New Hampshire is reporting 17 confirmed cases of Cyclospora associated with consumption of iceberg lettuce recalled by Taylor Farms de Mexico.
The outbreak victims reported having eaten the recalled lettuce at Cheshire Medical Center, 580 Court Street, Keene, NH. The New Hampshire Department of Health and Human Services recommends that anyone who ate at this location between the beginning of June through July 20, 2026 and who develops severe or persistent watery diarrhea should contact their health care provider for evaluation and testing for Cyclospora infection.
This is the first time that cases have been explicitly linked by a state or federal health agency to an establishment other than a Taco Bell outlet.
In addition to the New Hampshire cases, Oregon, Washington, and Arkansas are reporting possible outbreak cases of Cyclospora in residents who traveled to one of the nine states identified by the CDC as part of the Taylor Farms outbreak in the 14 days before becoming ill.
Arkansas has not revealed how many of its 92 lab-confirmed Cyclospora cases may have been acquired by travelers to one of the outbreak states. Oregon reports two such cases, explaining that both individuals “…traveled to other states involved in the recent nationwide recall of pre-shredded iceberg lettuce associated with the outbreak.” Washington is more specific, stating that two cases are being included in the Taylor Farms outbreak. Both individuals traveled to Michigan and ate at a Taco Bell outlet.
It is unclear whether the Oregon, Washington, and Arkansas outbreak cases will be noted separately by the CDC or included in the totals for the states to which the victims traveled.
In any event, the number of outbreak states has now reached double digits.
Cyclospora surveillance news
Three of the hardest hit states in the broader Cyclospora picture updated their surveillance data this week.
The CDC last updated its Taylor Farms outbreak page and its Cyclospora surveillance page on July 24th. There is no indication of when the next update will be issued.
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Cyclospora cayetanensis is not an easy pathogen to deal with. It cannot be grown in the lab. It cannot be studied in lab animals. It cannot be inactivated by the chemical treatments that kill bacteria.
People become infected by eating contaminated food or drinking contaminated water. The pathogen takes up its home in the lining of the intestines, multiplies, and is shed in an inactive form (oocysts) in feces. Human feces. Over a period of days, the oocysts self-fertilize through asexual or sexual reproduction and become embryos capable of infecting their next human victim.
Cyclospora does not multiply outside of a host animal. In the case of C. cayetanensis, that host—the only host—is the human body.
For a field crop such as iceberg lettuce to be contaminated with Cyclospora, it must have come into direct contact with human feces contained either in irrigation water or in fertilizer or soil amendments.
CDC’s slips are showing
The CDC’s reporting of both the Taylor Farms lettuce outbreak and of the country-wide surge in Cyclospora reports has been slipshod and unclear.
When the CDC posts a new outbreak investigation notice, the information usually includes both a map showing the distribution of outbreak cases by state and what is called an Epi Curve—a chart that tracks the case reports by date of illness onset. Both of those visual aides are accompanied by data tables.
The CDC posted its initial notice of a Cyclospora outbreak on July 14, 2026. The notice indicated the number of cases confirmed to be part of the outbreak, and the four states where cases had been confirmed, but did not offer either a breakdown of cases by state or an Epi Curve. Instead, the notice simply advised that the earliest outbreak victims reported becoming ill on June 22, 2026.
In its July 17th update, the CDC added a case distribution map, updated the number of states to five from four, increased the number of confirmed cases to 1,644, and modified the earliest illness onset date to May 13, 2026. There was still no Epi Curve included with the update.
It was July 24th before the CDC finally added an Epi Curve to its outbreak investigation notice. They also updated the number of confirmed cases to 1,947 and added four more states to the outbreak case map. The July 24th notice also modified the illness onset date range once again, advancing the earliest illness onset from May 13th to June 22nd (tip of the keyboard to Bill Marler for pointing out this date discrepancy).
In doing so, the CDC removed at least 210 cases from the tally (Michigan dropped from 1,141 to 931). We don’t know how many more cases were removed, as we do not have an Epi Curve that shows the number of cases by onset date between May 13th and June 22nd.
Unusual Epi Curve
This is the Epi Curve that the CDC posted on July 24th. Notice two things: (1) the curve begins right near a peak in case numbers and (2) there are twin peaks.
For comparison, here are two Epi Curves from previous Cyclospora outbreaks, one from 2019 and the other from 2020
Notice the difference? In both of these older Cyclospora outbreaks associated with leafy greans, there was a build-up of cases. Just a few, at first, then an acceleration to a peak followed by a drop-off.
An outbreak does not burst onto the scene at the peak of its strength.
The twin peaks of the current outbreak also are very unusual. This could be a reporting glitch, with some states lagging in their reports to the CDC. It could be a data collation and analysis lag at the CDC. Or it might be real. We’ll have to wait and see.
Cyclospora surveillance data don’t compute
On July 24th, the CDC also updated its Cyclospora surveillance data, reporting 4,173 laboratory-confirmed domestic cases across 41 states, with an additional 7,400+ cases that are not yet lab-confirmed.
Setting aside the reporting and data-processing lags that have resulted in states posting higher numbers on their own websites than those revealed in the CDC report, there are discrepancies between the data in the surveillance table and the data reported for the Taylor Farms outbreak.
Specifically, the CDC reports a total of “301 to 500” Ohio cases in the surveillance table, but 639 Ohio outbreak cases. Similarly, West Virginia is shown as having reported 42 outbreak cases; yet, only “11 to 30” total cases in the surveillance table.
And while we’re at it, since when does the CDC indicate case-count data by range rather than by actual numbers of cases? The agency knows very well what the case counts are by state. It uses those counts to arrive at the national total. Under normal circumstances, the case-count table shows those individual numbers and NOT a relatively meaningless range, such as the “901 to 2100” cases attributed to Michigan or the “301 to 500” cases shown for Ohio.
What is going on here?
Important surveillance tool tossed in the trash
Once upon a time, the CDC actively searched for incipient Cyclospora infections. The FoodNet program, which covers ten states plus some counties in California, provides active surveillance of the incidence of foodborne diseases in about 16% of the population. In the words of the CDC, “FoodNet is an active surveillance system, meaning that public health officials routinely communicate with more than 700 clinical laboratories serving the surveillance area to identify new infections and conduct periodic audits to ensure that all infections are reported.” (emphasis added).
While FoodNet was not designed specifically to detect foodborne disease outbreaks, it was an important tool to ensure that the systems the CDC relies upon for outbreak detection are functioning as they were meant to.
On July 1, 2025, the CDC changed the reporting requirement for Cyclospora and several other foodborne pathogens from mandatory to optional. Only Salmonella and shiga toxin-producing E. coli remain from the original ten pathogens or conditions that formed the basis for the original FoodNet program.
The FDA’s unforced error
On July 18, 2026, the FDA announced that it had found Cyclospora in a sample of Taylor Farms de Mexico’s shredded iceberg lettuce. One day later, the agency retracted that announcement, explaining that, “Due to the complexity in detection of Cyclospora, FDA laboratory experts re-reviewed the sample results and have concluded that the finding does not represent true amplification and should be considered a false positive.”
What a rookie error!
The sample result should have been reviewed by the agency’s experts before the result was announced, not afterwards. This fumbling of the ball significantly damaged the credibility of the rest of the evidence supporting the FDA’s conclusion that Taylor Farms de Mexico was the source of the outbreak. Instead, it spawned a rash of conspiracy theories on social media. Suggestions that Taylor Farms had twisted arms to get the FDA to retract its lab findings. Hints of payoffs at the most senior levels of the government.
Also feeding those conspiracy theories was the FDA’s apparent reluctance to name Taylor Farms de Mexico as the source of the contaminated lettuce, focussing instead on Taco Bell, the franchise chain named by most of the interviewed outbreak patients as the place where they had consumed iceberg lettuce.
On July 16th, the FDA said that it had identified “…a single supplier of iceberg lettuce from Mexico used by Taco Bell locations where sick people ate before becoming ill,” and was “…working directly with the identified supplier to determine if potentially contaminated shredded iceberg lettuce remains on the market.” It was only on July 17th, the day Taylor Farms de Mexico announced a product recall, that the FDA added the company’s name to the information in the outbreak investigation report on the agency’s website.
What is worse than decimation?
The term “decimation” derives from the old Roman custom of disciplining a military legion by executing 10% of the ranks.
What has taken place within the CDC and the FDA under Trump 2.0 is far worse. The cuts initiated in 2025 by Elon Musk’s so-called “Department of Government Efficiency” were catastrophic. Senior employees who had been promoted into new jobs within the prior two years were ‘probationary’ and therefore able to be terminated with minimal red tape. Similarly, the enthusiastic young blood at the CDC, the interns who had been hired to train as disease detectives, were easy targets for dismissal.
To add to the confusion, the entire communications staff at both agencies was laid off (although some were later ‘invited’ back), and it shows.
It shows in the reduced frequency of outbreak investigation updates on the CDC website.
It shows in the poorly written recall notices on the FDA website.
The old FDA—the agency I once knew and respected—would not have made the rookie mistake of releasing a lab result before it had been confirmed.
The old CDC would not have released surveillance reports and investigation outbreak reports containing multiple errors and/or inconsistencies.
This is what happens when the inmates are given the keys to the asylum’s executive offices.
It’s time to put control of these essential health agencies back into professional hands.
It’s time to change the locks.
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Shredded iceberg lettuce imported by Taylor Farms de Mexico and implicated in this summer’s 5-state Cyclospora outbreak was supplied to KFC, Pizza Hut, Subway, Trader Joe’s, Walmart, Sysco, Cross Valley Farms, and Peak Fresh Produce, and may have also been distributed to other consignees, according to information released on July 20, 2026 by the Alabama Department of Public Health.
The outbreak was linked initially to lettuce supplied to Taco Bell outlets, but this does not account for all of the reported cases.
Taco Bell removed all of the implicated lettuce from its stores as soon as the epidemiological connection between that product and the Cyclospora cases was established.
The recall notice released by Taylor Farms de Mexico provided minimal information as to the brands and destinations of the shredded lettuce implicated in the outbreak. The notice contained a long list of products, most of which were identified as having been supplied to the foodservice market. Those products were identified using semi-comprehensible codes: CV, JB, MARK, PK, SUB, SY, and TF and were distributed to customers in 27 states (AL, AR, CT, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, MI, MO, MS, NC, NH, NJ, OH, OK, PA, SC, TN, TX, VA, and WI).
In addition, two products were labeled as “retail” and identified as MKTSD.
The MKTSD products were eventually revealed by the FDA to be Marketside brand products sold by Walmart in fifteen states (AL, AR, FL, GA, IN, KS, KY, LA, MO, MS, OK, TN, TX, VA, WV).
TF most likely refers to Taylor Farms’ own brand.
As of today (July 21, 2026), no additional distribution information has been released to the public by either the company or the FDA.
Where have all the cases gone?
The CDC last updated the Taco Bell-linked outbreak case counts and distribution on July 18th. As of that date, the federal agency was reporting “more than 1,644” cases and 94 hospitalizations in five states.
The states with identified outbreak cases, according to the CDC, are: Indiana (47), Kentucky (25), Michigan (1,141), Ohio (420), and West Virginia (11).
As of July 21st, the CDC’s cyclosporiasis surveillance update recognized 4,173 confirmed cases of domestic origin and 308 hospitalizations in 41 states. Michigan was hardest hit, with “901 to 2100” confirmed cases, followed by Ohio with “301 to 500.” The agency is aware of an additional 7,400 cases awaiting confirmation.
Here is what the individual states have to report:
Alabama:- As of July 20th, Alabama has recorded 28 cases. Four cases (14.3%) are related to international travel, and eight cases (28.6%) are associated with two separate foodborne outbreaks at Mexican-style restaurants (not Taco Bell).
California:- As of July 14th, there are no known outbreaks in the state. California has logged 41 provisional cases, compared to 80 cases in 2025.
Connecticut:- The state has confirmed 35 cases, which is nearly double the 19 cases confirmed by this time in 2025. No specific food source has been identified in Connecticut as yet.
Georgia:- The state is unaware of “any Georgia-specific outbreaks, clusters, or potential links to the outbreak.”
Illinois:- As of 7:00am on July 21st, Illinois has recorded 408 confirmed and probable cases, of which 215 were domestically acquired and 145 reported travel outside of the US. The travel status of 48 of the patients is unknown, and 31 people have been hospitalized.
Maine:- Two confirmed cases, neither of which is linked to the 5-state outbreak.
Michigan:- As of July 21st, the state has recorded 6,571 cases (102 hospitalizations as of July 16th).
Missouri:- More than 80 positive lab reports during the week of July 7 – July 14, 2026. The state describes this as a “substantial increase” over the usual frequency.
New Jersey:- 46 cyclosporiasis cases statewide between May 1 and July 11, which the state describes as a typical seasonal uptick in cases.
New York:- The state is reporting 129 cases outside of New York City for the calendar year as of July 8th (compared to a typical level of 20-55 cases), and 381 cases in New York City for the calendar year to date, about three times the level for the same period of 2025.
North Carolina:- 561 cases reported between May 1st and July 20th, including 16 people hospitalized.
Ohio:- 177 cases between June 20th and July 2nd, with 28 hospitalized. The information on the state’s website was last updated on July 8th.
Rhode Island:- Six cases so far in 2026, which is a normal baseline level for this state. There is no indication of a common food source.
South Carolina:- 23 cases so far this year, which is a normal frequency. No outbreaks are under investigation in the state.
Virginia:- 79 cases, of which 38 were domestically acquired and 14 are of unknown travel origin or pending. As of now, there is no evidence linking these to case clusters in other states.
The FDA’s “oopsie”
Cyclospora detection in a food sample is not a trivial exercise. The parasite does not multiply outside of the human body, so it cannot be cultured in a lab.
The only way to detect Cyclospora at a sensitivity that provides any sort of meaningful result is to use PCR (DNA amplification). The procedure used by the FDA to test samples of leafy greens (or other produce) for Cyclospora involves four main steps:
Washing the sample with a detergent solution that helps to free the Cyclospora from the surface of the produce
Spinning the liquid in a centrifuge to concentrate the wash debris
Extracting DNA from the wash debris
Performing the PCR procedure on the extracted DNA
The reliability of the result depends on the correct PCR processing of the extracted DNA and on the specificity of the DNA probe used to complete the analysis. Both false positive and false negative results may occur.
Unfortunately, it would appear that someone at the FDA jumped the gun and reported a result that was not a clear-cut positive. On review (possibly on retesting, although the FDA Investigation update does not specify details), the agency expert concluded that “…the finding does not represent true amplification and should be considered a false positive.”
The retraction of the initial positive finding does NOT invalidate the epidemiological evidence linking the shredded iceberg lettuce from Taylor Farms de Mexico to the outbreak cases. Nor does it point to some conspiracy between the Trump Administration and Taylor Farms to exonerate the company from its role in the outbreak.
What next?
The 5-state outbreak linked to shredded lettuce served at Taco Bell outlets accounts for just a fraction of the massive increase in Cyclospora cases reported this season. The FDA has four additional outbreaks under investigation, but these account for only 36 cases as of last week’s update.
The clue to solving this massive outbreak probably lies in the Taylor Farms distribution list.
Meanwhile, consumers should play it safe and avoid purchasing or consuming shredded lettuce or food items (such as salads or tacos) containing shredded lettuce.
“Reads like a true crime novel” – Food Safety News
Interested in learning more about food safety and the history of foodborne disease outbreaks and investigations?
Click on the link to listen to a short excerpt, then follow the buy links to add a digital, print or audio copy to your personal library.