The parasitic infection that causes prolonged and often severe diarrhea has exploded across Michigan this summer, with state health officials reporting more than 10,700 cases of cyclosporiasis as of the end of July.
This represents a massive increase from the roughly 50 cases the state normally sees in an entire year.
Of the Michigan infections, at least 193 people have been hospitalized, and the majority of cases have been concentrated in the southeast part of the state around Detroit, with Oakland County alone reporting over 1,000 infections.
Adults in their 20s through 40s have been hit hardest.
Michigan Department of Health and Human Services investigators say available evidence points to lettuce or salad greens as a potential source, though no specific grower, supplier, or brand has been definitively identified for the bulk of the state’s cases, and other food items have not been fully ruled out.
Over 4,000 people have also been infected in Ohio, the state with the second largest outbreak.
Officials continue to urge residents to thoroughly wash and trim produce such as lettuce, leafy greens, cilantro, basil, green onions, raspberries, and snow peas before eating.
Michigan HHS advised the following safety measures for preparing lettuce and salad greens:
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Purchase whole heads: Buy whole heads of lettuce rather than pre-washed, bagged lettuce or pre-mixed salad kits.
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Discard outer layers: Before preparation, remove and discard the outer two to three layers of leaves.
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Wash inner leaves: Thoroughly wash the remaining inner leaves under clean running water.
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Prioritize cooking: For greens that can be cooked, cooking to an internal temperature of at least 158°F (70°C) is the safest option. The parasite is resistant to routine chemical disinfection, and washing alone cannot guarantee removal.
Federal health authorities are also tracking a separate but related multistate outbreak of cyclosporiasis specifically linked to shredded iceberg lettuce supplied by Taylor Farms de Mexico and served at Taco Bell and other restaurants.
As of late July, that cluster had impacted at least 1,947 people across Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia, with 98 hospitalizations.
Epidemiologic data showed that a large majority of people who ate at Taco Bell and later fell ill had consumed the iceberg lettuce.
On July 17, Taylor Farms initiated a voluntary recall of all iceberg lettuce sourced from central Mexico.
The FDA noted that an earlier positive Cyclospora test on a Taylor Farms sample was later reclassified as a false positive due to testing complexities, and that no confirmed positive product samples had been verified as of mid-July.
Nationwide, the Centers for Disease Control and Prevention has recorded 6,707 confirmed domestically acquired cases of cyclosporiasis since May 1, along with more than 11,500 additional cases that remain under investigation or lack full confirmation.
Cases have been reported in 45 states, and the CDC is investigating multiple outbreaks that may involve different food sources.
Cyclospora is a microscopic parasite that spreads primarily through food or water contaminated with human feces.
Once excreted, the parasite requires one to two weeks in the environment to become infectious, which is why most illnesses stem from contaminated produce rather than direct person-to-person contact.
Symptoms typically include watery or explosive diarrhea, abdominal cramping, nausea, vomiting, fatigue, and loss of appetite.
Unlike many common foodborne illnesses that resolve quickly, cyclosporiasis often lasts for weeks or returns in cycles if left untreated.
The standard treatment is the antibiotic combination of trimethoprim-sulfamethoxazole, along with rest and hydration.
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