UPDATE 7/17/2026: The FDA advises do not eat shredded iceberg lettuce from Mexico served at Taco Bell locations in IN, KY, MI, OH, and WV. FDA’s investigation is ongoing.
Taco Bell locations in IN, KY, MI, OH, and WV. Additional states may be added to this advisory as more information becomes available. Taco Bell is working to stop use of all lettuce implicated by this investigation. Not all Taco Bell locations in these states received implicated product.
Recommendations: If you have symptoms of cyclosporiasis, contact your health care provider to report symptoms and receive care, especially if you ate shredded iceberg lettuce in the two weeks before you got sick.
If you purchased or received food items with shredded iceberg lettuce served at Taco Bell at one of these locations, carefully clean and sanitize any surfaces or containers that it touched. Follow FDA’s safe handling and cleaning advice to reduce the risk of cross-contamination. Read FDA’s Cyclospora information for additional information about Cyclospora and what consumers can do.
The FDA and CDC, in collaboration with state and local partners, are investigating a multistate outbreak of Cyclospora illnesses linked to shredded iceberg lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio, and West Virginia. The illnesses included in this outbreak are a subset of the Cyclospora illnesses identified nationwide.
Based on epidemiological information collected by CDC, a total of 1,644 people infected with Cyclospora and reporting exposure to Taco Bell have been reported by five states. Illnesses started on dates ranging from May 13, 2026, to July 13, 2026. There have been 94 hospitalizations, and no deaths have been reported. MI analyzed food exposure details from 190 of the cases who reported eating at Taco Bell and shared these findings with CDC. Ingredient level analyses on meals eaten by these cases indicate that 90% of those interviewed reported eating iceberg lettuce.
FDA’s traceback investigation has identified convergence on a single supplier of iceberg lettuce from Mexico used by Taco Bell locations where sick people ate before becoming ill.
FDA is working directly with the identified supplier to determine if potentially contaminated shredded iceberg lettuce remains on the market. As part of this investigation, FDA and state partners have initiated collection of product samples for testing and analysis. Additionally, FDA has increased screening at the border for products implicated in the outbreak.
FDA is also working with Taco Bell and they have committed to stop using any lettuce from the supplier identified by FDA’s traceback investigation.
FDA and state partners are actively investigating the source and scope of the contamination. Because the investigation remains ongoing, additional implicated brands, restaurants, retailers, or distribution channels may be identified as the investigation continues. This advisory will be updated promptly as new information becomes available.
FDA is aware that the case counts in this advisory may not match what is being reported by individual states. State data may include both probable and confirmed cases, while CDC and FDA include confirmed cases only. State case counts may also include initial case reports that have not yet been reported to CDC. As cases are confirmed, these numbers will continue to update.
Additionally, 2026 national surveillance numbers reported by the CDC track laboratory-confirmed cases in the U.S. overall, which include this outbreak as well as illnesses that are not a part of this outbreak.
7/14/2025: Maryland health officials are investigating an increase in Cyclosporiasis cases as hundreds of infections involving the intestinal parasite are reported across the United States.
The Maryland Department of Health confirmed 32 cases in the state during 2026. Health officials said investigators have not identified a common source connecting the Maryland cases.
Cyclosporiasis is an intestinal infection caused by the microscopic parasite Cyclospora Cayetanensis. People generally become infected after eating food or drinking water contaminated with feces containing the parasite. The illness is unlikely to spread directly from one person to another because the parasite must remain in the environment for days or weeks after leaving the body before it becomes infectious.
Cases are most commonly identified during the spring and summer. Federal health officials consider May 1 through August 31 the primary Cyclosporiasis season in the United States.
As of July 9, the Centers for Disease Control and Prevention had received reports of 843 domestically acquired cases across 31 states. At least 86 patients were hospitalized, and no deaths had been reported. The CDC was also reviewing more than 1,500 additional illnesses to determine whether they qualified as domestically acquired Cyclosporiasis cases.
The federal total does not include another 343 infections involving people who became sick after traveling outside the United States.
Several clusters are being investigated by local, state and federal health agencies. However, authorities have not identified one food item or source responsible for all illnesses, and no nationwide recall has been announced in connection with the overall increase.
Foodborne outbreaks involving Cyclospora have previously been associated with fresh produce. Investigators often have difficulty identifying the source because symptoms may not begin until approximately one week after contaminated food or water was consumed.
Symptoms of Cyclosporiasis
The most common symptom is frequent watery diarrhea. Other symptoms can include:
- Frequent or sometimes explosive bowel movements
- Stomach cramps
- Loss of appetite
- Substantial weight loss
- Extreme fatigue
- Gas and bloating
- Nausea or vomiting
- Low-grade fever
Symptoms typically begin one to 14 days after exposure, with most people becoming sick after approximately one week. Symptoms may disappear and then return. Without treatment, the illness can continue for several weeks or longer.
People with weakened immune systems may experience a longer or more severe illness.
Anyone experiencing persistent or severe diarrhea should contact a healthcare provider. Patients should tell their provider about recent travel and foods eaten before symptoms began.
Testing can require a specific request because many laboratories do not routinely screen stool samples for Cyclospora. A patient may also need to provide more than one stool sample before the parasite is detected.
Cyclosporiasis is commonly treated with the prescription antibiotic trimethoprim-sulfamethoxazole, also known as TMP-SMX. People who are allergic to sulfa medications should discuss other options with their healthcare provider.
Reducing the Risk of Infection
Health officials recommend washing hands with soap and water before and after preparing food and thoroughly rinsing fruits and vegetables under running water before eating, cutting or cooking them.
Firm produce, including melons and cucumbers, should be scrubbed with a clean produce brush. Damaged or bruised areas should be removed, and cut or peeled produce should be refrigerated within two hours.
Washing produce may lower the risk of illness, but it may not remove every Cyclospora organism from contaminated food. Routine chemical disinfectants and sanitizers may also be ineffective against the parasite.
Maryland health officials are continuing to monitor reported infections as the state moves through the period when Cyclosporiasis cases are most frequently detected.
