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A Newsweek map shows the states reporting the highest numbers of cyclospora cases in 2026, as federal health officials investigate a newly identified outbreak and continue to track the largest cyclosporiasis surge recorded in the United States.
The Food and Drug Administration (FDA) announced on July 22 that it is investigating a second cyclospora outbreak affecting 72 people, though the food product linked to those illnesses has not yet been identified.
The announcement comes just days after federal investigators traced a separate five-state outbreak to shredded iceberg lettuce supplied by Taylor Farms de Mexico and served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio and West Virginia.
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Cases of the gastrointestinal illness caused by the parasite have been reported in multiple states, but not every illness may have been caused by the same source.
The new investigation adds to a growing public health response after the Centers for Disease Control and Prevention (CDC) reported more than 4,000 confirmed domestically acquired cases of cyclosporiasis across 41 states since May 1, alongside more than 7,000 additional reports awaiting confirmation.
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Michigan remains the state hardest hit by the outbreak.
According to the Michigan Department of Health and Human Services, the state had reported 7,171 cases as of July 22, including at least 102 hospitalizations.
Ohio has also experienced a significant outbreak, with state officials reporting more than 2,200 cases and dozens of hospitalizations.
Indiana has reported 594 cases, New York has reported 517 cases, Kentucky has reported 192 and Oklahoma has reported 172.
CDC surveillance data shows confirmed cases have been reported across 41 states. However, state-level totals are often substantially higher because they include both probable and confirmed cases, while CDC surveillance reports only laboratory-confirmed infections.
The CDC also states that it assumes a lag of 6 weeks between the onset of the illness and the case being reported to the CDC.
The federal agency said it is also reviewing approximately 7,400 additional reports that have not yet been confirmed.
The outbreak may not be limited to the states with known illnesses, and the true number of sick people is likely much higher than the number reported, as many people recover from Cyclospora without medical care and are not tested for it.
New Cyclospora Outbreak Under Investigation
The FDA said the newly identified outbreak has sickened 72 people, but investigators have not yet determined the source.
The announcement was made one day after Health and Human Services Secretary Robert F. Kennedy Jr. said the major cyclospora outbreak linked to lettuce was "under control" following a federal investigation that identified a likely source and helped prompt a large-scale product removal.
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An HHS spokesperson told Newsweek that FDA investigators continue to examine whether additional products, retailers, restaurants or distribution channels may be connected to ongoing illnesses.
The FDA has not identified the states involved in the latest 72-case outbreak.
Five-State Outbreak Linked to Taco Bell Lettuce
On Friday, federal health officials confirmed that they had traced shredded iceberg lettuce served at Taco Bell locations across five states—Indiana, Kentucky, Michigan, Ohio and West Virginia - as the source of the cyclospora outbreak.
Thereafter, Taylor Farms has said that it was voluntarily recalling all iceberg lettuce sourced from central Mexico from the U.S. market, "out of an abundance of caution," on July 17.
The company said in a statement: "As a family owned and operated company, we are deeply concerned for those who became ill, their families, and the many Americans whose trust in the safety of their fresh produce has been shaken."
The FDA said that none of the samples tested for cyclospora in this outbreak had been confirmed positive as of July 19.
The agency had previously said that a lettuce sample from Taylor Farms had tested positive, but later said that that result was a false positive.
Taco Bell also said it completed the removal of affected lettuce from restaurants nationwide.
The FDA has cautioned that its investigation remains ongoing and that other brands, retailers and restaurants could still be identified.
Michigan health officials have noted that many people who became ill said they had not eaten at Taco Bell, prompting investigators to explore whether the contaminated lettuce may have entered additional supply chains.
Taco Bell Offering $1 Lettuce-Free Enchiritos
Amid the ongoing cyclosporiasis outbreak, Taco Bell announced on July 22 that they were selling $1, lettuce-free Enchiritos.
That includes a flour tortilla, filled with ground beef, beans, diced onions, cheddar cheese and a red sauce.
The item is temporary, and it is not clear how long it will be on sale for.
What Is Cyclosporiasis?
Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis.
Symptoms typically appear about a week after exposure but can develop anywhere from two days to two weeks later. Common symptoms include watery diarrhea, stomach cramps, nausea, bloating, fatigue, loss of appetite and weight loss.
Without treatment, symptoms can persist for weeks or even months, and some patients experience recurring bouts of diarrhea.
The CDC advises anyone experiencing symptoms to contact a healthcare provider and seek testing.
What Consumers Can Do
Federal health officials recommend washing fruits and vegetables thoroughly and taking extra precautions with pre-cut or pre-packaged produce.
However, cyclospora is difficult to remove through washing alone. The FDA says cooking produce to at least 158 degrees Fahrenheit (70 degrees Celsius) is the most reliable way to kill the parasite.
Consumers experiencing persistent diarrhea, weight loss, fatigue or stomach cramps are advised to seek medical attention, particularly if symptoms develop within two weeks of eating fresh produce.
The CDC reports that people between the ages of 2 and 95 have been sick, with 44 the mean age of illness.
As investigators work to identify the source of the newly announced 72-case outbreak, officials warn that additional products or distribution channels could still be linked to illnesses in the weeks ahead.
Contact Newsweek editors on this story: Matthew Robinson and Cristina Diciu.
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