reported 11,234 confirmed cases statewide, an increase of 461 from the previous Friday update. Hospitalizations have reached 193. Data shows that adults aged 30 to 39 years have been the hardest hit, with 2,216 reported cases, and Wayne County has reported the highest concentration of infections with 1,379 cases.

Investigation into the Source

The investigation into the source of the parasite, Cyclospora cayetanensis, has focused heavily on lettuce and salad greens. An FDA investigation linked the outbreak across nine states to iceberg lettuce from Taylor Farms operations in central Mexico. This led to a voluntary recall on July 17 of iceberg lettuce products from Taylor Farms de Mexico, affecting retail stores and food service customers in 27 states.

The recall included Marketside Bagged Iceberg Salad and Shredded Iceberg Salads distributed by Taylor Farms at Walmart. Additionally, shredded lettuce served at Taco Bell locations in Michigan, Ohio, West Virginia, Kentucky, and Indiana was linked to the outbreak. In response, some Taco Bell locations have offered deals on lettuce-free menu items.

The identification of the source has been fraught with contradictions. On July 19, Taylor Farms stated that the FDA had not identified a single positive product test result for cyclospora, following a report that a positive sample was actually a false positive. However, the FDA later clarified on social media that this finding did not change the basis of the investigation, stating that substantial epidemiological data continued to support the voluntary recall.

National Impact and Surveillance

The outbreak has expanded to 45 states. According to the Centers for Disease Control and Prevention (CDC), there were 6,707 laboratory-confirmed cases nationwide as of July 28. More than 11,500 additional suspected cases are awaiting confirmation, primarily in Michigan and Ohio. As of July 31, the Ohio Department of Health reported 4,013 cases.

The discrepancy between state and federal numbers is attributed to a six-week lag in CDC surveillance, which only includes laboratory-confirmed cases occurring since May 1. In Florida, the state health department reported 254 cases across 39 counties since May 1. While Florida has not linked its cases to a specific outbreak, the University of South Florida Morsani College of Medicine noted that the state's warm climate and year-round produce access make it vulnerable to seasonal rises in the parasite during late spring and summer.

Health Risks and Prevention

Cyclosporiasis is an intestinal illness characterized by watery, often explosive diarrhea. Other symptoms include:

• Severe abdominal cramping, bloating, and gas
• Nausea and vomiting
• Fatigue and low-grade fever
• Significant weight loss and loss of appetite
• Headaches and body aches

Symptoms typically appear between two days and two weeks after exposure. Without treatment, the illness can last for weeks or months, often featuring waxing and waning symptoms.

To reduce risk, the MDHHS and CDC recommend the following:

• Buy whole heads of lettuce rather than pre-washed bagged lettuce or premixed salad kits.
• Discard the outer two to three layers of leaves before preparation.
• Wash remaining inner leaves under clean running water.
• Cook leafy greens to a temperature of at least 158 degrees, as washing alone cannot guarantee the removal of the parasite.

Experts warn against using soap, bleach, or household disinfectants on produce, as well as UV washers or ozone devices, which lack sufficient real-world evidence for killing the parasite.

Legal and Administrative Fallout

The outbreak has led to legal action. Attorney Ron Simon stated he has filed a lawsuit in the United States against Taco Bell and Taylor Farms. According to Simon, the defendants have 30 days to answer the lawsuit.

Some food safety experts and former CDC officials suggest that cuts to federal health agencies have complicated the government's ability to respond to such foodborne outbreaks. Dr. John Openshaw, an infectious disease physician at Stanford University, noted that tracing outbreaks requires trained staff and resources, and that any cuts to these elements impede the ability to identify how pathogens enter the food supply.

The U.S. Department of Health and Human Services has confirmed it is aware of the deaths in Michigan as the investigation continues.