Sunday, July 19, 2026

Last Saturday this column was called Four Outbreaks, No Source, and a System That Would Rather Not Know. This week one of those four finally got a source, a company name, and a recall — and within seventy-two hours the government demonstrated exactly how little that accomplishes when there are no lot codes behind it, no customer list, and no obligation to produce either. A parasite most people still can’t pronounce is now the largest foodborne outbreak in this country in years. Here’s what moved.

The lettuce got a name: Taylor Farms de Mexico. On Thursday the FDA and CDC linked a five-state Cyclosporaoutbreak to shredded iceberg lettuce served at Taco Bell in Indiana, Kentucky, Michigan, Ohio and West Virginia. On Friday FDA named Taylor Farms de Mexico outright, and the company announced it was pulling every iceberg lettuce it sources from central Mexico. Taco Bell, to its credit, had already moved on its own — pulling product in select states before any federal advisory required it, and completing a nationwide removal by Friday. The operator acted before the regulator named the supplier, while the National Restaurant Association said nothing at all.

Then the recall came out, and it went to twenty-seven states, not five. The recall notice covers product distributed June 29 through July 16 across 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 — twenty-two states beyond the outbreak advisory. It includes Marketside-brand 12- and 24-ounce iceberg salad and 8- and 16-ounce shredded lettuce sold at Walmart, with best-if-used-by dates running to August 3. Which is difficult to square with the reassurance that grocery store lettuce wasn’t affected. I wrote about the recall Friday, and about FDA reprinting it word for word with no lot codes and no customer names on Saturday. FDA’s brand-name field literally reads “CV, JB, Mark and more.”

And then the part that should stop everyone cold. On Saturday FDA reported that a sample of shredded iceberg lettuce supplied by Taylor Farms de Mexico had tested positive for Cyclospora — collected at the border during targeted import surveillance, as a result of this very investigation. Taylor Farms confirmed the positive product is not part of its current recall. The lot is detained, and the company is still working out whether any of it reached commerce or people’s kitchens. Read that twice. The parasite turned up on product still being shipped into this country, outside a recall the company itself drew, after that same company told the public this traced to one independent farm and represented under one percent of the U.S. iceberg supply. Either the recall is scoped too narrowly or the contamination is broader than one farm. Credit where it’s due for finding it — now tell us where the rest of that lot went.

The counting problem got worse, not better. CDC’s confirmed outbreak number is 1,644 cases in five states with 94 hospitalizations and no deaths. Michigan alone has reported more than 5,000 cases and 102 hospitalizations. Cyclosporiasis has now been reported in thirty-four states this year — more than 6,700 confirmed-or-probable cases against roughly 2,700 in all of 2025. CDC now tells the public it can take as long as six weeks to determine whether a sick person belongs to a Cyclospora outbreak, up from “several weeks” a few days earlier. That isn’t a footnote. That is the whole reason the official number and the real number are living on different planets.

Four more Cyclospora investigations are sitting right next to it with nothing in the product column. The FDA’s outbreak table is now carrying fourteen active investigations, eight of them with no food identified — last week it was thirteen and eight. Four of the eight are separate Cyclospora clusters, with federal counts of 18, 8, 8 and 2 beside blank product columns. A Salmonella Oranienburg cluster climbed from 51 to 69 cases with no food named. A SalmonellaEnteritidis cluster climbed from 80 to 91, same story. An E. coli O157:H7 investigation still sits at fourteen. Here’s the tell: the row for the Taco Bell outbreak itself, reference number 1390, still reads “Not Yet Identified,” because the table hasn’t been updated since Wednesday — four days after FDA named Taylor Farms de Mexico on its own website. When the agency’s tracking document contradicts the agency’s advisory, the problem isn’t a missing rule. It’s that nobody is required to keep the ledger current.

Chilean blueberries, Maryland cheese, and four hospitalized babies. The E. coli O145:H28 outbreak tied to frozen blueberries sold at Publix moved this week — FDA has now initiated sampling. The Listeria monocytogenes outbreak in requesón and soft ricotta has a recall, an inspection and sampling all running, with a death in Maryland and a count that keeps climbing past what the table shows. Salmonella in moringa leaf powder is now the fourth separate moringa investigation in twelve months. And the infant botulism outbreak tied to Nara Organics whole-milk powdered infant formula is still open — four babies, all hospitalized, in California, Pennsylvania and Washington. I represent families in these cases. FDA sent the formula industry a letter on July 13 telling manufacturers to actually know where their ingredients come from. It should not take two botulism outbreaks in two years to get that letter written.

Recalls beyond the lettuce. Fayus Inc., doing business as Yusol International Foods, expanded its recall of OLA-OLA pounded yam over undeclared milk, across two-, four-, five- and ten-pound bags with expirations running to 2029. Canada pulled various brands of meat products over Listeria monocytogenes. PepsiCo recalled Doritos Chilli Heatwave in Ireland and the U.K. for undeclared milk. Phyllis Entis has the full international roundup, as she does every week, more reliably than the agencies whose notices she is reposting.

And the fix that Congress pushed to 2028. FDA had to run border surveillance to find this parasite on a bag of lettuce, and even then the company got to decide whether that bag fell inside or outside its own recall. The Food Traceability Ruleaddresses exactly this — lot-level records, key data elements at every critical tracking event, electronic production within twenty-four hours, leafy greens squarely on the Food Traceability List. It was finalized in November 2022. Compliance was to begin January 20, 2026. FDA moved it thirty months, and last November Congress made the delay binding through July 20, 2028. Walmart didn’t wait — it imposed its own supplier traceability requirements in August 2025 and has been assessing chargebacks since. So the technology exists and retailers can demand it. What’s missing is a legal obligation, and this week is what its absence looks like. I wrote back to Western Growers about that, and then read what everyone else in the industry had to say.

That’s the week — a parasite with a name at last, a recall that stops short of the product that tested positive, and a traceability rule that would answer the only question anyone is asking, sitting on a shelf until 2028. Naming the company was the easy part. Telling seven thousand sick Americans where the lettuce went is the part nobody is required to do. Check back next Saturday.

About Bill Marler

William “Bill” Marler has spent more than thirty years as a food safety lawyer and advocate—work that began with the 1993 Jack in the Box E. coli outbreak and has never really stopped since. In the years that followed, he has represented victims in nearly every major foodborne illness outbreak in the United States. That case, and the movement it launched, is the subject of the book “Poisoned” and the Emmy Award–winning Netflix documentary of the same name. Bill’s work has been profiled in The New Yorker (“A Bug in the System”), the Seattle Times (“30 years after the deadly E. coli outbreak, a Seattle attorney still fights for food safety”), the Washington Post (“He helped make burgers safer. Now he’s fighting food poisoning again”), and many others.

Dozens of times a year, Bill speaks to industry, regulators, and universities across the United States, Canada, Europe, Africa, China, and Australia about a simple idea: outbreaks are preventable. He has testified before Congress on the Food Safety Modernization Act and teaches food safety at institutions including the Harvard T.H. Chan School of Public Health. He writes regularly about food litigation and food safety at Marler Blog, and in 2009 he founded Food Safety News, which he continues to publish.

WHAT IS CYCLOSPORA?

Cyclospora is a parasite composed of one cell, too small to be seen without a microscope. The organism was previously thought to be a blue-green alga or a large form of Cryptosporidium. Cyclospora cayetanensis was long regarded as the only species of this organism found in humans; however, genomic analyses reported by CDC scientists in 2023 indicate that what had been identified as C. cayetanensis actually comprises at least three genetically distinct, reproductively isolated species that infect people—C. cayetanensis, C. ashfordi, and C. henanensis.[1]

Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis, which is transmissible by ingestion of fecally contaminated food or water.[2] Cyclosporiasis is most common in tropical and subtropical regions of the world. In the United States, foodborne outbreaks of cyclosporiasis have been linked to various types of imported fresh produce (e.g., basil, raspberries, and snow peas). For years, the lack of validated molecular typing tools hampered efforts to link cases and trace outbreaks. Since about 2018, however, CDC has developed and begun using a C. cayetanensisgenotyping system—based on targeted deep sequencing of mitochondrial and nuclear DNA markers—to complement outbreak investigations and connect geographically scattered cases, and work continues to refine it into a nationwide typing network.[3]

Outbreaks of cyclosporiasis in humans have been reported mostly from North America, from the infection sources of contaminated fresh food products, such as soft fruits (raspberries), leafy vegetables (coriander, basil, and mixed salad), and herbs. Soil is another possible infection source, particularly in areas with poor environmental sanitation.[4]

The Centers for Disease Control and Prevention (CDC) has been conducting national surveillance for cyclosporiasis since it became a nationally notifiable disease in January 1999. As of 2026, cyclosporiasis is reportable in 47 states, the District of Columbia, and New York City (NYC).[5] Health departments voluntarily notify CDC of cases of cyclosporiasis through the National Notifiable Diseases Surveillance System and submit additional case information using the CDC cyclosporiasis case report form or the Cyclosporiasis National Hypothesis Generating Questionnaire (CNHGQ).[6]

While cyclosporiasis cases are reported year-round in the United States, cyclosporiasis acquired in the United States (i.e., “domestically acquired,” or cases of cyclosporiasis that are not associated with travel to a country that is considered endemic for Cyclospora) is most common during the spring and summer months. The exact timing and duration of U.S. cyclosporiasis seasons can vary, but reports tend to increase starting in May. In 2020, multiple outbreaks of cyclosporiasis were identified and found to be linked to different produce items. As of September 23, 2020, the CDC documented 1,241 laboratory-confirmed cases of cyclosporiasis in people who had no history of international travel during the 14-day period before illness onset.[7] Reported cases have climbed markedly over the past decade—from 537 in 2016 to 3,519 in 2018 and 4,703 in 2019—an increase that reflects both a genuine rise in illness and the growing use of rapid multiplex molecular stool panels (such as the FDA-cleared BioFire FilmArray gastrointestinal panel) that now detect Cyclospora as a matter of routine.[8] The seasonal pattern has continued in the years since; early in the 2026 season, for example, CDC reported 145 domestically acquired cases across 17 states between May 1 and June 16.[9]

What are the typical symptoms of Cyclospora infection?

Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, and loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with Cyclospora do not have any symptoms. The time between becoming infected and becoming ill is usually about one week. If not treated, the illness may last from a few days up to six weeks. Symptoms also may recur one or more times (relapse). In addition, people who have previously been infected with Cyclospora can become infected again.[10]

Where does Cyclospora come from?

The modes of transmission of C. cayetanensis are still not completely documented, although fecal–oral transmission is the major route. Direct person-to-person transmission is unlikely. Indirect transmission can occur if an infected person contaminates the environment, the oocysts sporulate under the right conditions, and then contaminated food and water are ingested. The role of soil in transmission has also been proposed. The relative importance of these various modes of transmission and sources of infection is not known.[11]

The dissemination of infective Cyclospora oocysts via water, soil, and unprocessed foods (e.g., fruits and vegetables, including ready-to-eat salads) is enabled by their small size (8–10 μm), low specific gravity, and high infectivity. Such oocysts can survive for weeks to months in water and food, depending on the environmental temperature, and are resistant to the routine sanitization or chemical disinfection procedures used in irrigation systems, recreational waters, or drinking water treatment plants.[12]

How is Cyclospora diagnosed?

Cyclosporiasis is usually diagnosed symptomatically in clinical settings, including the presence of watery diarrhea, abdominal cramping, and bloating. In untreated, immunocompetent people, the diarrhea can last from days to weeks to a month or more, and can wax and wane, with variable oocyst shedding. Oocysts can continue to be shed (intermittently or continuously) by non-symptomatic people, and symptoms can also persist in the absence of oocysts in feces. In a clinical context, conventional diagnosis usually involves microscopic examination of intestinal tissue biopsy sections, stool samples for the presence of developmental stages of Cyclospora, or advanced molecular testing for DNA. Improved specificity and sensitivity have been possible largely through the use of PCR, which enables the specific amplification of genetic loci from tiny amounts of genomic DNA of Cyclospora. Because of the intermittent nature of oocyst shedding and the low numbers of this stage in feces, it is recommended that multiple stool samples be collected at 2–3-day intervals over a period of more than a week, to increase the likelihood of identifying the disease microscopically.[13]

Why is Cyclospora so difficult to detect, in patients and in food?

Cyclosporiasis is easy to miss in the laboratory, and the reasons matter to every outbreak investigation. The routine ova-and-parasite examination performed on most stool specimens, a concentrated wet mount and trichrome stain, does not reliably detect Cyclospora, because the oocysts stain poorly with the stains that examination uses. Microscopic detection requires that the laboratory be asked to do something additional: a modified acid-fast or modified (“hot”) safranin stain of a concentrated specimen, or examination under ultraviolet light, which takes advantage of the fact that Cyclospora oocysts autofluoresce blue or green against a black background. Even then the oocysts stain inconsistently, and some appear only as unstained “ghost cells.” The American Society for Microbiology advises clinical laboratories to tell clinicians affirmatively that a routine ova-and-parasite result does not rule out Cyclospora.[14] Head-to-head evaluation of ultraviolet fluorescence against modified acid-fast staining reflects how long this organism went underdiagnosed for want of the right stain and the right suspicion.[15]

Shedding compounds the problem. Even symptomatic patients often do not pass enough oocysts to be found in a single specimen, and shedding is intermittent, which is why CDC and ASM both recommend that several specimens be collected on different days, generally at least three collected more than twenty-four hours apart.[16] A patient who submits one sample on a day the diarrhea has eased may test negative while still infected. The spread of FDA-cleared multiplex molecular gastrointestinal panels has changed this substantially, because those panels detect Cyclospora DNA from a single specimen without anyone having to suspect the parasite in advance. But not every panel includes Cyclospora, and not every laboratory has adopted one. The practical consequence is that reported case counts track testing practice at least as closely as they track illness, and a state that tests aggressively will appear to have more disease than a state that does not.

Testing the food is harder still, for a reason that has no counterpart in bacterial outbreaks: Cyclospora cannot be grown. There is no in vitro culture system and no animal model, so nothing can be biologically enriched or amplified before testing.[17] Detection instead depends on washing the produce, concentrating the wash, and running a real-time PCR assay on whatever DNA is recovered, the method set out in the FDA Bacteriological Analytical Manual, Chapter 19b. That method was originally validated for cilantro and raspberries and has since been extended by matrix studies to romaine lettuce, shredded cabbage, carrots, basil, parsley and berries; in December 2024 FDA replaced the assay’s 18S ribosomal RNA target with a more specific mitochondrial target for use by its regulatory laboratories.[18]

The reported detection limit is on the order of five oocysts in a twenty-five gram sample, but that figure describes ideal laboratory conditions with a known quantity of oocysts deliberately applied. When Canadian government scientists verified the FDA method for use in their own national produce survey, leafy greens spiked with two hundred oocysts were detected ninety-three percent of the time, and leafy greens spiked with ten oocysts only thirty percent of the time.[19]Complex prepared foods interfere further; the fat content of dishes such as salsa and guacamole required a separate set of method modifications before as few as five oocysts could be recovered.[20] Contamination is also patchy rather than uniform, so a negative twenty-five gram sample says very little about the leaf next to it. And because the assay detects parasite DNA, a positive result does not by itself establish that the oocysts were sporulated and infectious, just as a negative result does not establish that a lot was clean.

Timing finishes the job. Leafy greens have a shelf life measured in days, the incubation period for cyclosporiasis is roughly a week, and diagnosis, reporting and interview take weeks more. By the time investigators know which product to sample, the implicated lot has almost always been eaten or thrown away. The absence of a positive product sample in a Cyclospora outbreak is therefore close to meaningless as evidence of anything, a point worth remembering whenever a supplier offers clean test results as exoneration.

Why genetic fingerprinting of Cyclospora does not work the way it does for E. coli and Listeria

In a bacterial outbreak the laboratory evidence can be close to conclusive. E. coli O157:H7 and Listeria monocytogenes can be cultured, grown from a patient’s stool, from a package of food, from a swab of a drain or a slicer on a processing line. Once the organism is in hand its entire genome can be sequenced, and public health laboratories compare those genomes through PulseNet and, on the food and environmental side, GenomeTrakr, using core-genome multilocus sequence typing and high-quality single-nucleotide polymorphism analysis.[21] Isolates from patients hundreds of miles apart that differ by only a handful of alleles are for practical purposes the same strain, and when the strain from a sick person matches the strain recovered from a food or from a plant environment, the connection between the illness and its source is established as a matter of microbiology rather than inference.[22]

None of that machinery exists for Cyclospora. Because the parasite cannot be cultured, there is no way to enrich it before sequencing; DNA must be recovered from oocysts purified directly out of raw stool by density gradient centrifugation and flow cytometry, and even then most of the DNA in the preparation belongs to something other than Cyclospora.[23] The genome is large, with draft assemblies running to roughly forty-five megabases, so obtaining adequate coverage from a clinical specimen is impractical, and whole genome sequencing is simply not a feasible routine typing strategy for this organism.[24] CDC has therefore had to build something different: targeted deep amplicon sequencing of eight genotyping markers, six nuclear and two mitochondrial,[25] with the resulting haplotype data run through a custom bioinformatic clustering workflow that groups genetically related infections into what are called temporal genetic clusters.

That system works, and it deserves credit. Evaluated against epidemiologically defined clusters from 2019, it showed roughly ninety percent sensitivity and ninety-nine percent specificity.[26] But its limits are structural rather than incidental. A specimen must amplify at a minimum of five of the eight markers before it can be run through the clustering algorithm at all, and specimens with weak parasite signal are screened out before typing begins; whether a specimen sequences successfully turns in part on how it was stored before it reached Atlanta.[27] Not every laboratory-confirmed case has a specimen submitted for genotyping, and not every specimen submitted yields a usable genotype, both of which cause genetic clusters to understate the true size of an outbreak.[28]

The deeper obstacle is biological. Cyclospora reproduces sexually in the human intestine, which means that a single infection is genetically heterogeneous and that two people who ate from the same bag of salad will carry parasites that are typically similar but not necessarily identical.[29] There is no equivalent of the near-identity match that bacterial sequencing delivers. What the analysis produces is a probabilistic statement that a group of infections is more closely related to one another than to background cases, which is genuinely useful for telling epidemiologists which patients to interview together, but which cannot, standing alone, name a food. As the investigators themselves have put it, genetic clustering results become actionable, in the sense of supporting a recall, only when an epidemiological investigation identifies a common vehicle.[30]

Genotyping the product is harder yet, because the number of oocysts on a contaminated leaf is far lower than the number in an infected patient’s stool. FDA researchers have developed a targeted amplicon sequencing assay aimed squarely at that problem, covering fifty-two loci and several hundred known single-nucleotide polymorphism sites, and have shown that it can haplotype at least twenty-four markers from leafy greens carrying as few as ten oocysts in twenty-five grams, and that samples inoculated from the same oocyst source cluster together.[31] That is a real advance. It is not yet a deployed national surveillance network, and nothing in the Cyclospora toolbox today can do what a Listeria genome match does routinely, which is to set the organism from the patient beside the organism from the product and declare them the same.

The consequence is that Cyclospora investigations rest on epidemiology and on paper: what sick people remember eating, and whether the supply chain can be reconstructed backward from a restaurant or a bag of salad to a particular field and a particular week. Where records are lot-level and electronic, that reconstruction takes days. Where they are not, it takes months, and by then the growing season has turned over and the product is long gone.

What are the serious and long-term risks of Cyclospora infection?

Cyclospora has been associated with a variety of chronic complications such as malabsorption, reactive arthritis, and cholecystitis (inflammation of the gallbladder). Since Cyclospora infections tend to respond to the appropriate treatment, complications are more likely to occur in individuals who are not treated or not treated promptly. Extraintestinal infection also appears to occur more commonly in individuals with a compromised immune system.[32]

Although human cyclosporiasis is usually not fatal in developed countries such as the United States, protracted diarrhea often leads to dehydration, particularly in infants who are at greatest risk of severe dehydration and death, especially if cyclosporiasis is complicated by infections with other pathogens (viral, bacterial, or parasitic—e.g., Cryptosporidium and Giardia), malnutrition, or malabsorption, particularly in underprivileged communities.[33]

According to the CDC[34], the recommended treatment is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. It is advisable for people who have diarrhea to also rest and drink plenty of fluids.

How can Cyclospora infection be prevented?

There is no vaccine for cyclosporiasis, and no medication is available to prevent infection before exposure. Because the parasite is spread through food or water that has been contaminated with feces, the best available protection, according to the CDC, is to avoid consuming food or water that may be contaminated.[35]

Standard food-safety and hygiene practices reduce the likelihood of infection. Public health authorities recommend washing hands with soap and water before and after handling or preparing raw produce; washing all fruits and vegetables thoroughly under running water before eating, cutting, or cooking (items labeled “prewashed” need not be washed again); scrubbing firm produce such as melons and cucumbers with a clean produce brush; cutting away any damaged or bruised areas; and refrigerating cut, peeled, or cooked produce within two hours.[36]

These measures decrease but do not eliminate the risk of transmission. Rinsing or washing produce is not likely to remove Cyclospora oocysts, which adhere tightly to surfaces, and the parasite is resistant to routine chemical disinfection methods such as those using chlorine.[37] The theoretical infective dose may be as low as a single sporulated oocyst, and there is no way to render contaminated produce reliably safe short of avoiding it altogether.[38]

Travelers to tropical or subtropical regions where cyclosporiasis is endemic face a heightened risk and should follow the food and water precautions set out in the CDC’s Yellow Book, consuming only water known to be safe—such as sealed bottled water, boiled tap water, or carbonated beverages. In such settings, routine chemical disinfection or sanitization of food or water is unlikely to inactivate the parasite.[39]

For retailers, restaurants, and other food-service operators, the FDA recommends washing and sanitizing utensils, cutting boards, surfaces, display cases, and refrigerators before and after handling potentially contaminated products, sourcing produce from reputable suppliers, and maintaining purchase records so that traceback investigations can identify a contaminated source when an outbreak occurs.[40]

[1]           CDC. (2024, May 17). Three of a Kind: CDC Researchers Find Cyclospora Is Not Just a Single Species. Advanced Molecular Detection, Centers for Disease Control and Prevention. https://www.cdc.gov/advanced-molecular-detection/php/success-stories/cyclospora.html

[2]           Casillas, S. M., Hall, R. L., & Herwaldt, B. L. (2019). Cyclosporiasis Surveillance – United States, 2011-2015. Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C.: 2002), 68(3), 1–16. https://doi.org/10.15585/mmwr.ss6803a1

[3]           Nascimento, F. S., et al. (2019). Mitochondrial Junction Region as Genotyping Marker for Cyclospora cayetanensis. Emerging Infectious Diseases, 25(7). https://doi.org/10.3201/eid2507.181447

[4]           Giangaspero, A., & Gasser, R. B. (2019). Human cyclosporiasis. The Lancet Infectious Diseases, 19(7), e226–e236. https://doi.org/10.1016/S1473-3099(18)30789-8

[5]           CDC. (2026). Surveillance of Cyclosporiasis. Centers for Disease Control and Prevention. Retrieved July 2026, from https://www.cdc.gov/cyclosporiasis/php/surveillance/index.html

[6]           Casillas, Ibid, Note 2 at Page 1.

[7]           CDC. (2020, September 24). Cyclosporiasis Outbreak Investigations – United States, 2020. Centers for Disease Control and Prevention. https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/seasonal/index.html  

[8]           CDC. (2023). Notes from the Field: Doubling of Cyclosporiasis Cases Partially Attributable to a Salad Kit — Florida, 2021–2022. MMWR Morbidity and Mortality Weekly Report, 72(27), 748–749.

[9]           CDC, Ibid, Note 5.

[10]         Cyclosporiasis – Disease. (2018, May 11). https://www.cdc.gov/parasites/cyclosporiasis/disease.html

[11]         Almeria S, Cinar HN, Dubey JP. Cyclospora cayetanensis and Cyclosporiasis: An Update. Microorganisms. 2019; 7(9):317.

[12]         Giangaspero, Ibid, Note 4 at Page 1.

[13]         Giangaspero, Ibid, Note 4 at Page 3-4.

[14]         American Society for Microbiology. (2025). Cyclospora Detection and Reporting From Clinical Samples. https://asm.org/guideline/cyclospora-detection-and-reporting-from-clinical-s

[15]         Mathison, B. A., et al. (2024). Shedding new light on Cyclospora: how the use of ultraviolet fluorescence microscopy can improve diagnosis of cyclosporiasis. Journal of Clinical Microbiology. https://doi.org/10.1128/jcm.01084-24

[16]         CDC. (2025). Clinical Overview of Cyclosporiasis. Centers for Disease Control and Prevention. https://www.cdc.gov/cyclosporiasis/hcp/clinical-overview/index.html

[17]         McCaughan, C., et al. (2026). Current Knowledge and Future Directions for Cyclospora cayetanensis Research and Its Surrogates. Comprehensive Reviews in Food Science and Food Safety. https://doi.org/10.1111/1541-4337.70327

[18]         U.S. Food and Drug Administration. BAM Chapter 19b: Molecular Detection of Cyclospora cayetanensis in Fresh Produce Using Real-Time PCR (December 2024 modification adopting the Mit1C qPCR target). https://www.fda.gov/food/laboratory-methods-food/bam-chapter-19b-molecular-detection-cyclospora-cayetanensis-fresh-produce-using-real-time-pcr

[19]         Verification and Use of the US-FDA BAM 19b Method for Detection of Cyclospora cayetanensis in a Survey of Fresh Produce by CFIA Laboratory. (2022). Microorganisms, 10(3), 559. https://doi.org/10.3390/microorganisms10030559

[20]         Almeria, S., et al. (2021). Modifications of the U.S. Food and Drug Administration validated method for detection of Cyclospora cayetanensis oocysts in prepared dishes: Mexican-style salsas and guacamole. Food Microbiology, 96, 103719. https://pubmed.ncbi.nlm.nih.gov/33494896/

[21]         Validation of Core and Whole-Genome Multi-Locus Sequence Typing Schemes for Shiga-Toxin-Producing E. coli (STEC) Outbreak Detection in a National Surveillance Network, PulseNet 2.0, USA. (2025). Microorganisms. https://pmc.ncbi.nlm.nih.gov/articles/PMC12195096/

[22]         Chen, Y., et al. (2017). Whole Genome and Core Genome Multilocus Sequence Typing and Single Nucleotide Polymorphism Analyses of Listeria monocytogenes Isolates Associated with an Outbreak Linked to Cheese, United States, 2013. Applied and Environmental Microbiology, 83(15). https://pmc.ncbi.nlm.nih.gov/articles/PMC5514676/

[23]         Qvarnstrom, Y., et al. (2018). Purification of Cyclospora cayetanensis oocysts obtained from human stool specimens for whole genome sequencing. BMC Microbiology, 18, 165. https://pmc.ncbi.nlm.nih.gov/articles/PMC6182803/

[24]         Barratt, J. L. N., et al. (2022). Genotyping Cyclospora cayetanensis From Multiple Outbreak Clusters With an Emphasis on a Cluster Linked to Bagged Salad Mix – United States, 2020. The Journal of Infectious Diseases, 225(12), 2176-2180. https://doi.org/10.1093/infdis/jiab495

[25]         Nascimento, Ibid, Note 3 (eight-marker targeted amplicon deep sequencing scheme, six nuclear and two mitochondrial markers).

[26]         Barratt, J. L. N., et al. (2021). Investigation of US Cyclospora cayetanensis outbreaks in 2019 and evaluation of an improved Cyclospora genotyping system against 2019 cyclosporiasis outbreak clusters. Epidemiology and Infection, 149, e214. https://pmc.ncbi.nlm.nih.gov/articles/PMC8506454/

[27]         Assessing the sequencing success and analytical specificity of a targeted amplicon deep sequencing workflow for genotyping the foodborne parasite Cyclospora. (2025). Journal of Clinical Microbiology. https://doi.org/10.1128/jcm.01811-24

[28]         Retrospective evaluation of an integrated molecular-epidemiological approach to cyclosporiasis outbreak investigations – United States, 2021. (2023). Epidemiology and Infection, 151, e163. https://pmc.ncbi.nlm.nih.gov/articles/PMC10540164/

[29]         Barratt, Ibid, Note 24.

[30]         Ibid, Note 28.

[31]         Nascimento, F. S., et al. (2023). Development of a targeted amplicon sequencing method for genotyping Cyclospora cayetanensis from fresh produce and clinical samples with enhanced genomic resolution and sensitivity. Frontiers in Microbiology, 14. https://pmc.ncbi.nlm.nih.gov/articles/PMC10311907/

[32]         CDC. (2020, October 21). CDC – Cyclosporiasis – Resources for Health Professionals. Centers for Disease Control and Prevention. https://www.cdc.gov/parasites/cyclosporiasis/health_professionals/index.html

[33]         Giangaspero, Ibid, Note 4 at Page 2.

[34]         CDC. (2020, September 17). CDC – Cycloporiasis – General Information – Cyclosporiasis FAQs. https://www.cdc.gov/parasites/cyclosporiasis/gen_info/faqs.html

[35]         CDC. (2024, August 8). Preventing Cyclosporiasis. Centers for Disease Control and Prevention. https://www.cdc.gov/cyclosporiasis/prevention/index.html

[36]         New York State Department of Health. (2025). Cyclospora Infection (Cyclosporiasis) Fact Sheet. https://www.health.ny.gov/diseases/communicable/cyclosporiasis/fact_sheet.htm

[37]         U.S. Food and Drug Administration. Cyclospora. https://www.fda.gov/food/foodborne-pathogens/cyclospora

[38]         Goodrich Schneider, R., Schneider, K. R., et al. Preventing Foodborne Illness: Cyclosporiasis (FSHN0519/FS130). University of Florida IFAS Extension. https://ask.ifas.ufl.edu/publication/FS130

[39]         CDC, Ibid, Note 35.

[40]         U.S. Food and Drug Administration, Ibid, Note 37.

Earlier this week I wrote a response to Joelle Mosso of Western Growers, who argued that this summer’s Cyclosporaresponse exposed three major gaps in our public health system. I agreed with two of her three points and said so publicly, which is not a sentence I write often.

I then went looking for what everyone else had said. One of those statements has since been quietly deleted, and the restaurant chain at the center of this outbreak moved faster than the association that speaks for it. Here is what each group said, what I say back, and the three things I think we all actually want.

The calendar matters, because everything below turns on it. On July 16 the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention named shredded iceberg lettuce served at Taco Bell in five states. On July 17 FDA named the supplier, Taylor Farms de Mexico, and the company pulled all iceberg from central Mexico off the U.S. market. On July 18 FDA reported that a sample of that lettuce, caught at the border, tested positive for Cyclospora. Seventy-two hours from first naming to laboratory confirmation.

The International Fresh Produce Association, or IFPA, speaks for growers, packers and processors — and for United Fresh and the Produce Marketing Association, which merged into it in 2022, so there is no separate statement from either to look for. Its founding board chair was Bruce Taylor, CEO of Taylor Farms. On July 16, Chief Science Officer Max Teplitski warned that “the response we are seeing will likely not slow this outbreak down.” He argued that officials were rushing to place blame rather than find a source. No contaminated product had been identified though samples were taken a week earlier. Questionnaires were a valuable signal, not robust evidence.

Every one of those claims was overtaken within two days, and I say that without pleasure. No contaminated product? There is a positive lot now, and it is detained. Only questionnaires? Michigan analyzed 190 people who ate at Taco Bell and found 90 percent ate iceberg lettuce — epidemiology, then traceback to a single supplier, then laboratory confirmation. All three legs in a Cyclospora case is close to unheard of, because this parasite will not grow in culture, a point Teplitski made himself and made correctly. Then someone went looking with the right method and found the thing he said nobody had found.

IFPA also published a consumer FAQ that is far better, and I want to give it credit and then turn it around. It explains why traceback is so hard: one bag of salad can combine lettuce from several growers across different states or countries, washed and packed at a single facility, and once commingled there is no way to tell whose product is in the bag. Exactly right — and the best argument anyone has made this month for the Food Traceability Rule, which exists to solve that precise problem. IFPA wrote the case for the rule while its industry was asking to delay it.

The California Leafy Greens Marketing Agreement, or LGMA, speaks for the lettuce farms, and there are two statements at the same web address — only one still there. The version live today extends sympathies, credits officials for moving quickly, accepts Mexican-grown lettuce as the likely source, and notes California and Arizona grow about 90 percent of America’s lettuce. The version captured on July 15 called lettuce a leading suspect, said investigators were relying primarily on interviews, said Cyclospora is “more commonly associated with imported fresh produce than with domestically produced leafy greens,” and told members CDC discontinued routine national reporting of cyclosporiasis in 2025 following federal budget reductions.

Same URL, no correction, no update stamp. And here is what I want LGMA to hear: the paragraph you deleted is the truest thing any trade group has said about this outbreak. Surveillance was gutted in 2025, which is exactly why CDC confirms 1,644 outbreak cases while Michigan alone reports more than 5,000, and why I have spent two weeks explaining the difference between a confirmed case and a sick person. Your members are hurt by that gap worse than anyone — a clean California grower cannot prove they are clean when nobody can count accurately or trace quickly. Do not delete that paragraph. Send it to Congress. I will co-sign it.

The National Restaurant Association has said nothing. USA TODAY asked the NRA and Yum! Brands, McDonald’s, Chick-fil-A, Jersey Mike’s, Burger King, Subway and Wendy’s what they were doing about a parasite moving through restaurant lettuce. Not one answered. Meanwhile Dipisa’s Pizza in Stevensville, Michigan pulled lettuce, tomatoes and onions off its menu on July 10. Nor can I find a word from the Fresh Produce Association of the Americas, which represents the importers who bring Mexican produce into this country — the very channel this outbreak came through.

Silence is a position. An outbreak centered on restaurants, in states full of NRA members, and the association that exists to speak for those members produced nothing an operator could act on — no sourcing guidance, no advice on what to ask a distributor, no word of support for franchisees about to lose a month of sales through no fault of their own. Independent operators figured it out alone. They deserved better from the organization they pay dues to.

FMI — The Food Industry Association speaks for the grocery stores, and FMI got it right. I will say so plainly, because it is true and nobody else will. Its cyclosporiasis backgrounder is operational rather than defensive. Asked whether there has been a recall, it answers “Yes, products containing shredded iceberg lettuce have been recalled” and links the notice. It explains the confirmed-versus-probable divergence accurately and without spin. It is the only one of these documents that would survive being read aloud in a deposition.

My one criticism is meant as a suggestion. FMI never tells member grocers to pull the product from the shelf — and FDA named Marketside-brand bags at Walmart, with best-by dates running to August 3. CDC now says the recall covers lettuce sold at retail and tells consumers, restaurants and retailers to throw it out. FMI is the organization best positioned to make that happen in ten thousand stores at once. Say it, and you will have done more for public health this month than any regulator.

And then Taco Bell, which is not a trade association but belongs in this accounting. On Thursday July 16, before the federal confirmation and with no advisory requiring it, Taco Bell said it was voluntarily removing potentially impacted lettuce and pulling the ingredient from its national supply chain indefinitely. On July 17 it confirmed removal was complete and said, “public health is a shared responsibility among restaurants, their suppliers, and authorities.”

Taco Bell moved ahead of the government instead of waiting to be told. Worth noting that Taco Bell is a Yum! Brands company, and Yum! was among those that did not answer USA TODAY’s questions a week earlier — so the brand at the center of this acted while its parent, which also owns KFC and Pizza Hut, stayed quiet. Compare both to Taylor Farms, which called the source a specific independent farm representing less than one percent of the U.S. iceberg supply — a sentence engineered to shrink a problem — and to the trade association they both belong to, which said nothing at all. When the operator with the most to lose acts faster than the association paid to protect it, the association should ask itself why.

Now back to where I started. I told Western Growers it was right about two of three, and I meant it. What I would say to all of you comes down to three things we already agree on. Rebuild national Cyclospora surveillance and extend it into the water — irrigation, post-harvest, wastewater — where this parasite lives; Mosso asked for that and so did Teplitski, and they are both right. Give FDA real import authority, because in 2013, after a Cyclospora outbreak traced to this Taylor Farms, FDA announced increased surveillance of Mexican leafy greens, and thirteen years later announced it again, and it worked both times. And put the Food Traceability Rule back on schedule.

That last one is where I need the industry, because you can move it and I cannot. FSMA 204 requires lot-level records producible in twenty-four hours, leafy greens are on the list, and compliance was set for January 20, 2026. FDA announced a thirty-month delay in March 2025, published it that August, and in November Congress made it binding through July 20, 2028. Then this outbreak arrived, and FDA published a recall notice with no lot codes, customers identified only as CV, JB, MARK, MKTSD, PK, SUB, SY and TF, and a positive lot FDA says may be “available in commerce or in consumers homes” because nobody is required to be able to find it. IFPA’s own FAQ explains why that is unacceptable better than I can.

And here I have to say something uncomfortable, because it is true and because leaving it out would make everything above dishonest. The organization that has fought hardest against this rule is FMI — the same FMI whose outbreak communication I just praised. FMI has called the Food Traceability Rule overly complex, said its requirements go well beyond what Congress directed and are so burdensome as to not be achievable with currently available technology, and when FDA announced the thirty-month delay, President and CEO Leslie Sarasin applauded it and urged the agency to reexamine parts of the rule. The National Grocers Association applauded too, arguing the rule disproportionately impacts smaller grocers and that the original timeline was nearly impossible to meet. The Global Cold Chain Alliance said it was encouraged by this delay. And in 2024, Representatives Scott Franklin, Sanford Bishop and Jimmy Panetta introduced the Food Traceability Enhancement Act, which would have delayed compliance further and stripped lot-code requirements from restaurants, retail stores and warehouses outright. FMI and NGA both supported it.

Someone did fight for it. The Safe Food Coalition filed formal opposition to the delay in September 2025, telling the Commissioner that January 2026 already gave industry ample time and that no one should need more than a decade and a half to implement a law passed in 2010. The Center for Science in the Public Interest said the delay would only keep the public in the dark. The Center for Food Safety is the reason the rule exists at all — when FDA blew its statutory deadline, CFS sued, and a court order forced the rulemaking. To its credit, the National Restaurant Association is not on the other side of this one: its own guidance page calls the rule a measure expected to result in fewer foodborne illnesses and deaths and tells restaurants to prepare now. I could find no evidence IFPA lobbied for the delay either.

So set the two things side by side. FMI wrote the clearest, most useful public document of this outbreak — and FMI is the most effective reason FDA could not trace a bag of shredded lettuce in twenty-four hours when it mattered. I do not think that makes the backgrounder less good. I think it makes this outbreak the strongest argument against FMI’s own position that anyone could have written, and I would rather FMI reach that conclusion than have me keep pointing at it.

Congress should hold a hearing — a working one, not a show trial. Energy and Commerce and Senate HELP both have jurisdiction, and four questions need answers on the record. Why was routine Cyclospora surveillance discontinued in 2025, who decided it, and what did it save? Why did FDA screen Mexican leafy greens at the border in 2013, stop, and only start again after people got sick? How does a lot of lettuce test positive and stay outside a recall? And with this outbreak showing precisely what the traceability rule was written to prevent, will FDA and Congress defend the delay under oath?

One association argued the investigation could not work. One made the right argument and then deleted it. One said nothing. One did its job. A restaurant chain moved before it was asked. And one wrote something thoughtful enough that I answered it, which is how this whole thing started. I am not keeping score for its own sake. I care what happens next summer, because this parasite comes back every summer, and it always will until somebody fixes those three things. Want to put me out of business? Fix it.

Let me start with the part that deserves praise, because it is real and because I do not say it often enough. FDA tested. It stood up targeted import surveillance on shredded iceberg lettuce coming out of central Mexico, it pulled a sample, and it found Cyclospora. That is hard to do. This parasite cannot be cultured, it does not grow in a lab, and detecting it on produce takes a molecular method that most of the food safety world was not running on lettuce a decade ago. In 2013, when this same company’s same Guanajuato facility was tied to a Cyclospora outbreak, the case was built on epidemiology and traceback, and the company spent that summer telling reporters its own tests were all negative. This time somebody went looking with the right tool and found it. Whoever ordered that sampling and whoever ran that assay did their job.

Now the rest.

Read the sentences FDA wrote next, slowly. A sample of shredded iceberg lettuce supplied by Taylor Farms de Mexico has tested positive for Cyclospora. Taylor Farms has confirmed that this positive product is not part of their current recall. They are working to identify whether any part of this implicated lot is available in commerce or in consumers’ homes. The positive lot is currently detained.

In consumers’ homes. FDA has confirmed Cyclospora in a specific, identified lot of lettuce, does not know where that lot went, has told the American public it may be sitting in their refrigerators tonight, and has not recalled it. The lot is detained. A detention holds the portion FDA has its hands on. It does nothing whatsoever about whatever already cleared, already shipped, already got broken down at a distribution center and delivered to a restaurant or stacked in a cooler at a grocery store. Detention is not a recall. It protects the government’s evidence. It does not protect the family making tacos on a Saturday night.

And how is it not part of the recall? Taylor Farms told the country yesterday that it was voluntarily removing all iceberg lettuce sourced from central Mexico from the U.S. market. Not some. All. Either that statement was not true, or the recall is narrower than the statement, or this lot falls outside the June 29 through July 16 distribution window and that window is wrong. Those are the only three possibilities and every one of them is bad. FDA is repeating the company’s answer instead of demanding one.

There is a second question FDA has not answered, and it may be the more important one. When was that sample collected? FDA says only that it came from targeted import surveillance conducted as a result of this outbreak investigation. It does not give a date. FDA announced increased border screening on July 16. Taylor Farms announced its removal on July 17. If the positive was pulled after the company said it had taken all of this lettuce off the market, then contaminated product was still moving across the border after the removal was announced, and the public is entitled to know that. FDA should say when.

Two more things. FDA finally named a customer — in its advisory it identifies Marketside-brand product available at Walmart: twelve and twenty-four ounce Iceberg Salad and eight and sixteen ounce Shredded Lettuce, best if used by July 18 through August 3. Good. But go look at the recall notice itself, which is where a shopper would actually go. Those same items appear there under the code MKTSD. Not Marketside. Not Walmart. Four letters. The brand field at the top of that notice reads, in its entirety, “CV, JB, Mark and more.” FDA decoded exactly one of the eight customer codes on that list and left the other seven as initials, and it did the decoding on a different page than the one carrying the recall. And scroll up on that advisory and FDA still tells you Taylor Fresh Foods has not publicly provided distribution information or a list of customers — in the same document where FDA names one.

Then there is the lot codes. FDA’s update tells consumers that a complete list of affected products including lot codes is available on the company’s recall notice. I have read that notice. There are no lot codes in it. There are brand initials, a segment column, a product description and a best-by range. FDA is vouching for a disclosure that does not exist, on the very day it is telling people a contaminated lot may be in their kitchens.

So: thank you for testing. Genuinely, and without qualification. Now finish the job. Publish the lot number. Publish the collection date. Publish the customers behind the other seven codes — you ran the traceback, you have them. And recall the positive lot. Sixteen hundred people have an explanation and something close to seven thousand are still waiting for one.

The FDA posted the iceberg lettuce recall this morning. Read the top of the page before you read anything else. It says COMPANY ANNOUNCEMENT, and then it says that when a company announces a recall, the agency posts the company’s announcement as a public service, and that FDA does not endorse either the product or the company. That is not the FDA weighing in. That is the FDA hosting. Everything below the disclaimer is Taylor Farms’ text, reproduced without a word of federal comment.

So here is what the federal government is now telling the public, in Taylor Farms’ voice. Shredded iceberg went out June 29 through July 16 to twenty-seven states — Alabama, Arkansas, Connecticut, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Missouri, Mississippi, North Carolina, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin. The outbreak advisory that sits one link away still describes a five-state problem at Taco Bell.

Then comes the sentence that should have ended the guessing. A complete list of affected products, lot codes, use-by dates and instructions for returning or disposing of them, the announcement says, is available here. Look at the table. There are no lot codes. Four columns — brand, segment, description, best-if-used-by — and not one of them is a lot code. FDA published a promise of lot codes on top of a table that does not contain any, and nobody at the agency appears to have looked.

The brand column is worse. FDA’s own summary field lists the brand names as “CV, JB, Mark and more.” Those are not brands. They are Taylor Farms’ internal customer codes — CV, JB, MARK, MKTSD, PK, SUB, SY, TF. No one in America has ever seen a bag of lettuce labeled CV. I spent yesterday’s post working out who those codes most likely are, said plainly that it was inference, and invited anyone to correct me. Today one of them got confirmed. Walmart pulled four Marketside bagged iceberg products — iceberg salad in 12- and 24-ounce bags, shredded lettuce in 8- and 16-ounce bags — matching the MKTSD retail entries exactly, in all four sizes, and its notice carries the same twenty-seven states.

Credit where it belongs. Mike Snider at USA Today got Walmart on the record and put those four products and that state list in front of the public. Not the FDA, which had the recall on its own website. Not Taylor Farms, which wrote it. A trending-news reporter with a phone and the sense to call the retailer whose store brand was sitting in the table in code.

Snider also put to me the question the recall itself refuses to answer — who else got this lettuce — and I gave him what the codes point to: the national distributors US Foods and Markon, and the chains Subway and Jack in the Box. I told him what I wrote here yesterday, that this is an inadequate public notice for an outbreak that may have sickened seven thousand Americans. I will say the rest of it again, because nothing has changed since.

“Because somebody knows. Taylor Farms knows. FDA knows, because it ran the traceback. The family deciding what to put on the table tonight does not, and there is no defensible reason for that.”

And I told him the part I think actually explains the silence.

“I fear that most of the companies that are listed there are just hoping that no one ties them to illnesses.”

Notice what all of this does to the line that grocery store shredded lettuce is not affected, which CDC is still running. Marketside is grocery store shredded lettuce. It is on the recall list, labeled Retail, in consumer sizes, and it has now been pulled from shelves. The federal advisory has not been updated to say so.

Now the company’s own statement. Six sentences. Three of them are about what Taylor Farms is not: no Taylor Farms-branded salads or kits are associated with this outbreak, no Taylor Farms-branded salad kits contain iceberg lettuce, and the implicated farm represents less than one percent of the U.S. iceberg supply. The company then ran a banner across the top of taylorfarms.com repeating the first one. That is a brand-protection document with a condolence paragraph stapled to the front.

The one percent deserves its own moment. That is market share. It is not exposure. One farm’s iceberg, chopped and shredded and blended into four-by-five-pound foodservice cases and retail bags, shipped to twenty-seven states over eighteen days through Sysco and through the codes that look like US Foods, Performance Food Group and Markon, is not one percent of anything a person eating lunch cares about. The denominator is not the national lettuce supply. It is the number of bags.

There is one more thing neither document will say. Illnesses in this outbreak began in mid-May. The recall covers product distributed beginning June 29. The lettuce that made people sick was eaten weeks before the recall window opens and is long since gone. So, the recall does not answer the only question that matters to the people already sick — where did the lettuce go? — while the advisory answers it with five states and one restaurant chain and the company’s own list says twenty-seven states and at least eight customers nobody will name. Michigan alone reported more than 5,000 cases and 102 hospitalizations as of July 16. The confirmed outbreak count is 1,644.

None of this required heroics. It required lot codes and customer names on the day of the recall. That is exactly what the Food Traceability Rule under FSMA 204 was written to produce — lot-level records on leafy greens, handed to FDA within twenty-four hours — and it is exactly what got pushed to 2028. Walmart did not wait. It imposed its own supplier traceability requirements last August, which is very likely why it could identify and pull four items in a day while the federal advisory still reads like a Taco Bell story.

FDA had one job this week that it could not delegate: tell people where the lettuce went. Instead, it reprinted the press release of the company that sent it there, disclaimed any endorsement of the contents, and left the customers in code. It took a reporter to find the first name on the list.

Taylor Farms has posted a recall notice on its own website. As of this morning it is still not on FDA’s recalls page, which means the only place an American consumer can find out what was pulled is the website of the company that sold it. Set that aside for a moment, because what the notice says is more interesting than where it is posted.

Start with geography. FDA and CDC have told the public to avoid shredded iceberg lettuce at Taco Bell locations in five states — Indiana, Kentucky, Michigan, Ohio and West Virginia. Taylor Farms says the recalled shredded iceberg was distributed to twenty-seven: Alabama, Arkansas, Connecticut, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Missouri, Mississippi, North Carolina, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin. Twenty-two states received recalled product and have no advisory telling anyone in them anything.

Now, who has actually gone public? Two companies. Taco Bell said it completed removal of affected Taylor Farms lettuce from its restaurants on July 17 and pulled the ingredient from its supply chain nationwide. And Sysco confirmed Friday it was withdrawing all Taylor Farms iceberg lettuce from Mexico at the supplier’s request, having halted sales and distribution the day before. Reuters’ industry source says Taylor Farms called clients on Thursday — including Taco Bell’s parent Yum Brands and Sysco — and that the five-pound bags from the Guanajuato plant go to hospitals, ballparks and fast-food chains. Hospitals. Consider who eats lettuce in a hospital.

That is the entire list of companies that have said anything. Two. Meanwhile the analytics firm Placer.ai told CBS Newsthat product removals at some quick-service chains — plural — appear to be denting restaurant traffic. Somebody else is pulling lettuce and not saying so.

Which brings us to the recall notice itself, where the other customers are hiding in plain sight. The chart lists thirty-five products under eight brand codes: CV, JB, MARK, MKTSD, PK, SUB, SY and TF. Those are customer codes, and Taylor Farms knows exactly what every one of them means.

Before I go further, let me be clear about two things. What follows is inference, not confirmation, and I am showing my reasoning so anyone can check it. And being a Taylor Farms customer is not wrongdoing. Every company below bought lettuce in good faith from one of the largest produce processors in America. The question is not whether they did something wrong. The question is whether product they received reached people who are now sick, and whether the public is entitled to know that. I think the answer is obviously yes.

Start with the pattern rather than the letters. Four codes — CV, MARK, SY and TF — each carry nearly the identical broad assortment: 50/50 blend, 80/20 blend, chopped, salad mix, salad with separate bag, shred. That is what a broadline distributor or a produce cooperative buys, because it stocks the whole catalog for thousands of downstream customers. Three others — SUB, JB and PK — carry one or two items apiece, which is what a single restaurant chain buys, because a chain buys the one cut its recipe calls for. SY is confirmed as Sysco, a broadliner, and it sits squarely in the first group. The pattern holds.

That matters because the big foodservice distributors do not buy produce under their own names. They buy it under private produce labels, and those labels line up with these codes:

SY is Sysco. Confirmed by Sysco’s own announcement.

MKTSD appears to be Marketside, Walmart’s store brand. The four entries are iceberg salad in 12-ounce and 24-ouncebags and shredded lettuce in 8-ounce and 16-ounce bags, matching the Marketside line exactly, in all four sizes. Everything else on the recall is a four-by-five-pound foodservice case.

CV appears to be Cross Valley Farms, the exclusive produce label of US Foods. That would explain why its assortment mirrors Sysco’s nearly line for line — US Foods is the second-largest broadline distributor in the country.

PK appears to be Peak Fresh Produce, the produce label of Performance Food Group. Sysco, US Foods and PFG are the big three, and it would be strange for a national shredded lettuce program to reach two of them and not the third.

MARK appears to be Markon, the foodservice produce cooperative whose member distributors buy precisely this assortment under the First Crop label.

TF is Taylor Farms’ own foodservice label.

SUB appears to be Subway. It carries exactly one item on the recall — quarter-inch shredded lettuce in five-pound cases — which is the sandwich cut, and Subway is the largest buyer of shredded lettuce in the United States. A single-SKU, single-cut buying pattern is what a sandwich chain looks like on a processor’s customer list.

JB appears to be Jack in the Box. It likewise carries one item, eighth-inch fine shred, the finer cut used as a taco and burger topping rather than a sandwich filler. I will note that JB is the thinnest of these reads — Jimmy John’s or Jason’s Deli would be the other candidates a reasonable person might land on, though both would more naturally abbreviate differently.

Let me be straight about the gradient. Sysco is confirmed. Marketside, Cross Valley Farms, Peak Fresh Produce and Markon rest on private-label conventions plus a buying pattern that matches, and I would be surprised to be wrong about them. Subway and Jack in the Box rest on initials plus a cut, which is weaker, and I am telling you that rather than presenting seven findings of equal weight.

The Marketside finding deserves its own paragraph, because of what CDC told NBC News on Friday morning: shredded lettuce sold in grocery stores or served in other restaurants is not affected. Taylor Farms’ own recall notice lists consumer retail bags of shredded iceberg lettuce and iceberg salad. Both statements are in the public record this weekend and they cannot both be true. Federal officials themselves told STAT that other brands, restaurants, retailers or distribution channels could yet be tied to the outbreak. And Michigan’s chief medical executive, Dr. Natasha Bagdasarian, made the point plainly: a supplier that sells to restaurants may also stock grocery stores, and many people who got sick in her state said they never ate at Taco Bell.

So here is my invitation, and I mean it without sarcasm. If US Foods, Performance Food Group, Markon, Walmart, Subway or Jack in the Box are reading this — say so. Tell the public whether you received this product, where it went, and what you have done about it. Sysco did that on Friday and the sky did not fall. If I have any of this wrong, tell me and I will correct it here the same day, prominently, and thank you for it. What I will not do is pretend that a table of initials on a corporate website is adequate public notice for an outbreak that may have sickened seven thousand Americans.

Because somebody knows. Taylor Farms knows. FDA knows, because it ran the traceback. The family deciding what to put on the table tonight does not, and there is no defensible reason for that.

Then there is the timing, which I expect will matter most in litigation. Taylor Farms says the recalled product was distributed June 29 through July 16, with best-if-used-by dates running into early August. Illnesses in this outbreak began May 13. So the recall covers product sitting in walk-ins and on shelves right now — worth doing — but it does not cover the lettuce that sickened people in May and most of June. That product was eaten weeks ago. A recall is forward-looking damage control. It is not an accounting of what already happened, and nobody should mistake it for one.

Which is precisely why the Food Traceability Rule matters. FSMA Section 204 requires lot-level records at every critical tracking event and delivery of those records to FDA in a standard electronic format within twenty-four hours. It was supposed to be in force on January 20 of this year. FDA proposed pushing it to July 2028, and Congress made that stick. Had it been operating, the twenty-seven-state distribution list and the real names behind those eight codes would have been in FDA’s hands in a day — in May. Instead we got them in the third week of July, from a corporate website, as abbreviations.

So here is what should happen this week. FDA should post this recall on its own site, where consumers actually look. It should state which customers received the product and in which states, rather than leaving initials on a company page for reporters and lawyers to decode. And it should explain how consumer-sized retail bags appear on a recall list while the public is being told grocery lettuce is fine. Nearly seven thousand Americans may have been sickened. Sixteen hundred have an explanation. The rest are still waiting, and a recall that names no customers and reaches twenty-seven states tells them nothing they can use.

Below is the full list of recalled product as published by Taylor Farms.

Recalled Products — Taylor Farms de Mexico (as posted July 17, 2026)

BrandDescriptionBest If Used By
CVBLEND LETT/ROM 50/50 NOCLR 4/5#7/16/2026 – 8/1/2026
CVBLEND LETT/ROM 80/20 4/5#7/16/2026 – 8/2/2026
CVBLEND LETT/ROM 80/20 WITH SEP BAGGIES 4/5#7/16/2026 – 8/1/2026
CVLETTUCE CHOP 4/5#7/16/2026 – 8/1/2026
CVLETTUCE SALAD MIX 4/5#7/17/2026 – 7/25/2026
CVLETTUCE SALAD WITH SEP BAG 4/5#7/16/2026 – 8/1/2026
CVLETTUCE SHRED 1/4″ 4/5#7/16/2026 – 8/2/2026
JB1/8″ SHRED LETTUCE 4/5#7/16/2026 – 7/30/2026
MARKBLEND LETT/ROM 80/20 4/5#7/21/2026 – 7/29/2026
MARKBLEND LETT/ROM 80/20 WITH SEP BAGGIES 4/5#7/16/2026 – 8/1/2026
MARKLETTUCE CHOP 4/5#7/18/2026 – 7/30/2026
MARKLETTUCE SALAD MIX 4/5#7/21/2026 – 7/29/2026
MARKLETTUCE SALAD WITH SEP BAG 4/5#7/16/2026 – 8/1/2026
MARKLETTUCE SHRED 1/4″ 4/5#7/16/2026 – 8/1/2026
MARKBLEND LETT/ROM 50/50 NOCLR 4/5#7/16/2026 – 7/29/2026
MARKLETTUCE SHRED 3/8″ 4/5#7/21/2026, 7/28/2026
MKTSDIceberg Salad, 12 oz, 24 oz7/18/2026 – 8/3/2026
MKTSDShredded Lettuce, 8 oz, 16 oz7/18/2026 – 8/3/2026
PKLETTUCE SHRED 1/8″ 4/5#7/16, 7/20, 7/25, 7/28, 7/30/2026
PKLETTUCE SALAD W/BAG 4/5#7/18/2026 – 8/1/2026
SUBSHRED LETTUCE 1/4″ 4/5#7/16/2026 – 7/31/2026
SYBLEND LETT/ROM 50/50 NOCLR 4/5#7/18, 7/21, 7/29, 8/1/2026
SYBLEND LETT/ROM 80/20 4/5#7/16/2026 – 8/3/2026
SYLETTUCE CHOP 4/5#7/16/2026 – 8/3/2026
SYLETTUCE SALAD MIX 4/5#7/21/2026 – 8/3/2026
SYLETTUCE SALAD WITH SEP BAG 4/5#7/16/2026 – 8/3/2026
SYLETTUCE SHRED 1/8″ 4/5#7/16/2026 – 8/3/2026
SYBLEND LETT/ROM 70/30 NOCOLR 4/5#7/16/2026 – 7/30/2026
TFBLEND LETT/ROM 80/20 4/5#7/16/2026 – 8/3/2026
TFLETTUCE CHOP 4/5#7/16/2026 – 7/31/2026
TFLETTUCE SALAD MIX 4/5#7/16/2026 – 8/1/2026
TFBLEND LETT/ROM 50/50 NOCLR 4/5#7/19/2026 – 8/3/2026
TFLETTUCE SALAD W/BAG 4/5#7/16/2026 – 8/1/2026
TFBLEND LETT/ROM 70/30 NOCOLR 4/5#7/16/2026 – 8/3/2026
TFLETTUCE CHOP 1X1″ 4/4#7/16/2026 – 8/3/2026

Source: Taylor Farms Product Recall Information, last updated July 17, 2026. Consumers with questions can reach Taylor Farms customer care at 855-455-0098.

Joelle Mosso of Western Growers has written that this summer’s Cyclospora response exposed three major gaps in our public health system — risk communication, national surveillance, and FDA’s handling of imported risk. I have spent twenty years suing the produce industry, and I am going to say something that will surprise people on both sides: she is largely right. On surveillance and imports she is closer than most of the public health commentary I have read this month. However, on risk communication she has identified a real problem but reached for the wrong remedy. The remedy she needs is sitting on a shelf with a 2028 date on it.

Take her surveillance point first, because it is the most important thing in her piece. Mosso argues that restoring what existed before July 2025 is not enough, and that we need a network capable of showing where infectious oocysts actually are — which waterways, which wastewater systems, which environmental conditions and regions create elevated risk. That is exactly right, and more ambitious than anything anyone in government is currently proposing. Putting Cyclosporaback on FoodNet’s mandatory reporting list, after CDC cut the required pathogen list from eight to two, is the floor. Environmental monitoring of surface water and wastewater is the ceiling. We built wastewater surveillance networks for a virus in eighteen months during a pandemic. We can do it for a parasite that has been sickening thousands of Americans every summer for years.

She is right on imports too and this outbreak proves the point. When contamination enters through a foreign supplier and the public message is essentially “be careful with fresh produce,” the foreign supplier is not the one who pays. The grower in Salinas who did everything correctly pays. FDA’s foreign supplier verification program has been a paper exercise for a decade. The lettuce came from central Mexico. Somebody in the United States bought it, and whatever verification obligations attached to that purchase stopped none of this.

Now her third point, where I part company — not with the diagnosis, but with the cure. Mosso objects to vague warnings that cast suspicion across an entire food category, and she is completely right that they are destructive. They frighten people away from vegetables they ought to be eating, they punish growers who did nothing wrong, and they leave sick people no better informed about what actually hurt them. But the answer to a vague warning is not a quieter warning. It is a faster and more specific one. And specificity is not a communications skill. It is a records problem.

Watch how this outbreak actually resolved. Illnesses began May 13. FDA and CDC issued broad Cyclospora advisories with no source, which is precisely the category-wide suspicion Mosso is complaining about. Then the Washington Post reported on July 16 that the supplier was Taylor Farms, and the next day FDA and CDC confirmed the traceback had converged on Taylor Farms de Mexico. The instant that name appeared, the vague-category problem evaporated. Every other iceberg grower in America was cleared by that one piece of specific information. Two months of undifferentiated suspicion ended the moment somebody could say whose lettuce it was.

So why did it take two months? Because tracing a head of lettuce from a taco back to a field is still, in 2026, largely a manual exercise — investigators interviewing thousands of sick people, then chasing paper invoices backward through distributors and processors one company at a time. There is a fix for that, and it is already federal law. FSMA Section 204, the Food Traceability Rule, was finalized in November 2022. It puts leafy greens on the Food Traceability List, requires lot-level records at every critical tracking event, and — this is the part that matters here — requires a company to hand FDA those records in a standardized electronic format within twenty-four hours of a request. Twenty-four hours, not eight weeks.

It was supposed to take effect January 20, 2026. In August 2025, FDA proposed pushing the compliance date out thirty months to July 20, 2028, citing how much time industry needed. In November 2025 Congress made it binding, directing FDA not to enforce the rule before that date. The single tool most likely to have compressed this outbreak’s two-month mystery into a two-day answer was scheduled to be operating six months before the first person got sick, and instead it will not be enforced until the summer of 2028.

That is the whole argument, and I would like Western Growers to make it with me. If the industry genuinely wants public communication that names a supplier instead of smearing a commodity, the industry has to want the traceability that makes naming possible. You cannot ask for precision and simultaneously ask for another three years before the records requirement bites. Notably, Walmart did not wait — it began requiring standardized traceability data from its suppliers in August 2025, ahead of any federal deadline, because a retailer with real exposure understands that lot-level records are self-defense. The growers who invested early are the ones who get exonerated fastest when the next outbreak hits. The ones who lobbied for delay will spend the next outbreak in the same undifferentiated cloud Mosso is objecting to now.

Here is a process I can get behind. If Western Growers wants to call for congressional hearings into how this outbreak happened, I will stand next to them and say so. I have testified before Congress, and I know how easily a hearing becomes theater. This one does not have to be. There are four questions with actual answers, and every one of them is embarrassing to somebody.

First: how did a human parasite get onto a field of lettuce in central Mexico, and what did the American company buying that lettuce know about the water and the sanitation? 

Second: why did it take from May 13 to July 17 to name a supplier, and what specifically slowed the traceback? 

Third — and this is the one nobody wants to touch — the government has now attributed 1,644 illnesses to Taco Bell and Taylor Farms. CDC’s own count is 1,645 laboratory-confirmed cases across 34 states with more than 5,100 additional reports still awaiting analysis, and the states themselves are reporting far more; Michigan alone was at 4,312 as of July 16. So, the official explanation covers a fraction of the sick. Where did everyone else’s parasite come from? That question will die quietly the moment the news cycle moves on unless somebody with subpoena power asks it out loud.

Fourth: what did the DOGE cuts do? Not as a partisan talking point — as a factual record built under oath. What happened to FDA’s investigative capacity, to CDC’s outbreak response, and to the state and local health departments that do the actual interviewing, after the funding and staffing reductions of the past two years. What was the practical consequence of taking Cyclospora off FoodNet’s required reporting list in July 2025. Whether a fully staffed system would have named this supplier in June instead of the middle of July, and how many of the people who got sick between those two dates would not have. Somebody at CDC and FDA knows the answer to that. Ask them under oath and put it in the record.

Mosso closes by saying the produce industry has an important role but cannot solve a systemic environmental and public health problem alone. That is true and I would not ask it to. But it cannot be a shield either. Cyclospora is a human parasite. It does not come from cattle or deer or birds. It reaches lettuce through human waste — contaminated irrigation water, or fields where the people cutting the crop lack a clean toilet and a sink within a reasonable walk. Wastewater monitoring will tell us where the parasite is circulating. It will not put a handwashing station at the end of a row, and it will not tell an investigator which lot went to which restaurant. Those two things are the industry’s job, and they were the industry’s job in 2013, when this same subsidiary was tied to a Cyclospora outbreak that sickened 535 people in 19 states through salad served at Olive Garden and Red Lobster and the lettuce too came from Mexico.

So here is my offer. I will back Mosso on environmental surveillance, on import controls, and on the proposition that vague advisories hurt innocent people. I will say publicly that Western Growers is right about the public health system, because it is. In exchange, I want the produce industry to stop treating the Food Traceability Rule as a burden to be deferred and start treating it as the fastest available cure for exactly the communication problem it is complaining about. Move the date back. Build the systems now. And call for the hearings — loudly, by name, to the committees that fund these agencies. The people I represent — the ones who lost fifteen pounds and six weeks to a taco — do not care which institution failed them. They care that thirteen years after Olive Garden, people are still sitting on a toilet with explosive diarrhea.

The Food and Drug Administration has finally put a name on the iceberg lettuce. In an updated advisory posted July 17, FDA said its traceback converged on a single supplier of the shredded iceberg served at the Taco Bell locations where people got sick: Taylor Farms de Mexico. The CDC advisory says the same. And Taylor Farms de Mexico announced it was voluntarily removing all iceberg lettuce sourced from central Mexico from the U.S. market and told FDA it would begin a recall. As of this writing that recall notice is on Taylor’s own site but has not yet been posted by FDA.

The confirmed outbreak is ugly enough on its own. FDA and CDC count 1,644 people infected with Cyclospora who reported eating at Taco Bell across five states — Indiana, Kentucky, Michigan, Ohio and West Virginia — with 94 hospitalizations and illness onsets running from May 13 to July 13. In Michigan, where investigators did the ingredient-level interviews, roughly nine in ten of the cases they questioned reported eating iceberg lettuce.

But here is the question the advisories do not answer, and the one that matters most: where else did Taylor Farms de Mexico lettuce go?

Look at the two numbers side by side. The Taco Bell outbreak accounts for about 1,644 confirmed illnesses. The national Cyclospora count right now is roughly 1,645 confirmed cases, with another 5,100-plus still under investigation — nearly 6,745 possible illnesses spread across 34 states. In other words, essentially every confirmed case in the country traces back to Taco Bell, while more than five thousand probable cases across three dozen states trace back to nothing at all — at least not yet.

Which is it? Either the country is enduring several unrelated Cyclospora outbreaks at once, which is what federal officials are suggesting, or the same contaminated iceberg found its way into channels well beyond five states’ worth of Taco Bells, and the traceback simply has not caught up.

The recall itself hints at the answer. Taylor Farms did not pull the lettuce it shipped to Taco Bell. It pulled all iceberg lettuce sourced from central Mexico, nationwide, indefinitely. You do not yank an entire region’s supply out of the national market to solve a one-customer, five-state problem. That product went somewhere. Taylor Farms is one of the largest fresh-cut produce suppliers in the country, and beyond Taco Bell its known customers include KFC, Pizza Hut, Walmart and Trader Joe’s — and KFC and Pizza Hut share a corporate parent with Taco Bell. CDC, meanwhile, says shredded lettuce sold in grocery stores or served at other restaurants is not affected. Federal officials also admit they do not yet know whether Taylor Farms sent this lettuce to other vendors. Both of those things cannot be true.

In 2013 the very same subsidiary — Taylor Farms de Mexico — was tied to a Cyclospora outbreak that sickened 535 people in 19 states, traced to salad mix served at Olive Garden and Red Lobster. Back then, too, the company responded by halting far more than the implicated product, and FDA reassured the public that grocery-store packages were not implicated. Thirteen years later the subsidiary, the parasite, the country of origin and it’s-only-this-one-channel reassurance are all the same.

The people counting the days between bathroom trips deserve a straight answer. FDA named the supplier. Now it needs to tell us where the rest of that lettuce went — and whether the thousands sickened outside those five states ate it too.

From silence to statement

When the Washington Post first reported on July 16 that federal investigators had traced the suspected source of the Cyclospora outbreak to shredded iceberg lettuce that Taylor Farms supplied to Taco Bell, neither company responded to the newspaper’s request for comment. Both issued statements the following day, after Bloomberg reported that Taylor Farms was removing iceberg lettuce sourced from central Mexico and was preparing a recall of ingredients tied to the outbreak.

What Taylor Farms put out (its own statement, posted to its newsroom and social media)

Taylor Farms posted a statement to its corporate newsroom and to Instagram and Facebook. It said that, based on information provided the prior day by the FDA, Taylor Farms de Mexico is voluntarily removing all iceberg lettuce sourced from central Mexico from the U.S. market. The company said the FDA traceback was indicating a “specific independent farm” that represents less than 1% of the U.S. iceberg lettuce supply as the potential source, and that it had removed all iceberg lettuce from that region indefinitely. It was careful to distance its retail line: Taylor Farms emphasized that no Taylor Farms branded salads or kits are associated with the outbreak, adding that none of its branded salad kits contain iceberg lettuce. The company said that, as a family-owned company, it is deeply concerned for those who became ill and their families and the Americans whose trust in the safety of fresh produce has been shaken, and that it is committed to doing everything in its power to address the issue, support the investigation, and help restore trust.

Taylor Farms’ statement to Forbes

The statement Taylor Farms provided to Forbes’ Antonio Pequeño IV carried the same core message with a couple of additions: it repeated the voluntary removal of central-Mexico iceberg lettuce and the “specific independent farm” / “less than 1%” framing, added that no other Taylor Fresh Foods products across the country are impacted, and said the trust it had “worked for decades to earn” had been shaken and that it is committed to restoring that confidence, promising continuous updates as new information emerges.

Taco Bell’s statement to Forbes

Taco Bell told Forbes that, as of July 17, it had completed removal of the affected Taylor Farms lettuce from its restaurants. It said that, based on ongoing conversations with public health officials and out of an abundance of caution, it had voluntarily removed the product from its supply chain nationwide so guests could enjoy their food safely. Taco Bell called public health a shared responsibility among restaurants, their suppliers, and authorities, said it was proud to have acted quickly and proactively, and encouraged other restaurants, retailers, and food-service operators to take the same precautionary action.

One factual note that ties them together

Both companies used the word “voluntarily,” and the reporting frames this as Taylor Farms preparing and undertaking a voluntary removal rather than a mandated action. As of these statements, no FDA recall had been issued tied to the outbreak.

Just how big in the Taylor Farms/Taco Bell outbreak? Are there other outbreaks linked to other products? Are others foreign or domestically acquired? Many questions?

In the last day the numbers came further into view — not because the federal count moved, but because two states caught up to it. Ohio, which the CDC still carries in the low hundreds, now reports more than 1,300 cases through its own health department; Michigan crossed 5,000. Indiana climbed to 327, Illinois to 277, and Maryland doubled to 69. Add up what the fifty state health departments are actually reporting and the national total is now roughly 8,700 — closing in on 9,000, and more than five times the 1,644 the government has confirmed. The chart below reflects those numbers.

Here is where all fifty state health departments stood as of July 17, 2026 — the number each reports for 2026, and whether it calls those cases part of an outbreak.

State2026 cases reportedPart of the outbreak?Source
AlabamaNo domestic cases in CDC listNot partCDC
Alaska1–10 (CDC band)Cases reported; not in clusterCDC / NBC
Arizona1–10 (CDC band)Cases reported; not in clusterCDC / NBC
ArkansasAs many as 10 (Jul 15)Not declared part; not in clusterAR DOH / WMC
California41 provisional (Jan–Jun); fewer than 2025; mostly internationalNo — CDPH: not among states with an increaseCDPH
Colorado~150; mostly international travelNo — CDPHE: not part of the Midwest outbreakCDPHE
Connecticut35 (up from 19 in 2025)Links its cases to the national outbreakCT DPH
DelawareNo domestic cases in CDC listNot partCDC
Florida96 (May 1–Jul 11); nearly doubled in a weekNo — FL DOH: “seasonal disease that affects Floridians every year”FL DOH / WUSF
GeorgiaIn CDC count; GA DPH reports no state-specific clusterNot declared partGA DPH / Epoch
HawaiiNo domestic cases in CDC listNot partCDC
IdahoNo domestic cases in CDC listNot partCDC
Illinois277 (Jul 16); 23 hospitalizedNo — “no evidence of a large outbreak”IDPH / TODAY
Indiana327 (Jul 17); up from prior yearsYes — calls itself part of the nationwide outbreakIN DOH / Epoch
Iowa1–10 (CDC band)Cases reported; not in clusterCDC / NBC
Kansas55 (37 domestic); 6 hospitalizedDomestic cases rising; no KS sourceKDHE / WIBW
Kentucky100 reported / 61 confirmedYes — in the 5-state outbreakKY DPH alert
Louisiana1–10 (CDC band); “seasonal spike”Not declared part; not in clusterLA DOH / WAFB
MaineNo domestic cases in CDC listNot partCDC
Maryland69 (Jul 17); some travel-relatedNo — no common link identifiedMD DOH / Epoch
Massachusetts18 (normal seasonal amount)No — not affected by the Midwest outbreakMA DPH / WBUR
Michigan~5,002 (Jul 17); 102 hospitalized — leads the nationYes — leads the 5-state outbreak; iceberg lettuce namedMDHHS
Minnesota1–10 (CDC band); MDH annual only (2025: 68)Cases reported; not in clusterCDC / MDH
MississippiNo domestic cases in CDC listNot partCDC
MissouriNo domestic cases in CDC listNot partCDC
MontanaNo domestic cases in CDC listNot partCDC
Nebraska1–10 (CDC band)Cases reported; not in clusterCDC / NBC
NevadaNo domestic cases in CDC listNot partCDC
New Hampshire1–10 (CDC band)Cases reported; not in clusterCDC / NBC
New Jersey46No — “not experiencing … outbreaks”NJ DOH
New MexicoNo domestic cases in CDC listNot partCDC
New York~470 statewide incl. NYCNo — NYSDOH: “not a major deviation from the norm”NY DOH / CBS NY
North Carolina307 (Jul 14); 13 hospitalizedInvestigating; not in 5-state clusterNCDHHS
North DakotaNo domestic cases in CDC listNot partCDC
Ohio~1,316 (Jul 16–17); 96 hospitalized; Lucas Co. 278Yes — in the 5-state outbreakODH / Ohio Capital Journal
Oklahoma57 (Jul 17); 6 hospitalizedPart of the national outbreak; no OK sourceOSDH / Epoch
OregonNo domestic cases in CDC listNot partCDC
Pennsylvania28 (voluntary reporting)No — mostly imported / travel-relatedPA DOH / WHYY
Rhode Island4 (since May 1)Cases reported; not in clusterRI DOH / Epoch
South CarolinaNo domestic cases in CDC listNot partCDC
South DakotaNo domestic cases in CDC listNot partCDC
Tennessee11–30 (Jul 17)Investigating; not in clusterTN DOH / Epoch
Texas68 (through Jul 13); 15 hospitalizedMeets CDC outbreak case definition; not in clusterTX DSHS
Utah1–10; not related to the wider outbreak (UT DHHS)No — not part of the outbreakUT DHHS / Epoch
VermontNo domestic cases in CDC listNot partCDC
Virginia10No — not a pattern that would “constitute an outbreak”VDH
Washington27 since May 1 (22 travel-related; 3 domestic)No — WA DOH: not seeing an outbreakWA DOH / FOX 13
West Virginia69Yes — 5-state outbreak; statewide outbreak declaredWV OEPS
Wisconsin35 (≈double 2025; <10 domestic)No — WI DHS: travel-driven, not a domestic outbreakWI DHS / WPR
WyomingNo domestic cases in CDC listNot partCDC