This chart stood at 31,521 on Wednesday. Tonight it stands at 31,972. West Virginia and Florida posted new numbers, Michigan reported on Thursday, and one row of my own chart turned out to be short by 31 people. The federal outbreak linked to recalled iceberg lettuce from Taylor Farms de Mexico stands at 10,930 illnesses in 17 states, with at least 454 hospitalizations, 2 deaths and illness onsets running from June 14 through August 11, as of the August 20 update. The sharpest number on the federal pages tonight is not in that outbreak at all.
Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis, which people catch by eating food or drinking water contaminated with human feces. It is missed by the routine stool exam and has to be asked for by name.
Link to Two states posted new numbers and one row of my chart was wrong Two states posted new numbers and one row of my chart was wrong
West Virginia updated this morning and reports 313 cases with 20 hospitalized, up from 304 a week ago. Nine new illnesses is the smallest week West Virginia has had, and the hospitalization count did not move at all. Florida released its weekly figure Thursday and stands at 450 since May 1, through August 15. That is 43 new illnesses, and it is the fourth consecutive week the Florida number has fallen, running 97, then 87, then 66, then 43. Michigan reported Thursday at 14,277 cases, 335 hospitalizations and two deaths, an increase of 368 and the smallest weekly move of its outbreak.
Then there is Washington, and that correction is mine rather than anybody else’s. My chart carried 36. Washington State reports 67 cases through August 14, of which two were hospitalized. The 36 was the number of people the state had interviewed in an earlier version of that page, not the number of people who got sick, and I read the wrong line. Washington is also the most detailed accounting any state publishes: of 65 people interviewed, 42 had traveled to a country where this parasite is endemic, 22 had not left the country, and 11 of those 22 had traveled to a state with an outbreak. Three are tied to the Taco Bell outbreak, two in Michigan and one in Indiana.
Link to CDC has counted 828 hospitalizations this summer and attributed 454 of them CDC has counted 828 hospitalizations this summer and attributed 454 of them
This is a subtraction anybody can do from two federal pages, and I have not seen it made anywhere. CDC surveillance counts 828 hospitalizations among laboratory-confirmed cases acquired in the United States since May 1. The outbreak investigation page counts at least 454 hospitalizations in the multistate outbreak. The difference is 374 people.
Three hundred and seventy-four Americans have been hospitalized with this parasite this summer and have no food named for their illness. No recall covers them. No advisory names what they ate. That is 45 percent of every cyclosporiasis hospitalization CDC has counted this season, and it is a larger share than most people following this outbreak would guess. On deaths the arithmetic runs the other way and should be said plainly: both are in Michigan and both are inside the outbreak.
Link to Roughly seven in ten confirmed illnesses are tied to the lettuce, and about a third of every counted person Roughly seven in ten confirmed illnesses are tied to the lettuce, and about a third of every counted person
Of the 15,716 laboratory-confirmed domestic cases CDC counts, 10,930 are attributed to Taylor Farms lettuce, which is roughly seven in ten. Measured against the 27,557 confirmed and pending together, it is about four in ten. Measured against the 31,972 in the table below, it is about a third. Those denominators carry different dates, so the honest way to say it is roughly, never to a decimal place.
No state publishes its own attribution split. Michigan counts every case reported during the investigation period and has interviewed more than 2,900 people, many of whom never ate at Taco Bell, at another chain, or at any food establishment. New Hampshire is the one place in the country where a Taylor Farms product was named at a specific address, a hospital cafeteria salad bar in Keene, where 32 of the state’s 69 cases were tied to recalled product and 10 of the 16 people exposed at that salad bar were employees. A hospital can see illness in its own workforce. A grocery store cannot.
Link to The federal outbreak has not added a state, and CDC now says the parasites are genetically related The federal outbreak has not added a state, and CDC now says the parasites are genetically related
Both agencies updated Thursday and neither has moved since. The CDC outbreak page and the FDA advisorycarry 10,930 illnesses, at least 454 hospitalizations, two deaths and seventeen states, with FDA stating outright that no additional states have been added. That is the first update of this entire outbreak that added people without adding a state.
CDC also published something new. Investigators are performing genotyping on samples from sick people, which CDC distinguishes from whole genome sequencing because it targets specific markers rather than reading the whole organism, and CDC says the results show the parasites that caused these illnesses are genetically related. Read that precisely, because it matters. It ties the patients to each other. It does not tie them to the lettuce. There is still no confirmed positive product sample anywhere in this outbreak, and no isolate from a patient can be matched against one. What genotyping does is close off the argument that this summer is unrelated cyclosporiasis piling up at once.
On the surveillance side, CDC counts 15,716 laboratory-confirmed cases acquired in the United States since May 1, with 828 hospitalizations and two deaths, reported by 47 states plus the District of Columbia and Puerto Rico, data current through August 17. At least 11,841 more cases are not laboratory confirmed or still require work to determine where they were acquired. Confirmed and pending together come to 27,557. The people in the confirmed count ranged in age from 1 to 99, median 46, and 57 percent were female. The median illness onset was July 7 and onsets run through August 13. Counted separately, and not part of any of this, are 1,681 travel-associated cases with 61 hospitalizations.
Link to FDA raised the unexplained clusters from 236 people to 270 FDA raised the unexplained clusters from 236 people to 270
CDC still tells readers that it and FDA are investigating at least six other clusters of cyclosporiasis whose sources have not been confirmed, and still points them at FDA’s active investigation table. When I last wrote about those six they held 172, 25, 18, 11, 8 and 2 illnesses, which came to 236. The table now carries an August 19 stamp and those same six hold 201, 27, 18, 14, 8 and 2. That is 270 people carrying this parasite with no food named for any of them, no recall and no public announcement of any kind. My previous post said 236 and said the table had not moved. Both were wrong by the time it published.
The largest of the six went from 172 to 201, and FDA describes the change as an adjustment that now includes additional illnesses based on similarities in reported exposures. FDA has also now initiated sampling on that one. Three of the six are marked with the outbreak ended but the investigation still active, which means the illnesses stopped and the food was never found. On the same table FDA added two brand new E. coliinvestigations on August 19, eighteen cases of O103:H25 and twenty of O26:H11, neither with a product identified.
One more thing about that page. The recall banner at the top of FDA’s own outbreak table still links to the five-state version of the Cyclospora advisory. West Virginia’s outbreak page links to the same dead five-state address. Five states, on two government pages, when the advisory two clicks away says seventeen.
Link to FDA has now named the nine places where the recalled lettuce may also have gone FDA has now named the nine places where the recalled lettuce may also have gone
Alongside the thirty-one states with confirmed distribution, FDA identified the jurisdictions where the recalled lettuce may have been sent: California, Delaware, North Dakota, Rhode Island, South Dakota, Vermont, Washington, the District of Columbia and Puerto Rico. California is where Taylor Farms is headquartered. Its consumers learned this week that recalled lettuce may have reached their restaurants, weeks after thirty-one other states were told.
Link to Here is where all fifty states stand tonight Here is where all fifty states stand tonight
The Lettuce column is whether FDA has confirmed that recalled Taylor Farms de Mexico lettuce reached that state. The last column is a different question and the more important one: whether anybody has tied that state’s illnesses to Taylor Farms at all.
| State | 2026 cases | As of | All of 2025 | Lettuce | Taylor Farms |
| Michigan | 14,277 | Aug 20 | 50 | Yes | Linked |
| Ohio | 5,452 | Aug 13 | 76 | Yes | Linked |
| Indiana | 2,069 | Aug 19 | 27 | Yes | Linked |
| Missouri | 1,950 | Aug 16 | none reported | Yes | Linked |
| Illinois | 1,260 | Aug 11 | 301 | Yes | Linked |
| New York | 939 | Aug 17 | 694 | Yes | Unknown |
| North Carolina | 906 | Aug 11 | 300 | Yes | Linked |
| Kansas | 748 | Aug 12 | 29 | Yes | Linked |
| Kentucky | 620 | Jul 29 | 45 | Yes | Linked |
| Oklahoma | 506 | Aug 11 | 41 | Yes | Linked |
| Florida | 450 | Aug 15 | 210 | Yes | Unknown |
| Texas | 315 | Aug 11 | 512 | Yes | Unknown |
| West Virginia | 313 | Aug 21 | 8 | Yes | Linked |
| Iowa | 300 | Aug 13 | 64 | Yes | Linked |
| Arkansas | 277 | Aug 17 | 13 | Yes | Linked |
| Nebraska | 218 | Aug 6 | 51 | Yes | Linked |
| Wisconsin | 216 | Aug 5 | 65 | Yes | Unknown |
| Virginia | 214 | Aug 17 | 115 | Yes | Unknown |
| Colorado | 150 | Jul 17 | 205 | No | Unknown |
| Massachusetts | 145 | Aug 5 | 74 | Yes | Linked |
| Alabama | 85 | Aug 3 | 19 | Yes | Unknown |
| Pennsylvania | 82 | Jul 29 | not notifiable | Yes | Linked |
| Maryland | 69 | Jul 17 | 123 | Yes | No link found |
| New Hampshire | 69 | Aug 4 | 7 | Yes | Linked |
| Washington | 67 | Aug 14 | not available | May have | Travel link |
| New Jersey | 46 | Jul 11 | 180 | Yes | Unknown |
| California | 41 | Jul 14 | not available | May have | Unknown |
| Minnesota | 41 | Jul 17 | none reported | No | Unknown |
| Connecticut | 35 | Jul 17 | 41 | Yes | Unknown |
| Maine | 27 | Aug 7 | 4 | Yes | Linked |
| Oregon | 23 | Jul 24 | not available | No | Travel link |
| Arizona | 19 | Jul 17 | 49 | No | Unknown |
| Georgia | 11 | Jul 17 | 116 | Yes | Unknown |
| Tennessee | 11 | Jul 17 | 38 | Yes | Unknown |
| Mississippi | 7 | Jul 22 | not notifiable | Yes | Unknown |
| Alaska | 5 | Jul 16 | 6 | No | Unknown |
| Rhode Island | 4 | Jul 17 | 6 | May have | No link found |
| South Dakota | 3 | Jul 16 | 3 | May have | Unknown |
| Louisiana | 1 | Jul 17 | 99 | Yes | Unknown |
| Utah | 1 | Jul 17 | 37 | No | No link found |
| Hawaii | 5, all travel | Aug 14 | not available | No | No link found |
| Delaware | no count published | — | 1 | May have | Unknown |
| Idaho | no count published | — | not notifiable | No | Unknown |
| Montana | no count published | — | 8 | No | Unknown |
| Nevada | no count published | — | not notifiable | No | Unknown |
| New Mexico | no count published | — | 9 | No | No link found |
| North Dakota | no count published | — | 4 | May have | Unknown |
| South Carolina | no count published | — | 45 | Yes | Unknown |
| Vermont | no count published | — | 3 | May have | Unknown |
| Wyoming | no count published | — | 0 | No | Unknown |
| All fifty states | 31,972 | 31 | 17 |
Table: 2026 cyclosporiasis cases as published by each state health department, compiled August 21, 2026 from the sources linked in each row. Forty states publish a count that is added into the total; those forty rows sum to 31,972, which matches the figure in the footer. Hawaii publishes five cases and states that all five are travel-associated, so they are shown and excluded from the sum. Nine states publish no 2026 count. State figures are not directly comparable to one another, because states differ in whether they count probable cases and in how often they update.
Link to Seventeen states are marked Linked, and twenty-six are still marked Unknown Seventeen states are marked Linked, and twenty-six are still marked Unknown
The seventeen are the whole federal outbreak. They are the states CDC and FDA have attributed to the recalled lettuce, and for the nine that came first the attribution rested on Taco Bell exposure, which is to say on a customer remembering where they ate. Two more, Oregon and Washington, are marked Travel link, because their cases are residents who got sick after visiting an outbreak state rather than from anything sold at home. Five health departments have looked and said their cases are not tied to this outbreak: Rhode Island, New Mexico, Maryland, Utah and Hawaii.
That leaves twenty-six states marked Unknown. Between them they have reported thousands of illnesses, and not one of those illnesses has been either tied to this outbreak or ruled out of it. Thirteen of the twenty-six are on the federal list of states that received the recalled product, and they are still Unknown. That is not a finding that the lettuce stopped at their borders. It is the absence of the question. New York alone, with 939 cases and no source ever named, is the largest unattributed series in the country, and it is now a series that genotyping could resolve in a laboratory rather than an interview.
Forty states publish a 2026 count that is added into the total above. Nine publish nothing at all: Delaware, Idaho, Montana, Nevada, New Mexico, North Dakota, South Carolina, Vermont and Wyoming. South Carolina is on FDA’s confirmed distribution list and reported 45 cases in 2025, so it plainly counts this disease when it wants to. Its residents cannot look up a single number this season.
Link to The real number is far larger than 31,972 The real number is far larger than 31,972
Most people with cyclosporiasis never get a stool test, because the parasite is missed by the routine ova and parasite exam and has to be requested by name, and because somebody with a diarrheal illness that comes and goes for a month often never sees a doctor at all. The standard estimate of that gap comes from Scallan and colleagues, Foodborne Illness Acquired in the United States, Major Pathogens, in Emerging Infectious Diseases in 2011, which puts the underdiagnosis multiplier for Cyclospora at 83.1. Applied to CDC’s 15,716 laboratory-confirmed cases, that puts the real number near 1,306,000.
Link to Three questions people are actually asking tonight Three questions people are actually asking tonight
Link to Is the Cyclospora outbreak over? Is the Cyclospora outbreak over?
No, though new illnesses are slowing. The recalled lettuce is genuinely gone, because its best-by dates ran out at the beginning of August, and Michigan, Florida and West Virginia all had their smallest weeks of the outbreak this week. But CDC recorded illness onsets as recently as August 13, and it can take up to six weeks to determine whether a sick person belongs to an outbreak, so counts will keep rising into September for people who ate contaminated food in July. The season CDC defines closes on August 31. The counting does not.
Link to How do I know if my Cyclospora illness is part of this outbreak? How do I know if my Cyclospora illness is part of this outbreak?
You may not, and most people never will. A laboratory test is what connects an individual case, and CDC has attributed roughly seven in ten confirmed illnesses to the lettuce, which leaves thousands of people with a confirmed infection and no answer. If you were sick, ask your doctor whether a stool sample was tested specifically for Cyclospora, and ask your state health department whether your isolate was genotyped. Since CDC said this week that genotyping can group related cases, that question now has a real answer behind it.
Link to Is it safe to eat lettuce now? Is it safe to eat lettuce now?
The recalled product is off the market and its dates have passed. Washing will reduce but cannot be relied on to remove this parasite, and cooking produce to 158 degrees Fahrenheit kills it. The larger caution is that of the nineteen active federal investigations on FDA’s table, six are Cyclospora clusters with no food identified. Nobody can tell you what those 270 people ate, which means nobody can tell you what to avoid.
I wrote up the chart at 31,521 on Wednesday, and the first lawsuit of this outbreak was filed in Illinois this week. Michigan had the smallest week of its outbreak on the same day CDC raised the unexplained clusters by thirty-four people. Both are true at once. The season closes in ten days.