Michigan health officials have confirmed the first two U.S. deaths connected to a multistate Cyclospora outbreak linked epidemiologically to shredded iceberg lettuce. Both people had pre-existing health conditions, and officials said the infection may have aggravated their underlying illnesses. The deaths mark a serious escalation in an outbreak that affected thousands across the country; authorities have not publicly identified the individuals.
Michigan reported 11,234 infections and 193 hospitalizations in an earlier update, making it the state with the highest reported case count at that point. Later state reporting cited 14,718 cases and 373 hospitalizations as of September 6. The state also reported two deaths. Michigan and federal totals have differed substantially across updates: one comparison put Michigan’s count at 15,472, while the CDC’s state range was 4,000 to 6,999. These figures reflect different reporting dates and case definitions, including whether counts cover suspected or confirmed cases, and whether they are outbreak-associated.
National figures also vary by surveillance snapshot. One outbreak tally recorded at least 12,883 illnesses across 21 states and 570 hospitalizations. Michigan reported two deaths. A clinical report in Transplant Infectious Disease cited 15,716 laboratory-confirmed domestically acquired cases by August 17, along with a further 11,841 cases under investigation. The report also recorded 828 hospitalizations and two deaths in that dataset. These tallies use different scopes and definitions and should not be added together. The 2026 season was far larger than the 1,180 U.S. cases reported in 2025.
Cyclospora cayetanensis is an intestinal parasite transmitted through food or water contaminated with human waste. Infection can cause prolonged watery diarrhea, along with loss of appetite and weight loss. Fatigue is also common. Severe illness and fluid loss can pose particular risks to people with serious underlying conditions or weakened immune systems. A CDC Health Advisory highlighted the heightened exposure risk for solid-organ and blood-forming-cell transplant recipients. Treatment is available, but symptoms can persist for weeks.
Investigators initially focused on Taco Bell after illness clusters appeared in at least nine states. Interviews about shared exposures and distribution records later pointed to a broader supply-chain link: shredded iceberg lettuce supplied by Taylor Farms de Mexico and grown in central Mexico. The lettuce reportedly reached restaurants and retailers in more than 30 states. Food-service operations associated with Taco Bell and Subway used the lettuce, while Walmart sold Marketside-branded products. Distribution through both restaurant and retail channels made the outbreak difficult to trace to a single chain.
Taylor Farms voluntarily recalled iceberg lettuce sourced from basic Mexico on July 17, after epidemiological and traceback evidence converged on the product. The recall covered lettuce used by restaurants and products sold at retail. The company said its own testing had not produced a confirmed positive result as of August 13. The epidemiological evidence identified lettuce as the likely vehicle, but did not establish a single point of contamination or assign responsibility to a particular grower or company.
FDA investigators found Cyclospora in a drainage ditch near a farm and in a wastewater tank at a processing facility, but the agency did not establish that either environmental sample was genetically related to parasites recovered from patients. The CDC declared the outbreak over on September 11, while the FDA continued its investigation and closed it on October 2. The FDA also announced that a lettuce sample from outside the recalled products had tested positive, then retracted the result the following day as a false positive. The agency’s final reported position was that it could not determine exactly how the lettuce became contaminated.
Consumer Reports criticized the federal response, citing inconsistent case counts and communication problems, including delays. It sought explanations from the FDA and CDC. The investigation’s unresolved contamination pathway has kept attention on produce traceability and environmental monitoring. It has also raised questions about how agencies communicate evidence during foodborne-illness outbreaks. The recalled lettuce was identified as a probable outbreak vehicle through epidemiological and traceback work; that conclusion is distinct from laboratory confirmation of contamination in a specific product sample.
The outbreak has heightened concern about food safety and the vulnerability of people with chronic health conditions. The CDC continues to monitor cyclosporiasis and advises consumers to follow product recalls and food-safety notices. The episode also highlights the challenges of tracking fresh produce through a supply chain that crosses borders and serves restaurants as well as retail stores.
Cyclospora cayetanensis has caused outbreaks in North America over the past decade, often associated with fresh produce. While many healthy adults recover, older people and young children may face greater risks. People with compromised immune systems may also be more vulnerable. The Michigan deaths have reinforced the importance of timely public-health surveillance and rigorous food handling. The outbreak has also drawn comparisons to other recent public-health incidents in the US, such as the rise in accidental drownings in Catalonia, covered in detail in a related report on the growing number of pool-related deaths in Barcelona province.
