The Cyclospora outbreak linked to iceberg lettuce has expanded from nine states to 15, and the number of laboratory-confirmed illnesses connected to that cluster has more than tripled in less than two weeks, federal health officials said on August 5, 2026.
The Food and Drug Administration now lists 6,358 illnesses, 278 hospitalizations and two deaths in the linked outbreak. Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina joined Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania and West Virginia. Illness onset dates run through July 31.
The short answer for shoppers is important: officials have linked this specific 15-state outbreak to iceberg lettuce sourced from central Mexico. They have not said this cluster has expanded to fruit or to other vegetables. Other Cyclospora clusters and unclassified illnesses are being investigated separately, so a broader produce source could still be identified, but that remains a possibility—not a confirmed finding.
What changed in the official count
FDA's previous public update on July 24 listed 1,947 illnesses and at least 98 hospitalizations in nine states. The August 5 update added six states and increased the linked count by 4,411 illnesses. FDA said the rise partly reflects people who reported exposure to Taco Bell or to implicated iceberg lettuce, along with the addition of newly connected states.
The agency also warned that the count can keep rising after contaminated food leaves the market. It can take as long as six weeks for CDC and state investigators to determine whether a sick person belongs to this outbreak. Some people recover without testing, and the most recent illnesses may not yet appear in federal totals.
Why the national number is larger
CDC's broader surveillance page reported 10,468 laboratory-confirmed domestically acquired cases in 47 states from May 1 through August 3. That total includes the iceberg-lettuce outbreak plus infections that are not part of it. CDC was also reviewing more than 12,255 additional reports that were not laboratory-confirmed or still needed analysis, including checks for overseas exposure.
Those figures should not be added together and described as one confirmed outbreak. They measure different stages of investigation. The 6,358 figure is the confirmed count for the specific 15-state cluster; the 10,468 figure is the confirmed national surveillance count; and the additional reports remain unconfirmed or unresolved.
What the produce guidance actually says
Fresh fruits and vegetables have been linked to Cyclospora outbreaks in the past because the parasite can spread through food or water contaminated with human feces. That history does not establish that every type of produce is part of the current outbreak. FDA says no products have been identified for several other active Cyclospora investigations.
- Follow the current FDA outbreak page for products and locations tied to the known lettuce cluster.
- Wash all fresh produce under running water before preparing or eating it, including food from a grocery store, farmers market or home garden.
- Scrub firm produce such as melons and cucumbers with a clean produce brush.
- Do not wash fruits or vegetables with soap, detergent or commercial produce wash; FDA does not recommend those products.
- Remember that washing reduces some contamination but may not remove Cyclospora completely.
Buying locally can improve traceability when a grower can explain where and how food was produced, but “local” is not a safety guarantee. The outbreak investigation follows exposures and supply chains, not a simple local-versus-national label.
When to contact a clinician
Cyclospora commonly causes watery diarrhea that can be frequent and sometimes explosive. Other symptoms can include loss of appetite, weight loss, stomach cramps, bloating, nausea and fatigue. Symptoms usually begin about one week after exposure, can last for weeks without treatment and may seem to improve before returning.
Contact a health care provider for persistent or recurring diarrhea, signs of dehydration, or symptoms after a possible exposure. People with weakened immune systems or serious underlying health conditions can face longer or more severe illness. CDC says diagnosis may require a specific stool test, and the standard treatment is trimethoprim-sulfamethoxazole; patients with a sulfa allergy should discuss alternatives with a clinician.
What happens next
FDA says traceback points to iceberg lettuce from central Mexico in the 15-state outbreak, while CDC and state agencies continue interviewing patients and analyzing other clusters. Additional brands, restaurants, retailers or distribution channels could still be identified as investigators work through the reporting lag.
For now, the clearest distinction is between what officials have confirmed and what experts consider possible. The outbreak is broader and larger than it was in late July. The confirmed food link for this cluster remains iceberg lettuce, while other produce remains under general food-safety guidance unless public health agencies announce a specific connection.
