Shredded iceberg lettuce linked to cyclosporiasis in 15 states

The CDC and FDA said on August 5 that a Cyclospora outbreak linked to recalled iceberg lettuce had expanded to 15 states, with 6,358 laboratory-confirmed illnesses and 278 hospitalizations reported so far. Federal officials said epidemiologic and traceback data continue to show that iceberg lettuce from Taylor Farms de Mexico was contaminated and made people sick. Michigan health officials have also reported two deaths tied to the outbreak, the first deaths publicly identified in the multistate investigation. The August 5 update broadened the outbreak beyond the earlier five-state Taco Bell cluster and later nine-state tally. Federal officials said six states were newly added in the latest expansion: Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina. The FDA said many illnesses began before Taylor Farms de Mexico announced its July 17 recall. ### Which states are now part of the outbreak? (cdc.gov) The FDA said confirmed cases tied to recalled Taylor Farms de Mexico iceberg lettuce have been identified in Arkansas, Iowa, Illinois, Indiana, Kansas, Kentucky, Michigan, Missouri, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania and West Virginia. The agency said the affected cases include people who reported exposure to Taco Bell or to recalled Taylor Farms de Mexico iceberg lettuce. (cdc.gov) ABC11, citing the federal update, reported that the six newest states added on August 5 were Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina. That expansion followed a July 24 CDC update that had added Illinois, Kansas, Oklahoma and Pennsylvania to the original five-state outbreak. ### What product is being blamed? Taylor Farms de Mexico initiated a recall on July 17 covering all iceberg lettuce sourced from central Mexico, according to the CDC and FDA. (fda.gov) Federal officials said the recall included foodservice products as well as Marketside-brand products sold at select Walmart stores, including “Iceberg Salad” and “Shredded Lettuce” items with best-by dates from July 18 through August 3. (abc11.com) The CDC said recalled lettuce was distributed to consumers, restaurants and retailers in at least 27 states. The FDA said any Taco Bell locations that received recalled iceberg lettuce from Taylor Farms de Mexico were included in the advisory, and Taco Bell had indicated it stopped using that supplier’s lettuce as of July 17. ### What do officials say about the two Michigan deaths? Michigan’s Department of Health and Human Services said two deaths have been identified as part of the cyclosporiasis outbreak affecting the state. (cdc.gov) The department said medical records showed both people had significant underlying health conditions that may have been affected by cyclosporiasis and dehydration. The Michigan agency said both people became ill before the voluntary recall announced on July 17. It added that cyclosporiasis is generally not life-threatening and that death from the illness is uncommon in the United States. ### What symptoms are health officials telling people to watch for? The CDC said symptoms of cyclosporiasis can include watery diarrhea, fatigue and loss of appetite. (michigan.gov) The FDA lists other common symptoms as weight loss, stomach cramps or pain, bloating, gas and nausea, and says some people may also have vomiting, body aches, headache or fever. The CDC said symptoms usually begin about one week after infection, though the onset can range from two days to two weeks or more. (michigan.gov) The agency said routine stool tests do not always screen for Cyclospora, and patients may need to specifically request testing. ### Why are case counts still rising after the recall? The CDC said illnesses linked to this outbreak began on June 22 and continued through July 31. (cdc.gov) Federal officials said recent illnesses may not yet be fully reflected in the count because it can take as long as six weeks to determine whether a sick person is part of a Cyclospora outbreak. The CDC said the investigation remains open as of August 5. (cdc.gov) Consumers are being told not to eat recalled Taylor Farms de Mexico iceberg lettuce, to throw it away or return it, and to wash any surfaces or items that may have touched it with hot soapy water or in a dishwasher. (cdc.gov)