Diarrhea parasite investigation expands to three more states as cases continue to grow

Cases of the diarrhea parasite linked to lettuce that has caused a record number of illnesses are continuing to be detected in more states. 

There are multiple outbreaks of the parasite, cyclospora, currently being investigated by the CDC and FDA, but the one linked to shredded iceberg lettuce imported from Mexico has sickened 11,458 people and killed two. 

This is an increase from 10,900 cases reported last week. 

Additionally, cases have newly been linked in Georgia, Tennessee and Texas. There are now 20 states with cyclosporiasis cases linked to the lettuce.

The CDC said epidemiologic and traceback data showed that iceberg lettuce from Taylor Farms de Mexico, a central Mexico-based processor, was contaminated with cyclospora and the outbreak includes people who reported exposure to iceberg lettuce from the company served or purchased at various locations, including people who previously reported eating at Taco Bell. 

The parasite causes cyclosporiasis, a gastrointestinal infection that leads to sudden and painful diarrhea. Two people have died from the infection this year.

The lettuce was recalled in July and the FDA classified it as its highest risk level last week – Class I – indicating ‘a situation in which there is a reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death.’

The recalled products were distributed to 27 states, including Alabama, Arkansas, Connecticut, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Missouri, Mississippi, North Carolina, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin. 

The outbreak of cyclospora was first identified in July and linked to shredded lettuce served at certain Taco Bell locations.

Taco Bell then stopped using lettuce in its menu items.

Shortly after, produce supplier Taylor Farms voluntarily recalled iceberg lettuce grown in Mexico that the CDC and FDA said was linked to the outbreak.

However, it was then revealed that the positive test result for cyclospora in a sample of Taylor Farms lettuce was a false-positive.

The company has stated that no further testing of its products has detected the pathogen, but officials have maintained the produce is the source of the outbreak. 

In a statement at the time, Taylor Farms said: ‘No Taylor Farms branded salads or kits are associated with this cyclospora outbreak.

‘As a family-owned and operated company, we are deeply concerned for those who became ill, their families, and the many Americans whose trust in the safety of their fresh produce has been shaken.

‘That trust is something we’ve worked for decades to earn, and we are committed to doing everything in our power to restore that confidence.

‘Based on information provided yesterday by the FDA, Taylor Farms de Mexico is voluntarily removing all iceberg lettuce sourced from central Mexico.

‘No Taylor Farms branded salads or kits are associated with this outbreak. No Taylor Farms branded salad kits contain iceberg lettuce.

‘While the FDA traceback is indicating a specific independent farm, which represents less than 1 percent of the US’s iceberg lettuce supply, as the potential source of the outbreak, we have removed all iceberg lettuce from the region indefinitely.’

Earlier this month, Acting FDA Commissioner Kyle Diamantas said in an interview with CNBC that the FDA is ‘very confident that the iceberg lettuce from central Mexico was the culprit.’

No other possible source of the cyclosporiasis outbreak has been named or confirmed.

Diamantas added that the FDA ‘remains confident that all iceberg lettuce related to the cyclospora outbreak has been effectively removed from the market.’

The Department of Health and Human Services followed up in a social media post: ‘Cyclospora: contained, American food: safe.’

And the CDC’s cyclosporiasis surveillance page says it is investigating multiple clusters of the infection, ‘including the large multistate outbreak linked to processed iceberg lettuce from Central Mexico.’

In all, the US is reporting record locally acquired numbers of the infection, at least 17,180 confirmed cases, with nearly 12,000 more cases still under investigation.

There have been 922 hospitalizations and two deaths. Forty-eight states and Washington, DC are reporting cases.

The CDC said the outbreaks may not be limited to these states and cases are likely higher but not everyone infected with cyclosporiasis receives testing or treatment. 

Additionally, the amount of time it takes to investigate an outbreak and link cases to an active outbreak results in delays of case counts.