De Ann Davis, the senior vice president for science at Western Growers[1], published a piece on August 19 arguing that Congress should pursue Frank Yiannas’s[2] proposed National Foodborne Outbreak Investigation Board, conditionally. Her piece is called A Food Safety NTSB? A Strong Idea – If We Follow Through, and it deserves a great deal more notice than it is going to get. The science lead of the association that represents the growers producing more than half of this country’s fresh fruit and vegetables has just told Congress to take an independent outbreak board seriously, in the middle of the largest Cyclospora outbreak this country has ever recorded.

The produce industry’s own science lead just told Congress to pursue an independent board.

Her diagnosis is the same one Frank has been making, and she states it more economically than either of us has. Responsibility in the American food safety system is distributed; accountability is not. CDC coordinates most of the epidemiology. FDA and USDA regulate different foods. State and local agencies do the interviews, the testing and the inspections. And when an investigation is delayed, inconclusive or simply wrong, no single institution owns the failure to learn from it. That last clause is hers, and it is the best sentence written about this subject all year.

This is not a bystander. Davis was chief food safety officer at Kraft Foods Group while the regulatory framework of the Food Safety Modernization Act was being built, ran food safety and quality for Church Brothers Farms and for Earthbound Farm, and has served two terms on USDA’s National Advisory Committee on Microbiological Criteria for Foods. She is writing from inside the industry that would be investigated.

Her caution about airplanes is the same caution I raised six days ago.

Davis will not take the NTSB analogy on faith, and she is right not to. Food outbreaks are not airplane crashes. There is often no preserved scene, no identifiable moment and no wreckage. The food is eaten or thrown away, symptoms appear days later, records are incomplete, ingredients cross jurisdictions and borders, and a great many investigations never identify a vehicle at all. She also raises the risk nobody who likes this idea wants to hear, which is that a new federal body could duplicate what exists, slow an urgent decision, or start a fight over who is in charge while people are still getting sick.

I made the same move on August 13 in Food Safety News, under the headline Set the Airplanes Aside. The aviation comparison is the weakest part of a case that does not need it. Davis got there on her own and put it in fewer words. I have written before that the useful thing about this argument is how many different corners of the food world keep arriving at it independently, and this is another one.

Her seven design questions are the right questions, and most of them have no answer yet.

She lists them plainly. What case count, death, duration or public-interest threshold triggers an investigation? Does the board lead during the emergency, or begin an independent after-action review once it is over? Can it compel records, samples, testimony and access to a foreign facility? How are confidential business information, candid industry participation and victims’ legal rights all protected at once? Who pays for the investigation and for the corrective action it recommends? Must agencies respond within ninety days, keep the response updated annually, and explain a missed deadline? What evidence is required before a recommendation can be closed?

Every one of those is a real question, and the honest answer today is that Frank’s two published pieces contain roughly a hundred and fifty words of design language between them. Davis is not wrong that the proposal is a concept rather than a statute.

The question in her list I want to flag is the one about victims’ legal rights, because it is the hardest and almost nobody in industry commentary bothers to raise it. Aviation solved its version of that problem by making board reports inadmissible in civil cases and by keeping lawyers out of the investigation entirely. Copy that wholesale into food and you would seal the best root cause analysis ever performed on an outbreak away from the only forum in which sick people in this country have reliably gotten an answer. That she put it on the list at all is more than most people on her side of the table have done.

Where we part company is the sequence, not the substance.

Her last section is headed Build the Follow-Through Before Building the Board. I would put it the other way around. The follow-through is the board. A clock that starts when a recommendation is issued, a permanent public database that tracks that recommendation until somebody answers it, and an annual list that names the agency that has not answered — those three things are the mechanism, and there is nowhere in the system as it exists today to put any of them.

I know that because of a document FDA wrote thirteen years ago. In August 2013, after more than six hundred people in twenty-five states got cyclosporiasis, FDA investigators spent eight days at a lettuce plant in Guanajuato with their Mexican counterparts and wrote a recommendation that the firm determine whether Cyclospora is a reasonably likely hazard in that growing region and, if so, re-evaluate the wash step. That was the right recommendation. It had no addressee, no deadline, no database and nobody assigned to answer it. Thirteen years later: same region, same facility, same parasite, same commodity. Davis’s point and mine converge exactly there. Independence without follow-through produces reports. What I would add is that we have already run that experiment, and the report is sitting in a file.

Frank has been making this argument in public since November 2025.

He laid it out first in a STAT First Opinion piece on November 7, 2025, written after a Listeria outbreak in prepackaged pasta meals killed six people and the investigation never found the root cause. He brought it back in Food Safety News in July, asking whether Cyclospora is a seasonal nuisance or a preventable problem. Since then he has said versions of the same thing everywhere a reporter has asked. He told Politico that this response deserves an independent review and pointed at a lack of strong federal leadership. He told CNN that we do not do a good job investigating outbreaks once they occur, beyond pulling product off a shelf, and that the definition of insanity is doing the same thing and expecting a different result. He told The Packer that criticizing the agencies for a slow traceback is like criticizing emergency responders after taking away their GPS.

He is not the only one, and one of the other voices works for Taylor Farms.

I went looking for who else has weighed in on this idea, and there are more of them than the coverage suggests. On December 30, 2025, Food Safety Magazine ran a bonus episode of Food Safety Matters devoted to fixing the outbreak investigation system, with the independent board on the agenda. The four people on it were Frank; Drew McDonald, the senior vice president of quality and food safety at Taylor Fresh Foods in Salinas[3]; John Besser, who spent ten years as deputy chief of CDC’s Enteric Diseases Laboratory Branch after nineteen years running the infectious disease laboratory at the Minnesota Department of Health[4]; and Craig Hedberg of the University of Minnesota[5], who wrote the independent review of FDA’s foodborne outbreak response processes that FDA itself commissioned and published in 2021.

It is a podcast rather than a position paper, and I am not going to put words in anyone’s mouth about what each of them said. The fact worth sitting with is who was in the room. Seven months before this outbreak, a former deputy commissioner, a former CDC laboratory chief, the epidemiologist FDA hired to grade its own outbreak response, and the food safety executive of the company now at the center of the largest Cyclospora outbreak in American history all sat down together to discuss whether outbreak investigations should be taken away from the agencies that run them.

Earlier still, in June 2024, Eric Wilhelmsen[6] asked in Food Safety Magazine whether the outbreak investigation system can be improved and whether the airline industry is the right model for improving it. He ended with the question that is really Davis’s question and Frank’s question in five words: should enforcement action be separated from investigation? He also wrote, of people in my line of work, that plaintiff attorneys have a profit motive that cannot be ignored. He is right about that, and I have never pretended otherwise. It is also why I would rather be arguing about the drafting of a statute than about my own motives.

Thirteen letters from Congress, and still nobody has written the bill.

That is the part of Davis’s piece I would underline hardest. There is no draft statute. There is no white paper. There is no coalition and no member carrying it. Thirteen congressional letters have gone out about this outbreak and none of them asks for this. Her answer is to pursue the idea conditionally, with the conditions written into the authorizing language. My answer is the same, with the order reversed: somebody put it on paper, and then let the launch trigger, the subpoena power, the ninety-day clock and the treatment of victims’ rights be argued over a bill instead of over a concept. A board of this kind takes regulatory authority away from precisely nobody, which is more than can be said for every food agency reorganization proposed since the 1990s, all of which are dead.

A board like this does not have to have five seats, and this post already names six people for it.

The standing objection to Frank’s proposal is that it is a concept rather than a thing. Here is one way to make it less of one. The NTSB has five members, nominated by the President and confirmed by the Senate, with a statutory limit on how many of them may come from one party. A food board could be sized differently, and I would size it to the people who are actually available. Fill it with people who have already done this work in public and the argument stops being theoretical. Frank should chair it, and his best qualification is the one nobody lists: he ran the inside-the-agency version of this fix himself, put his name on it in December 2021, and concluded afterward that it was not enough. John Besser should have a seat, because a large part of what a board like this does is judge whether the laboratory and surveillance machinery actually worked, and he spent a decade running the part of CDC that builds it. Craig Hedberg should have another, because FDA already hired him once to grade its own outbreak response, and he is the only person named here who has written that report and then watched what became of it.

David Acheson[7] should be on it too, and he brings something none of the others do. He is a physician who treated people with these infections before he ever worked on policy, and who spent years at Tufts on the molecular pathogenesis of Shiga toxin, which is the biology of how a child ends up on dialysis. A board that reviews outcomes ought to have somebody on it who has stood at that bedside. He was also pulled into government service by the same outbreak that put me in this line of work: USDA recruited him to advise on Jack in the Box, and he stayed to become chief medical officer at the Food Safety and Inspection Service, then chief medical officer at FDA’s food center, then the agency’s first associate commissioner for foods.

Two things have to be said with his name, and both of them argue for him rather than against him. The first is that he was FDA’s food chief in the summer of 2008, when the agency spent weeks telling Americans to avoid tomatoes in an outbreak that turned out to be jalapeño and serrano peppers, and the tomato growers absorbed a loss for a vehicle that was never theirs. That is not a mark against him here. It is the most relevant line on his résumé. He has already lived the exact failure this board exists to prevent, from the inside, at the top, and he has written about traceability ever since like a man who remembers it. The second is that he has run a global food safety consulting firm since 2013, and a seat on a board like this would mean giving that up. That is the ordinary price of a Senate-confirmed appointment, and I would not pretend it is a small one to ask of a man who built the firm.

That is six people, and five is the number of members the NTSB has. My answer is not to cut one of them. Five is a figure Congress wrote into a statute in 1974, not a law of physics, and the statute that creates a food board can say whatever Congress wants it to say. Write it for seven. An odd number keeps a vote from tying, and I would leave the seventh chair open on purpose, because the drafting will turn up somebody obvious that none of us has thought of yet. Having more qualified people than chairs before a single line of the bill exists is not a problem with this proposal. It is the first hard evidence that the bench is there, and an argument about who sits in which chair is a far better argument than the one we are having now, which is whether any of this is worth doing at all.

Two of the people in this post cannot sit on it, and the reason they cannot is the argument itself. Members of a board like this must not hold a stake in the industries they investigate. De Ann Davis works for the growers. Drew McDonald works for the company at the center of this outbreak. That does not put either of them outside the work; it describes a different seat. Aviation solved this problem with the party system, where the operator and the manufacturer put their own technical people inside the investigation, with access to everything and no vote on the finding. That is where Davis and McDonald and Eric Wilhelmsen belong, and it is worth noticing that Davis’s seven questions read exactly like somebody who has already thought hard about what that seat ought to be able to see.

Trevor Suslow[8] belongs in that same seat, and his position makes the rule easier to see than any argument I could write. There is probably nobody alive who has spent more time on the microbiology of irrigation and wash water on fresh produce. He ran that program at UC Davis for twenty-five years, led its Postharvest Technology Center, and served as vice president of produce safety at the Produce Marketing Association. He is also, at this moment, a paid consultant to Taylor Farms on the investigation into this outbreak, and he told CNN this month that the company has been open with its research and its data and that he would have no trouble eating a bag of its lettuce today. He may be entirely right about that. The point is that no independent board could seat him while he holds that engagement, and no serious investigation of this outbreak should proceed without what he knows. Closing that gap is the entire reason the party system exists. It would also do him a favor. Inside an investigation his analysis would go into a public docket and be tested by people with no stake in the answer, rather than reaching the public as a quotation from the company’s consultant.

The same rule keeps me off the board, and it should. Neither I nor any other lawyer who bills an hour on these cases has any business voting on a probable cause finding.

Four named, one chair deliberately empty, and two left to fill. I would spend those two carefully. One belongs to a serving state epidemiologist, because most of this work is done in fifty state health departments and I have not read a version of this proposal that gives them a chair. The other belongs to a victims’ advocate, and there is an obvious place to look for one. On August 12, eleven consumer, public health and labor organizations wrote to congressional leadership asking Congress to rescind the rider that bars FDA from spending a dollar to enforce its own traceability rule before 2028. I said at the time that they were right and I wanted my name next to theirs. Stop Foodborne Illness signed that letter, and it exists because parents who lost children in 1993 decided to make something out of it. Its chief executive is Sandra Eskin[9], who spent twelve years running food safety policy at Pew through the passage of FSMA and then ran the Food Safety and Inspection Service at USDA as deputy and acting under secretary. I wrote when she was hired that the board could not have chosen better. Put her in the chair, or let those eleven groups pick somebody among them. What matters is that the seat is written into the statute rather than offered later as a courtesy.

I have not asked a single one of these people whether they want the job, and some of them will not thank me for the suggestion. That is fine. The point of naming them is that the objection to this proposal has always been that nobody can picture it, and the people who would make it work are already publishing under their own names. Congress does not have to go looking.

Meanwhile, CDC counts 15,716 confirmed cases of cyclosporiasis, 828 hospitalizations and two deaths through August 17, and my own fifty-state tally is now past 31,000 people. Federal investigators attribute 9,481 of those illnesses across seventeen states to iceberg lettuce. When a produce trade association’s chief scientist, a former FDA deputy commissioner, a former CDC laboratory chief, the physician who ran FDA’s food program, the epidemiologist FDA paid to evaluate its own outbreak response, and a plaintiff’s lawyer are all pointing at the same hole in the same system, the argument is no longer about whether the hole is there. It is about who is going to write the paragraph that fills it. Six of the names are above.


[1]De Ann Davis, Ph.D., has been senior vice president for science at Western Growers since June 2020, where she leads the association’s work on food safety, crop protection, sustainability and industry data. She spent roughly two decades in consumer product safety at Procter & Gamble, Kimberly-Clark and Alberto Culver before moving into food, and served as chief food safety officer at Kraft Foods Group during the development of the regulatory framework for the Food Safety Modernization Act. She was vice president of food safety and quality at Earthbound Farm and then at Church Brothers Farms, both Salinas Valley leafy greens companies, and food safety director at Commercial Food Sanitation. She was appointed to USDA’s National Advisory Committee on Microbiological Criteria for Foods in 2018 and reappointed to a second two-year term in 2021, and formerly chaired the board of advisors of the Center for Food Safety at the University of Georgia.

[2]Frank Yiannas, M.P.H., served as FDA deputy commissioner for food policy and response from December 2018 until February 2023, under two administrations, which made him the senior food safety official at the agency through the romaine outbreaks, the pandemic and the infant formula shortage. He was the architect of the New Era of Smarter Food Safety blueprint and, in December 2021, issued FDA’s Foodborne Outbreak Response Improvement Plan together with Stic Harris of the agency’s Coordinated Outbreak Response and Evaluation Network. Before FDA he spent ten years as vice president of food safety at Walmart, responsible for every Walmart and Sam’s Club location, and before that held food safety leadership roles at the Walt Disney Company. He is a past president of the International Association for Food Protection and now runs Smarter FY Solutions. I have known him since his Disney days and guest lecture in his food safety culture class at Michigan State every year.

[3]Drew McDonald is senior vice president of quality and food safety at Taylor Fresh Foods in Salinas, California, where he oversees the quality and food safety programs across the company’s foodservice, retail and deli operations, which fall under both FDA and USDA jurisdiction. He has more than thirty years in fresh produce and fresh foods and has worked with growers and processors around the world. He sits on the Food Safety Summit Educational Advisory Board and has chaired technical committees at the Center for Produce Safety and at United Fresh. He was educated at Lawrence University in Wisconsin.

[4]John Besser, Ph.D., spent ten years as deputy chief of the Enteric Diseases Laboratory Branch at CDC, working on the national and global programs that detect, characterize and track gastrointestinal disease, which is the laboratory machinery that makes multistate outbreak detection possible in the first place. Before CDC he led the infectious disease laboratory at the Minnesota Department of Health for nineteen years, and before that spent five years as a clinical microbiologist at the University of Minnesota Hospital. He is the author or co-author of more than seventy publications and now works as an independent consultant. His doctorate and master’s degree are both from the University of Minnesota.

[5]Craig Hedberg, Ph.D., is a professor in the Division of Environmental Health Sciences at the University of Minnesota and co-director of the Minnesota Integrated Food Safety Center of Excellence. His work treats public health surveillance as a precondition for effective food control and focuses on improving collaboration among public health agencies, regulators, academic researchers and industry during outbreak investigations. He led the University of Minnesota School of Public Health team that FDA contracted to produce An Independent Review of FDA’s Foodborne Outbreak Response Processes, which was built on interviews with senior officials at FDA, USDA’s Food Safety and Inspection Service and CDC, along with state health officials and industry and consumer outbreak experts, and which directly informed the agency’s 2021 improvement plan. He holds a doctorate in epidemiology and a master’s in environmental health, both from the University of Minnesota.

[6]Eric Wilhelmsen, Ph.D., CFS, has worked for more than thirty years in food safety and sampling across both academic and industrial positions, with technical work spanning juices, dietary supplements and botanicals, agricultural commodities, byproducts and beverages. He writes regularly for Food Safety Magazine and consults through the Alliance of Technical Professionals. He is candid about his vantage point: he opens the article cited here by noting that all of his experience has been for or at the behest of industry, that he has not walked a mile in a regulator’s shoes, and that he is aware of the glass in his own house.

[7]David W. K. Acheson, M.D., F.R.C.P., trained in internal medicine and infectious diseases in the United Kingdom and moved to the United States in 1987, where as an associate professor at Tufts University he ran basic research on the molecular pathogenesis of Shiga toxin-producing E. coli. That work brought him into government: he was recruited by USDA to advise on the Jack in the Box outbreak and became chief medical officer of the Food Safety and Inspection Service. In September 2002 he moved to FDA as chief medical officer of the Center for Food Safety and Applied Nutrition, then directed its Office of Food Defense, Communication and Emergency Response, and in 2007 became the agency’s first assistant commissioner for food protection and then its first associate commissioner for foods, a post he held until 2009. He led the development of FDA’s 2007 Food Protection Plan, much of which reappeared as authority granted to the agency by the Food Safety Modernization Act. He ran the global food safety practice at Leavitt Partners from 2009 to 2013 and founded The Acheson Group that year, which he still leads.

[8]Trevor Suslow, Ph.D., is an emeritus extension research specialist and professor of cooperative extension at the University of California, Davis, where he spent about twenty-five years and where he served as faculty director of the Postharvest Technology Center from 2016 to 2018. He was vice president of produce safety at the Produce Marketing Association, now the International Fresh Produce Association, from 2018 until 2020, then formed Trevor Suslow Consulting in 2021 and took on a technical advisory role to the executive director of the Center for Produce Safety. A plant pathologist by training, with his bachelor’s degree and doctorate both from the University of California, Berkeley, his published work runs through the microbiology and disinfection of preharvest and postharvest water, indicator and surrogate organisms, and the limits of rapid pathogen testing on leafy greens. He received the United Fresh Technical Award in 2012, the Elmer Marth Educator Award from the International Association for Food Protection in 2018 and its President’s Award in 2019, and was named by the Association of Food and Drug Officials to its list of twenty people who shaped the last thirty years of food safety.

[9]Sandra Eskin, J.D., has been chief executive officer of Stop Foodborne Illness since February 2025. She came to it from the Department of Agriculture, where she was appointed deputy under secretary for food safety in March 2021 and later served as acting under secretary, running the Office of Food Safety and overseeing the Food Safety and Inspection Service. Before that she spent twelve years as project director for food safety at the Pew Charitable Trusts, where she worked on the passage of the Food Safety Modernization Act, and earlier was deputy director of the Produce Safety Project at Georgetown University. She has sat on several federal advisory committees dealing with foodborne illness surveillance and meat and poultry safety. She holds a law degree from the University of California, and I wrote at the time of her appointment that the Stop board could not have chosen better.

On August 20, 2026, a nurse practitioner at a free clinic in Lee County, Florida told a television reporter that her clinic is not testing anyone for cyclosporiasis, because it serves mostly uninsured patients and the test costs them hundreds of dollars. Her clinic has seen cases anyway, in patients and in its own staff. None of those people were tested, which means none of them are among the cases Florida has reported this year. The same day, NPR published an account of what has happened to the people whose job it is to find cases.  I want to go back to bed and hide.

A clinic in the county with the most cases in southwest Florida is not testing anyone.

The clinic is Samaritan Health and Wellness Center, and the nurse practitioner is Susan Hook. Speaking to Gulf Coast News Now, she described patients passing more than twenty stools a day before seeking care and said of testing: We are not testing anyone. Her reason was not clinical. It was that her patients are uninsured and the test is expensive for them to reach. Lee Health hospitals in the same county do offer the test, with same-day results. The test exists. It is a few miles away. It costs what it costs.

The arithmetic behind that price is worth stating plainly. Cyclosporiasis is not found by a routine stool workup; a provider has to order it by name, and because the parasite is shed intermittently, CDC advises that a single negative specimen does not rule it out and that three specimens are optimal. Public laboratory fee schedules put a single direct examination for this parasite above one hundred dollars. Multiply by three, add an office visit, and the barrier is not abstract. Florida is at 460 cases through August 15, with 39 in Lee County and seven in Collier.

Nobody has measured how often this is happening, and no mechanism exists to measure it.

There is no survey of clinics, no state reports how many symptomatic people went untested, and this is the only named instance I have seen all summer. It is worth being precise about what it does and does not show: this is one clinic making a decision about cost, not a state policy of refusing to test the uninsured. But it is the first time anyone has put a name and a place to the thing every surveillance page hedges about when it says the true number is higher than the number reported.

Two facts frame the size of the hole. First, CDC’s 11,841 pending cases are all people who were tested; the backlog is a laboratory queue, not the missing population. Second, the standard estimate of the gap comes from Scallan and colleagues, Foodborne Illness Acquired in the United States, Major Pathogens, which puts the underdiagnosis multiplier for Cyclospora at 83.1. That multiplier has always been treated as a fact of nature. Part of it is a fact of billing.

The people who would do the counting are being cut.

NPR reported the same day on what has happened to the capacity behind these numbers. Bob Custard, president of the West Virginia Association of Sanitarians, says about half the positions on his state’s food safety organization chart are vacant, that one growing county went from four sanitarians to two and lost its only epidemiologist, and that West Virginia lawmakers responded in March by lowering the education requirementfor the job from a four-year degree to an associate degree. His summary of the national approach to foodborne illness: It is like we have a house, and we decided to take smoke detectors out.

The rest of that reporting is worse. Kentucky says its food safety staff is down thirty to fifty percent. Susan Mayne, who ran FDA’s food center until three years ago, says the teams that coordinated crisis response with foreign regulators were eliminated and that she does not know who is managing the relationship with Mexico now. Dan Jernigan, who ran the CDC center over the parasitic diseases laboratory, says that laboratory lost much of its funding when USAID closed, is missing at least a third of its staff, and is now triaging to multistate outbreaks when it used to help states with every one. Two USDA parasitology laboratories in Beltsville were told in May to relocate or lose their jobs, and their work has effectively stopped. In fairness, and it belongs in the same paragraph: Ohio says its response is unaffected, Michigan went to court and kept its grant money, HHS says the CDC laboratory supporting this response was not cut, and USDA says its research continues without disruption.

Things worth asking before I try to get some sleep, and they are answerable this week.

Will the Florida Department of Health run this test at no charge for a symptomatic uninsured patient, through a county health department or the state laboratory, as part of an outbreak investigation? State public health laboratories commonly do outbreak testing free. If Florida does, the failure is that the clinics treating the uninsured do not know it, which is fixable in a week with an email.

Will CDC put this parasite back into FoodNet? It was dropped last year along with five others, and it is the only system that produces a stable estimate of whether things are getting better or worse.

And will the agencies say what the genotyping shows? CDC said this week that it can group these parasites genetically. That capability sits in the same laboratory that has lost a third of its staff.

I have spent a month counting this outbreak state by state, and I have been treating the count as a floor because of reporting lag and because people recover at home without seeing a doctor. Add a third reason. In at least one clinic, in the middle of the largest cyclosporiasis outbreak this country has ever recorded, sick people are not being tested because of what the test costs. The parasite does not care whether anyone counted it. It is the rest of us who need the number.

As of today, August 20, 2026, five state health departments publish a count of their own residents who got cyclosporiasis while traveling inside the United States: Washington, Florida, Utah, Oregon and California. Between them they account for roughly fifty-eight people, a handful of whom have been formally tied to the Taylor Farms de Mexico lettuce outbreak. The other forty-five states publish nothing on the question at all.

Washington publishes the most complete travel breakdown in the country.

The Washington State Department of Health reports 67 cyclosporiasis cases between May 1 and August 14. Of the 65 people interviewed about travel, 42 had been to a country where the parasite is endemic and 38 of those had been to Mexico. One had traveled to a country that is not endemic. Twenty-two had not left the United States at all, and it is that group the state then breaks down again: 11 traveled to a state reporting an outbreak or an increase, three of them associated with the Taco Bell outbreak in Michigan and Indiana; four traveled to a state with no increase; and seven never left Washington.

An earlier version of that page went further still and named the destinations, listing cases who had traveled to Michigan, North Carolina, Tennessee and Oregon, and identifying the three counties whose residents appeared to have been exposed at home. No other state in the country publishes anything close to this.

Florida already had a field for this, and it fills it in every week.

Florida does something quietly different from the rest. Its reportable disease report carries acquisition as a standing category rather than as outbreak communication, so every week it publishes how many cases were acquired in state, out of state, outside the country, and unknown. As of August 1 the split was 201 acquired in Florida, 31 acquired in another state, 45 acquired abroad, and 65 still unknown. The statewide total has since climbed to 460 cases through August 15, spread across more than forty counties. Florida is not one of the seventeen outbreak states, and it has not tied any of those 31 to the lettuce.

Utah, Oregon and California report the same thing with less detail.

Utah has reported 48 cases since May 1, of which 31 involved travel outside the country, 12 involved travel to other states, and five involved no travel at all. Oregon announced two residents infected after traveling to states involved in the recall, out of 23 cases statewide this year. California says two of its cases were people who traveled to an affected state and ate at Taco Bell. Virginia belongs in the conversation as a near miss: it says some of its cases have reported travel to and exposures in outbreak states, and it publishes a domestic, international and unknown split, but it has never said how many of the domestic cases were acquired in another state.

CDC counts these people in the state they visited, not the state they live in.

This is the part worth sitting with. CDC’s outbreak investigation page says plainly that the total case count includes sick people who traveled to one of the seventeen states but reside in different states. A Californian who ate at a Taco Bell in Michigan is a Michigan number. That is defensible epidemiology, because the exposure happened in Michigan and that is where the food was. It also means a home state has no particular reason to say anything, and forty-six of them do not. The four that speak up are doing it voluntarily.

The practical result is that the geography of this outbreak looks tighter than it is. Seventeen states are on the federal map. People from at least four more got sick from the same event and are counted somewhere else, and nobody can say how many people in the remaining states are in the same position, because their departments have not looked or have not said. Every number in the fifty-state count I keep has this problem baked into it, mine included.

San Francisco just showed what genotyping does to that arithmetic.

On August 20 CDC said for the first time that genotyping of samples from sick people shows the parasites in this outbreak are genetically related, which it treats as evidence of a common source. The same day, the San Francisco Chronicle reported that the city has confirmed 10 cyclosporiasis cases this year and that one resident’s infection was genetically associated with the multistate outbreak. That person had traveled elsewhere in the United States, and the recalled lettuce was never distributed in California.

Read that next to everything above. Until this week, a case in a non-outbreak state got connected to the outbreak only if somebody remembered a meal in an interview. Now it can be connected in a laboratory, after the fact, in a city that had no reason to look. If that testing is being run widely, the seventeen-state map is going to start looking less like the footprint of the outbreak and more like a map of which states did the work.

State2026 casesAcquired in another stateTied to this outbreakAs of
Washington6711 traveled to a state with an outbreak or increase3 (Michigan 2, Indiana 1)Aug 14
Florida46031 acquired out of state (as of Aug 1)None statedAug 15
Utah4812None statedAug 5
Oregon2322Jul 24
California41 provisional2 named by the state, plus 1 in San Francisco2 (Taco Bell)Aug 20
Virginia214Reported but not quantifiedNone statedAug 17

State-published cyclosporiasis figures for residents infected while traveling within the United States, as of August 20, 2026, compiled from each state health department and, for San Francisco, from the San Francisco Chronicle. Case totals use each state’s own reporting period, which is why they are not directly comparable. Every other state and the District of Columbia publish no figure of this kind. Florida’s split is reported for the calendar year and was last broken out on August 1.

Washington is also a reminder to check my own work. That state is carried at 36 on my fifty-state chart and its own page now says 67. The correction is mine, and the reason it went unnoticed is the same reason this whole category goes unnoticed. The number was published on a page about travel rather than on a page about the outbreak.

Minnesota and Wisconsin have confirmed forty illnesses and three hospitalizations tied to alfalfa sprouts grown by Everything Sprouts of Minneapolis and sold to restaurants and grocery stores under the Everything Sprouts and Calco brands, with illness onsets running July 8 through August 8 and both states saying as of August 20, 2026 that the count will grow. The sick are carrying Salmonella and three separate serogroups of Shiga toxin-producing E. coli. Four pathogens in one product is the part of this worth stopping on, and it is the part the federal pages do not show.

Two state health departments named the grower on the same afternoon, and their counts do not quite match.

The Minnesota Department of Health release counts 23 Minnesotans ill between July 8 and August 8 with Salmonella and/or various strains of STEC, two of them hospitalized, no deaths. The Wisconsin Department of Health Services release went up the same day and counts 17 Wisconsinites with STEC and Salmonella, one hospitalized. Both departments tell people to check their refrigerators for Everything Sprouts and Calco alfalfa sprouts and throw them out.

The two releases do not agree. Minnesota credits Wisconsin with 18 cases; Wisconsin says 17. Forty is therefore the number I will use, and forty is a floor rather than a finding — Minnesota says additional states are involved, and STEC and Salmonella both take two to four weeks to travel from a sick person to a state database. Anyone who ate these sprouts in the past week is not in this number yet.

Four pathogens in one product is a seed signal, not a kitchen signal.

Mike Stobbe at the Associated Press published the pathogen breakdown of Minnesota’s 23 cases. Read it twice.

PathogenMinnesota cases
Salmonella (serotype not published; one of these patients also positive for STEC O168:H8)3
STEC O103:H257
STEC O26:H1113
Total23

Table 1. Minnesota’s 23 confirmed cases by pathogen, as reported August 20, 2026. Three plus seven plus thirteen equals twenty-three, which matches the total Minnesota published. One patient carried two different organisms at once.

A restaurant that mishandles food gives you one germ. A cook with norovirus gives you norovirus. What does not happen in a kitchen is Salmonella and three unrelated STEC serogroups arriving in the same product on the same days. That pattern means the contamination came in with the seed — alfalfa grown in an open field, exposed to whatever passed through it, harvested and bagged without any step that kills bacteria. The seed then goes into four days in a warm, wet germination tank, which is close to an ideal incubator, and the product is eaten raw. There is no kill step anywhere between the field and the sandwich.

FDA’s table carries two of the four, names no food, and CDC has posted nothing.

Go to FDA’s Investigations of Foodborne Illness Outbreaks table and search for sprouts and you will find nothing. Read the table instead of searching it and two entries appear, both posted August 19, the day before the states named the grower. Reference number 1394 is E. coli O103:H25, 18 cases, product listed as Not Yet Identified, traceback initiated. Reference number 1404 is E. coli O26:H11, 20 cases, product Not Yet Identified, traceback initiated. Those are the two STEC serogroups Minnesota named. There is no row for the Salmonellaand no row for O168:H8.

At CDC’s foodborne outbreak pages there is nothing on sprouts at all. The most recent food notice Atlanta has posted is the jalapeño Salmonella investigation updated August 19. CDC posts notices for a subset of what it works on and points the public to the National Outbreak Reporting System for a complete list, which is a reasonable policy and a poor substitute for a notice. Two states with a named grower, a named brand, forty sick people and product with a short shelf life still moving through refrigerators is exactly the situation a national notice exists for.

FDA warned this grower sixteen months ago, and the letter says nothing about alfalfa and nothing about seed.

On March 28, 2025, FDA issued Everything Sprouts a warning letter — MARCS-CMS 699480, addressed to owner Melissa L. Mann at the Minnehaha Avenue plant, following an inspection that ran October 30 through November 14, 2024. FDA found the firm’s mung bean, soybean and green sprouts adulterated under section 402(a)(4) because they had been prepared, packed or held under insanitary conditions. What the investigator wrote down is worth reading slowly. The roof was leaking through the ceiling tiles in the middle of the production room about four feet from the packaging tables, and the water was dripping onto totes of cooled, exposed mung bean sprouts as pallets moved through for packaging. Condensate was dripping off the condenser units inside the coolers holding sprouts. Black organic matter had built up on the overhead irrigation hose that passes directly over exposed soy sprouts. The plastic sheeting enclosing the growing cabins was ripped in several places and taped, with sprouts stuck to the tape in multiple locations throughout the facility.

Investigators had observed dripping condenser units at the same facility during inspections in 2023 and in 2018, under different ownership. Three inspections across seven years and two owners, and the same water is still dripping. On the roof, the firm told the investigator that it rents the building and that the landlord would repair it as a long-term project and gave no estimated date. FDA wrote that down too.

Twice in that letter FDA said it was unable to evaluate the adequacy of the corrective actions and would judge them at its next inspection. There is no next inspection on the public record — no close-out letter for 699480, no later warning letter, nothing. Sixteen months after FDA said it would check back the check-back had not happened and the product was in a four-pathogen outbreak in two states, and perhaps more.

Outbreaks with more than one germ are rare, and most of the American ones are raw milk.

Multiple serotypes of a single organism turn up fairly often, and sprouts are where they turn up. The 2016 Sprouts Extraordinaire outbreak ran Salmonella Reading and Abony together — 36 sick in nine states, and five people carried both organisms at once. The 2013–14 sprouted chia seed powder outbreak ran four serotypes, 94 sick across 16 states and four provinces. Marler Clark represented victims in both of those.

Genuinely different organisms in one vehicle is much rarer, and nearly every American example is unpasteurized milk. In 2010 the Hartmann dairy in Gibbon, Minnesota produced an E. coli O157:H7 outbreak in the spring and then Campylobacter and Cryptosporidium illnesses out of the same farm that summer. In 2023 Minnesota tied eight cryptosporidiosis cases and one E. coli O111:H8 case to a Hillman raw milk dairy, with one patient carrying both. That release is worth reading today, because MDH wrote down the principle itself: being infected with multiple germs, the department said, is not uncommon in raw milk outbreaks, because the contamination is fecal and fecal material carries whatever the animal was shedding.

That is the same logic now pointing at a seed field. The difference is that in raw milk we accept the multi-germ signature as a known feature. In produce we have no category for it, and the federal reporting form proves it.

The cleanest counter-example is sitting in the same commodity and the same two states. In February 2016 sprouts produced two outbreaks simultaneously — Salmonella Muenchen from Sweetwater Farms in Kansas and E. coli O157 from Jack & The Green Sprouts in River Falls, Wisconsin — and CDC said expressly that the two were not related. Same product category, two pathogens, deliberately kept apart. Minnesota looked at a comparable set of facts this week and went the other way, and Minnesota is right.

Sprouts have caused at least fifty-three American outbreaks in twenty years, and this one already ranks eleventh worldwide.

Here is every sprout outbreak of consequence worldwide over the last twenty years, ordered by size, with this week’s outbreak dropped into place at its current count.

#YearWherePathogenVehicle and firmCases
12011Germany, France, 14 more countriesE. coli O104:H4Fenugreek sprouts, Egyptian seed lot4,075
22015–16AustraliaSalmonella SaintpaulMung bean sprouts, South Australian sprouter547
32009United States, 14 statesSalmonella SaintpaulAlfalfa sprouts, common seed grower (Caudill)235
42010United KingdomSalmonella BareillyBean sprouts231
52010–11United States, 26 states and DCSalmonella I 4,[5],12:i:-Alfalfa sprouts, Tiny Greens140
62014–15United States, 12 statesSalmonella EnteritidisMung bean sprouts, Wonton Foods115
72011GermanySalmonella NewportMung bean sprouts, Dutch producer106
82013–14United States and CanadaSalmonella Newport, Hartford, Oranienburg, SaintpaulSprouted chia seed powder, Argentine seed94
92020United States, 10 statesE. coli O103Red clover sprouts, Chicago Indoor Garden51
102009FinlandSalmonellaBovismorbificansAlfalfa sprouts, Italian seed42
112026Minnesota and WisconsinSalmonella plus STEC O26:H11, O103:H25, O168:H8Alfalfa sprouts, Everything Sprouts / Calco40 and rising
122016United States, 9 statesSalmonella Reading and AbonyAlfalfa sprouts, Sprouts Extraordinaire36
132012United States, 11 statesE. coli O26Clover sprouts, Tiny Greens (Jimmy John’s)29
142016United States, 12 statesSalmonella Muenchen and KentuckyAlfalfa sprouts, Sweetwater Farms26
152011United States, 5 statesSalmonella EnteritidisAlfalfa sprouts, Evergreen Fresh Sprouts25
162014United States, 6 statesE. coli O121Clover sprouts, Evergreen Fresh Sprouts19
172016Minnesota and WisconsinE. coli O157Alfalfa sprouts, Jack & The Green Sprouts11

Table 2. Sprout-associated outbreaks worldwide, 2006–2026, ranked by reported case count. Counts are the final figures published by the investigating agency or in the peer-reviewed report; the 2026 row is Minnesota’s 23 plus Wisconsin’s 17 as of August 20, 2026, and is not final. Compiled from the sources linked below.

The aggregate is worse than any single line. Between 2000 and 2020, at least 53 sprout-associated outbreaks were reported to CDC’s National Outbreak Reporting System, causing 1,498 illnesses, 179 hospitalizations and five deaths. Narrowing to federal multistate files, FDA’s CORE Network handled fourteen multistate sprout investigations between 2012 and early 2020 — 496 laboratory-confirmed illnesses, 82 hospitalizations and three deaths across 45 states. FDA’s own boilerplate has said for fifteen years that there have been at least thirty reported sprout outbreaks since 1996.

Raw sprouts are the one produce item where the science has been settled for thirty years, and the advice has never changed.

Children, older adults, pregnant women and anyone with a weakened immune system should not eat them raw, ever. Everyone else should understand what they are choosing. Cooking sprouts thoroughly kills the bacteria; nothing you do at the sink will.

Three questions people are asking today.

I have Everything Sprouts or Calco alfalfa sprouts in my refrigerator. What do I do? Throw them away, in a sealed bag. Do not taste them and do not wash them and eat them — washing does not remove bacteria that grew inside the sprout during germination. Wash your hands and clean the drawer they sat in.

I ate them and I feel fine. Am I in the clear? Salmonella usually shows up six hours to six days after exposure and STEC two to five days, so watch for a week. Fever, stomach cramps and diarrhea — especially bloody diarrhea — mean call a doctor and say you ate raw sprouts.

Why does this keep happening to sprouts specifically? Because contamination usually arrives on the seed rather than in the plant, and the sprouting process is a warm wet incubation that multiplies whatever is present, on a product designed to be eaten raw. There is no step anywhere in that chain that kills bacteria before you eat them.

Under Control says RFK Jr.

CDC updated its outbreak investigation page today, August 20, and the multistate Cyclospora outbreak linked to Taylor Farms de Mexico iceberg lettuce now stands at 10,930 illnesses and 454 hospitalizations across 17 states, with 2 deaths in Michigan and illness onsets running from June 14 through August 11. Counting every state that publishes a number of its own, the fifty-state total is 31,889, up from 30,523 on Saturday. Nine rows on my chart have moved.

Cyclosporiasis is a diarrheal illness caused by Cyclospora cayetanensis, a microscopic parasite spread through food or water contaminated with human feces. It is not spread person to person, symptoms usually begin about a week after exposure, and without treatment they can come and go for a month or more.

CDC added 1,449 people to the outbreak today and did not add a single state.

A week ago the federal outbreak was 9,481 illnesses and 398 hospitalizations. Today it is 10,930 and 454, and the Fast Facts block says seventeen states with none new. That has not happened before in this investigation. Every prior update grew the map as well as the count, from five states to nine to fifteen to seventeen. This one added fourteen hundred people inside the footprint the agency already had.

For the first time, CDC says laboratory work ties these illnesses to each other.

Buried at the end of today’s update is a paragraph that was not there last week. Public health investigators are performing genotyping on samples from sick people, and CDC says the parasites that caused these illnesses are genetically related, which it calls additional evidence that the people in this outbreak got sick from the same source. CDC is careful to say genotyping is not whole genome sequencing. It targets particular markers to group related parasites rather than reading the whole organism.

Read that precisely, because it matters in both directions. It ties the patients to one another. It does not tie them to a head of lettuce, because there is no product isolate to compare them against and there never was. What it does do is close off the argument that this summer is just a lot of unrelated cyclosporiasis piling up at once, which is the strongest version of the case I laid out on my own blog yesterday. It also explains something I flagged two days ago, when the surveillance page quietly changed from saying CDC was working to develop and validate molecular tools to saying it uses them. The tools are being used, and today we learned what they found.

FDA updated on the same day, with the same figures, and changed one sentence that says a great deal. On August 13 the agency said it had initiated an onsite inspection and sampling at Taylor Farms de Mexico, the processor. Today it says it has initiated onsite inspections and sampling at iceberg lettuce growers in Mexico, plural, and that it is working with federal, state and international partners. The investigation has moved upstream from the plant to the fields. That is where a water-borne parasite would have reached the lettuce in the first place, and it is the part of the chain the traceability rule was written to make visible.

The backlog grew by 1,386 in the same week confirmations grew by 1,821.

CDC’s surveillance page is a different count from the outbreak count, and it updated Tuesday with data through August 17. It stands at 15,716 laboratory-confirmed cases of cyclosporiasis acquired in the United States since May 1, with 828 hospitalizations, across forty-seven states, the District of Columbia and Puerto Rico. The travel-associated series, counted separately and not part of this outbreak, is 1,681 with 61 hospitalizations.

The number of additional cases awaiting further investigation went from 10,455 to 11,841. New illnesses arrived faster than the laboratory work could clear them. A week ago that pile shrank for the first time all season and I read it as the lag finally clearing. It grew again. Confirmed and pending together now come to 27,557.

Seven in ten confirmed cases are now assigned to the lettuce.

Set the two federal counts against each other and the attribution ratio finally moved the right way. Of the 15,716 confirmed cases, 10,930 are assigned to the recalled lettuce, roughly seven in ten, where a week ago it was closer to six. Against the combined federal figure it is four in ten, and against the fifty-state total below it is about a third, which is another way of saying that two out of every three people counted in this country this summer have no federal attribution of any kind. Attribution here means a sick person told an interviewer what they ate, and the outbreak’s first illness is still dated June 14, three weeks in front of the earliest lettuce in the recall.

CDC also refreshed its outbreak map today, and the bands on it are worth a second look. The highest category tops out at 5,000 illnesses, which means no single state has more than five thousand of its cases assigned to this outbreak. Michigan by itself reports 14,277 cases of cyclosporiasis this season. The two figures count different things, because CDC counts only laboratory-confirmed illnesses it has attributed to the lettuce and Michigan counts every case reported during the investigation period. The gap is still the whole argument in one line. The hardest-hit state in the country has, at most, about a third of its illness assigned to the food that was recalled.

Not one state publishes an attribution split of its own. Michigan says plainly that it counts every case of cyclosporiasis reported during the investigation period rather than lettuce-attributed cases, and its investigators interviewed more than 2,900 sick people, many of whom never reported eating at Taco Bell, at another chain, or at any food establishment at all. New Hampshire is the exception, and it is the whole argument in one building. Sixty-nine cases statewide, thirty-two of them tied to recalled product, and the cluster began with nine people who ate from a hospital cafeteria salad bar in Keene. Ten of the sixteen people known to be exposed there were employees. That is the highest attribution rate in the country, and the reason is not that the lettuce in New Hampshire was different. A hospital can see illness in its own workforce and report it the same week. A grocery store cannot.

CDC deleted the paragraph that told readers where the lettuce went.

Something else changed today and it was not a number. The paragraph naming where the recalled lettuce was distributed, at least thirty-one states, to consumers, restaurants and retailers, including Taco Bell locations and Marketside products at select Walmart stores, has been removed from the consumer page, and the link to the recall notice, issued under the name Taylor Fresh Foods, went with it. What is left says the recall happened and the best-by dates have passed. The caption under the photograph now reads that the outbreak was linked to Taylor Farms de Mexico lettuce, in the past tense, where last week it read is. The tense is defensible, because the product really should be off the shelves by now. The distribution list is a different matter. It was the only place on a consumer-facing federal page where a reader could learn whether the lettuce reached their state, and it came down on the day the count went up by 1,449. FDA still publishes both lists, the foodservice distribution across thirty-one states and the Walmart retail list of fifteen, so the information has not vanished from the government. It has come off the page a worried consumer is likeliest to land on.

The six other clusters are still there. CDC says it and FDA are investigating at least six more groups of cases whose sources have not been confirmed, and points readers to FDA’s active investigation table, where they sit at 172, 25, 18, 11, 8 and 2 illnesses. That is 236 people carrying this parasite with no food named for any of them. That table has not been updated since August 12.

Michigan had its smallest week of the outbreak, and Texas turned out to be short by 117.

Michigan posted this morning at 14,277 cases and 335 hospitalizations, up 368 and 21. That is a rise of under three percent, the smallest week the state has had, and the department says the increase largely reflects a processing backlog rather than new illness. Wayne County is at 2,029 and Oakland at 1,499. Elsewhere, Missouri released a Sunday figure of 1,950, up 373 in a week. Illinois turns out to have been at 1,260 as of August 11 and Iowa at 300 across fifty-five counties as of August 13, and I had been carrying both at older numbers. Indiana posted 2,069 and crossed two thousand. New York posted 939 in its Wednesday update. Virginia is at 214 and Arkansas at 277. West Virginia holds at 304 and reports again on Friday.

Then there is Texas, and that correction is mine rather than anybody else’s. My chart last week carried 198, which is the figure the state gave a reporter on August 5. Texas does not run a dashboard. It hands a count to reporters once a week, and the most recent one published is 315 cases with 52 hospitalizations, an increase of more than a hundred in a single week. Texas is not one of the seventeen states in the federal outbreak, and the state says no source has been identified for its own cases.

Texas is also the row CDC’s new map flagged. When CDC published a downloadable state map last week the values came in bands rather than exact counts, and seven rows on my chart sat below the bottom of the band CDC had placed that state in. Texas was the first one I went back to and it was low by 117. Louisiana, Georgia, Tennessee, Minnesota, New Jersey and Pennsylvania are the other six, and every one of them still rests on a July roundup rather than on a state page. Utah belongs in the same paragraph: this chart says 1, and Utah’s own health department reports 48 cases since May 1, of which 17 is the like-for-like figure against the rest of this table. Those rows are mine to fix, and I would rather say so than quietly restate them.

Here is where all fifty states stand today. The Lettuce column is whether FDA has confirmed that recalled Taylor Farms de Mexico lettuce reached that state. The last column is a different question and the more important one: whether anybody has tied that state’s illnesses to Taylor Farms at all.

State2026 casesAs ofAll of 2025LettuceTaylor Farms
Michigan14,277Aug 2050YesLinked
Ohio5,452Aug 1376YesLinked
Indiana2,069Aug 1927YesLinked
Missouri1,950Aug 16none reportedYesLinked
Illinois1,260Aug 11301YesLinked
New York939Aug 17694YesUnknown
North Carolina906Aug 11300YesLinked
Kansas748Aug 1229YesLinked
Kentucky620Jul 2945YesLinked
Oklahoma506Aug 1141YesLinked
Florida407Aug 8210YesUnknown
Texas315Aug 11512YesUnknown
West Virginia304Aug 148YesLinked
Iowa300Aug 1364YesLinked
Arkansas277Aug 1713YesLinked
Nebraska218Aug 651YesLinked
Wisconsin216Aug 565YesUnknown
Virginia214Aug 17115YesUnknown
Colorado150Jul 17205NoUnknown
Massachusetts145Aug 574YesLinked
Alabama85Aug 319YesUnknown
Pennsylvania82Jul 29not notifiableYesLinked
Maryland69Jul 17123YesNo link found
New Hampshire69Aug 47YesLinked
New Jersey46Jul 11180YesUnknown
California41Jul 14not availableMay haveUnknown
Minnesota41Jul 17none reportedNoUnknown
Washington36Aug 7not availableMay haveTravel link
Connecticut35Jul 1741YesUnknown
Maine27Aug 74YesLinked
Oregon23Jul 24not availableNoTravel link
Arizona19Jul 1749NoUnknown
Georgia11Jul 17116YesUnknown
Tennessee11Jul 1738YesUnknown
Mississippi7Jul 22not notifiableYesUnknown
Alaska5Jul 166NoUnknown
Rhode Island4Jul 176May haveNo link found
South Dakota3Jul 163May haveUnknown
Louisiana1Jul 1799YesUnknown
Utah1Jul 1737NoNo link found
Hawaii5, all travelAug 14not availableNoNo link found
Delawareno count published1May haveUnknown
Idahono count publishednot notifiableNoUnknown
Montanano count published8NoUnknown
Nevadano count publishednot notifiableNoUnknown
New Mexicono count published9NoNo link found
North Dakotano count published4May haveUnknown
South Carolinano count published45YesUnknown
Vermontno count published3May haveUnknown
Wyomingno count published0NoUnknown
All fifty states31,889  3117

2026 cyclosporiasis counts as published by each state health department, as of August 20, 2026, compiled from the sources linked in each row. The forty counted rows sum to 31,889; Hawaii’s five travel-associated cases are shown and excluded from the total.

Twenty-six states have illnesses nobody has tied to this outbreak or ruled out of it.

Seventeen states are marked Linked, and that is the whole federal outbreak. They are the states FDA and CDChave attributed to the recalled lettuce, and for the nine that came first the attribution rested on Taco Bell exposure, which is to say on a customer remembering where they ate. Two more, Oregon and Washington, are marked Travel link, because their cases are residents who got sick after visiting an outbreak state rather than from anything sold at home. Five health departments have looked and said their cases are not tied to this outbreak: Rhode Island, New Mexico, Maryland, Utah and Hawaii. New Hampshire is still the only state anywhere that has named a Taylor Farms product at a specific place, a hospital cafeteria in Keene.

That leaves twenty-six marked Unknown. Between them they have reported thousands of illnesses, and not one of those illnesses has been either tied to this outbreak or ruled out of it. Thirteen of the twenty-six are on the federal list of states that received the recalled product, and they are still Unknown. That is not a finding that the lettuce stopped at their borders. It is the absence of the question.

Forty states publish a 2026 count that is added into the total above. Hawaii publishes five and says all five are travel-associated, so they are shown and left out of the sum. Nine states publish nothing at all: Delaware, Idaho, Montana, Nevada, New Mexico, North Dakota, South Carolina, Vermont and Wyoming. South Carolina is on FDA’s confirmed distribution list and reported 45 cases in 2025, so it plainly counts this disease when it wants to. Its residents cannot look up a single number this season.

The numbers are larger than we can comprehend. Most people with cyclosporiasis never get a stool test, because the parasite is missed by the routine ova and parasite exam and has to be asked for by name, and because somebody with a diarrheal illness that comes and goes for a month often never sees a doctor at all. The standard estimate of that gap comes from Scallan and colleagues, Foodborne Illness Acquired in the United States, Major Pathogens, in Emerging Infectious Diseases in 2011, which puts the underdiagnosis multiplier for Cyclospora at 83.1. Applied to CDC’s 15,716 laboratory-confirmed cases, that puts the real number near 1,306,000.

Three questions I am being asked this week.

Is the recalled lettuce still out there?

Both agencies say no. The best-by dates on the recalled Taylor Farms de Mexico product ran out weeks ago and it should not be in a store or a restaurant. The count keeps climbing because of the reporting lag, not because the same lettuce is still being served.

I got sick in July. Am I in these numbers?

Probably not yet, and possibly never. A case reaches the federal count only if a stool sample was tested specifically for this parasite and the person was interviewed afterward, and CDC says that can take as long as six weeks. Routine stool testing does not look for Cyclospora unless a physician asks for it by name.

Is it over?

The most recent illness CDC has dated began on August 11, nine days ago. The season the agency tracks closes on August 31.

Michigan had its smallest week of the outbreak today, and on the same day CDC added 1,449 people to the federal count without finding a new state to put them in. Both of those things are true at once. Eleven days remain in the season. The counting will not stop with it.

Minnesota and Wisconsin have tied 41 illnesses — 23 in Minnesota, 18 in Wisconsin — to alfalfa sprouts grown by Everything Sprouts, a Minnesota grower, and sold to restaurants and grocery stores under the Everything Sprouts and Calco brands. As of August 20, 2026, two people have been hospitalized and no one has died. Minnesota illness onsets run July 8 through August 8. Other states have found cases too.

If either brand is in your refrigerator, throw it out. Washing will not fix a contaminated sprout, and theMinnesota Department of Health (MDH) and Minnesota Department of Agriculture (MDA) are telling people to discard them rather than eat them.

Two different pathogens in one outbreak usually points at the seed.

The unusual fact in this release is not the case count. It is that MDH is reporting Salmonella and several strains of Shiga toxin-producing E. coli in the same cluster. Contamination introduced inside a sprouting facility — dirty equipment, a bad water line, an infected worker — tends to show up as one organism. When a run of sprouts carries several organisms at once, the explanation that has held up over three decades of these outbreaks is the seed itself: contaminated in the field or in storage, then handed to a sprouter who unknowingly amplifies it.

That matters for one practical reason. A sprouter buys seed by the lot, and a seed lot goes to more than one sprouter. In the 2009 Salmonella Saintpaul outbreak, investigators traced sprouts back to multiple growers in multiple states, which is precisely what pointed them at the seed. Neither Minnesota agency has said where Everything Sprouts got its seed or whether anyone else bought from the same lot. Until someone answers that, no one can say this outbreak stops at one grower.

Two brand names on one grower’s product is how sprouts reach you anonymously.

The sprouts in this outbreak went out under Everything Sprouts and under Calco. A consumer who buys the Calco clamshell has no reason to know who grew what is inside it, and a diner who gets sprouts on a sandwich has no label at all. That is the ordinary condition of this commodity, and it is why a warning keyed to a grower’s name reaches only part of the people who need it.

Twenty-three cases in about a month against a Minnesota baseline of 85 a year.

MDH reports that Minnesota normally sees roughly 85 STEC infections a year from the serogroups involved here, and about 1,000 Salmonella infections a year statewide. Set the outbreak against that baseline:

MeasureAs reported
Minnesota cases23
Wisconsin cases18
Total in the two states41
Other statesAdditional illnesses reported; no count released
Hospitalized2
Deaths0
Minnesota onset windowJuly 8 – August 8, 2026 (32 days)
Minnesota STEC baseline, these serogroupsAbout 85 cases per year
Minnesota Salmonella baseline, all sourcesAbout 1,000 cases per year

Source: MDH news release, August 20, 2026. State counts are as stated in the release; the 41 is my addition of the two. Check: 23 + 18 = 41.

The 32-day onset window is roughly nine percent of a year. Minnesota’s share of this outbreak is a meaningful fraction of what the state records from these organisms across an entire year, compressed into a month, and one grower’s product accounts for it.

Antibiotics are the wrong reflex for a Shiga toxin infection.

STEC illness usually starts two to five days after exposure and brings cramps and diarrhea that is often bloody, with little or no fever. Most people are better in five to seven days. Some are not: STEC can progress to hemolytic uremic syndrome, acute kidney failure, and treating that diarrhea with antibiotics can make HUS more likely rather than less. Anyone with bloody diarrhea should be seen by a doctor and should say out loud that sprouts were on the menu, because that one sentence changes what gets tested and what gets prescribed.

Salmonella runs a different course — diarrhea, abdominal pain and fever beginning anywhere from 12 hours to two weeks after exposure, usually clearing in five to seven days, with about 28 percent of laboratory-confirmed cases hospitalized. MDH keeps plain-language pages on Salmonella and on non-O157 STEC.

Sprouts have been doing this since 1995, and the guidance has been on the books since 1999.

None of this is new information to anyone in the sprout business. FDA issued sprout-specific guidance in 1999 recommending seed disinfection immediately before sprouting and testing of spent irrigation water on every batch. Outbreaks kept coming anyway, and when inspectors finally walked through the facilities they found what they found at Evergreen Fresh Sprouts in 2014 — irrigation water dripping off rusted valves, a corroded pitchfork used to move sprouts, a tennis racket used as a scoop.

The warm, wet, nutrient-rich conditions that turn a seed into a sprout are the same conditions a laboratory would choose to grow Salmonella. A handful of organisms on a seed becomes millions on the finished product in a few days, and there is no kill step afterward, because the product is sold to be eaten raw. This is why I do not eat them and have said so for thirty years.

The 41 are the people who got tested.

Forty-one is a floor, not a total. It counts the people sick enough to see a doctor, whose doctor ordered a stool culture, whose sample was cultured rather than screened, and whose isolate was sequenced and matched. Everyone who rode it out at home is invisible to that count. Both agencies say the number will rise, and the ordinary lag between getting sick and being counted means illnesses from the first week of August are still working their way through the system.

If you ate alfalfa sprouts in the past two weeks, what should you watch for? Cramps and diarrhea, particularly bloody diarrhea, and in the case of Salmonella, fever. Call your doctor and tell them you ate sprouts.

You have Calco or Everything Sprouts sprouts in the refrigerator — now what? Throw them out. Then wash the drawer they sat in and anything they touched with hot soapy water.

Should you ask for antibiotics? Not on your own. For a Shiga toxin infection, antibiotics can increase the risk of kidney failure. Let a physician who knows sprouts were involved make that call.

Two people are in the hospital and 41 are counted so far because a raw agricultural product with a thirty-year record of doing exactly this went out under two brand names into restaurants and grocery stores. The seed question is the one that decides whether this is one Minnesota grower’s problem or somebody else’s next month.

Updated August 20, 2026. This post first ran on July 23. Since then FDA has released the enforcement file for the July recall, which turns out to cover 236,192 cases and to name the buyers; the Cyclospora outbreak has grown by an order of magnitude; a second Taylor Farms recall has been issued in a different outbreak, from a different pathogen, in a different vegetable; and four recalls I had missed have been added to the roster below. What follows is the whole record as it now stands.

Every time Taylor Farms turns up at the center of an outbreak, the company says the same thing. This is an isolated event, our branded products are not involved, we acted quickly. Let us put the record in one place. What follows is every Taylor Farms outbreak I can verify from public sources, with the pathogen, the dates, the number of people sickened, and the product. I know these personally, because I represented the people and families impacted.

Then every recall I can verify, sorted by pathogen. Read them together and a pattern shows up that no single press release can explain away.

Three of the biggest outbreaks on this page produced no recall, and the biggest recall could not reach the food that made people sick.

Pay particular attention to the gap between the two lists. Three of the largest outbreaks here — 2013, November 2024, and the 2021 romaine cluster — produced no recall at all. Two more produced recalls that went only to foodservice customers by direct notice, with nothing posted for the public to read.

There is now a third category, and it is the one I would not have written in July. A recall can be announced the same day it is initiated, cover a quarter of a million cases of product, and still be incapable of reaching the food that made people sick. That is what the federal enforcement file shows about July 2026, and I will come to it below. A recall is not proof the system worked. Sometimes it is only proof that the shelf life ran out.

The outbreaks, in order, and whether a recall followed.

2009 — Salmonella Typhimurium — shredded lettuce. Shredded lettuce sickened 145 people in the western United States and at least 12 more in Canada. The product was shredded lettuce sold into fast-food and foodservice accounts, and the illnesses pointed at the processing step rather than at any one restaurant. No recall. This is the outbreak nobody remembers, four years ahead of everything else on this list.

June to August 2013 — Cyclospora — bagged salad mix. 631 people in 25 states were sickened. Iowa and Nebraska health officials concluded that the restaurant cases in their states traced to a salad mix produced by Taylor Farms de Mexico, served at Olive Garden and Red Lobster. The Texas cases, a large share of the national total, were never conclusively tied to the same product. In August, FDA, CDC and five Mexican agencies conducted an environmental assessment of the Doctor Mora plant and five ranches — not an inspection, and the distinction matters, because it is the reason the document exists at all. It remains the single most-cited record in this company’s history. No recall was issued. Production was suspended; the product already in commerce stayed there.

One line from 2013 has been repeated ever since and it is not accurate. The tests did not come back clean. Roughly 835 samples were negative, but the recycled wash water sample came back inconclusive, because turbidity defeated the filtration method entirely. FDA’s own method literature and the produce industry’s own technical bulletin both say that the 2013 investigation is what broke that method and drove the development of its replacement. The instrument clogged. That is not the same as a negative, and thirteen years later there is still no public result from the sampling program the company described to FDA.

November 2015 — E. coli O157:H7 — celery and onion diced blend. Nineteen people in seven states were infected, five were hospitalized, two developed hemolytic uremic syndrome and one required a kidney transplant. The vehicle was Costco’s rotisserie chicken salad; the ingredient was the celery and onion diced blend from Taylor Farms Pacific in Tracy, California. Montana’s public health laboratory got a presumptive positive off a retail sample. Taylor Farms Pacific recalled the blend and many other celery-containing products on November 26, 2015, and the recall grew past 155,000 items across Costco, Walmart, Sam’s Club, Target, Safeway, 7-Eleven and Starbucks. FDA’s follow-up analysis could not confirm the organism, and the company has called it a false alarm ever since. Nineteen people were still sick.

November 2021 — E. coli O121:H19 — romaine lettuce. A small cluster, and a telling one. Two Washington cases reported eating romaine at Panera Bread and two Minnesota cases reported eating romaine at Chipotle; the lettuce traced back to Taylor Farms. No recall, and no CDC advisory. I have since obtained the underlying records, and they are worse than the summary suggests. FDA’s own incident report redacts the converged processing facility under exemption (b)(4). The environmental assessment written by Public Health — Seattle and King County names Taylor Farms of Salinas outright, four separate times. CDC’s internal cluster deck contains the distributor receiving log with the lot numbers and harvest regions unredacted. And the national NORS record for the outbreak has an empty field where the King County assessment should have been linked, so the one document that named the company never reached the national file. FDA collected no samples, made no public communication, and closed the investigation in six days.

May 2023 — Cyclospora — Taco del Gnar, Ridgway, Colorado. The Colorado Department of Public Health and Environment and Ouray County Public Health investigated Cyclospora infections among patrons of a single restaurant, with fresh produce implicated and the supply chain running back to Taylor Farms. The public entry does not carry a case count. No recall. A documented single-restaurant Cyclospora cluster is rare, and this one sits three years ahead of the current outbreak with the same parasite and the same supplier.

October to December 2024 — E. coli O157:H7 — slivered yellow onions. One hundred four people in fourteen states, 34 hospitalized, four with hemolytic uremic syndrome, and one dead in Colorado. Sixty-three of 75 people interviewed — 84 percent — reported a menu item containing fresh slivered onions, and FDA’s traceback pointed at the onions served on McDonald’s Quarter Pounders. Taylor Farms initiated a voluntary recall of yellow onions on October 22, 2024 and notified its foodservice customers directly. There was no consumer-facing recall notice. FDA closed the investigation without ever recovering the outbreak strain from an onion, and the Colorado Springs plant drew a Form 483 listing biofilm on cleaned equipment, pre-op checks signed as passing on surfaces the investigator says should have failed, and about a dozen non-food-contact surfaces testing positive for Listeria across twenty months.

November 2024 — E. coli O157:H7 — romaine lettuce. Eighty-nine people in fifteen states, with onsets from November 4 to November 30, 2024. Thirty-six were hospitalized, seven developed HUS, and one person died. CDC and FDA closed the investigation in January 2025 without telling the public which company grew the lettuce. Our own epidemiologist found the common thread among clients who were whole-genome-sequencing matches to one another, and the name came out through federal court filings in April 2025. No recall. Fifty of the 89 were in Missouri, most of them from salads catered at a St. Louis high school. Taylor Farms denies every bit of it. In a statement to The Packer, the company said Taylor Farms product was not the source of the referenced 2024 E. coli outbreak, maintaining that its raw and finished product testing showed nothing and that tying its products to these illnesses was unfair to the families who got sick. Set that against what the traceback actually found: a single processor sourcing romaine from a single grower, with the lettuce at four of the five points of service running back to the same ranch and the same lot. See the unredacted FDA traceback report.

The 2026 Cyclospora outbreak is the largest in American history, and the recall behind it never could have reached the lettuce that caused it.

May 2026 to present — Cyclospora — shredded iceberg lettuce. The one we are living through, and it has grown beyond anything on this page. FDA’s advisory now counts 9,481 illnesses across seventeen states, 398 hospitalizations and two deaths, with the last illness onset on August 3. Those are the laboratory-confirmed cases tied to the recalled product. CDC’s national surveillance page reports 15,716 laboratory-confirmed cases of domestically acquired cyclosporiasis since May 1, against 1,180 in the same period of 2025, with at least 11,841 more that may require further investigation. My own fifty-state chart, built from what the states publish about themselves, stands above thirty-one thousand.

FDA’s traceback converged on a single supplier, Taylor Farms de Mexico, which provided the shredded iceberg lettuce used at Taco Bell locations where sick people ate. Taylor Farms de Mexico recalled all central-Mexico iceberg lettuce on July 17, 2026. The shredded product had gone into 27 states between June 29 and July 16, and Marketside-brand consumer bags were pulled from Walmart stores in 15 states, which is worth remembering every time you hear that only restaurants were affected.

Three weeks later FDA’s enforcement system produced the file, and I went and added it up. Event 99453 runs to twenty-one entries and 236,192 cases. That total appears nowhere — not in the company’s announcement, not on FDA’s website, not in any news story — because the system lists the entries and never sums them. The file also spells out the buyers the July notice had reduced to initials: Walmart’s Marketside at 109,476 cases, Taylor Farms’ own label, Cross Valley Farms, Sysco, Subway, Markon, Yum, Jack in the Box and Peak. Subway, at 8,075 cases, is the largest single restaurant chain in the recall and has said nothing publicly about it. Nearly 29 percent of the recalled volume was not iceberg-only — romaine, carrots and red cabbage came out of the same plant and into the same recall, and no federal outbreak page says so. The distribution field also lists Mexico, and I have not been able to find any notice given to Mexican consumers.

Here is the part that changes how this page should be read. Not one of the 236,192 cases carries a use-by date earlier than July 19, 2026 — two days after the recall was announced. CDC’s median illness onset was June 22. Lettuce cut before the end of June had already expired by July 17. It had been eaten. You cannot recall it. The front edge of that recall is not a finding about when contamination began. It is the recall date minus the shelf life. One thing in the file cuts against me and I will say it plainly: the recall initiation date is July 17, the same day it was announced. There is no hidden earlier date, and anyone waiting for one, myself included, should stop waiting.

Marler Clark has filed five complaints out of this outbreak so far, in Ohio, Michigan and Kentucky, against four separate franchise operators and Taco Bell itself, along with the Taylor entities. Four different operators, one lettuce supplier. We have been retained by more than four hundred people in twenty states to investigate how they acquired Cyclospora.

A second Taylor Farms recall this summer came from a different pathogen, a different vegetable and somebody else’s outbreak.

August 2026 — Salmonella Javiana — jalapeño peppers. This one belongs on the page, but not in the list above, and the distinction is the whole point. It is not a Taylor Farms outbreak. CDC and FDA traced it to jalapeños grown in Sinaloa, Mexico and imported by Coast Citrus Distributors, and the count now stands at 431 sick in 32 states with 57 hospitalizations, onsets running from June 19 to August 2. The grower has still not been named. Taylor Farms bought a contaminated ingredient here, the same as every other company downstream of it.

On August 9, Taylor Fresh Foods recalled twenty products made with those peppers — salsas, dips, guacamole, pico de gallo, sandwiches, salads and wraps — distributed to retail distribution centers in twenty-six states with best-if-used-by dates through August 16. The day before, USDA issued a public health alert for eighteen meat and poultry products made with the same jalapeños, fourteen of them out of four Taylor Farms plants. Two federal agencies, two documents, one ingredient.

The fairness point comes first, because it is real. The recalled Taylor Farms items carry best-by dates that begin after the last illness onset in the original reported window. This was a precautionary downstream recall of product built from the same grower’s peppers, not a recall of the food that made anyone sick. Going wide was the right instinct and the company deserves to have that said.

It earns its place here for a different reason. It is the mirror image of the lettuce recall, from the same parent company, six weeks apart. The lettuce recall reached exactly one consumer grocery banner: Marketside. The jalapeño recall reached seven — Hannaford, Kroger, Stop and Shop, Target, Trader Joe’s, Walmart and Whole Foods. Same company, same summer, two completely different levels of public visibility. And inside the jalapeño recall the same problem shows up at the level of the package: only five of the twenty recalled items carry a Taylor Farms name. Eleven carry no brand at all. A shopper holding the tub cannot tell who made it.

Every recall I can verify, sorted by pathogen.

Cyclospora cayetanensis

July 17 and 18, 2026 — shredded iceberg lettuce, iceberg salad, lettuce and romaine blends, and salad mixes with carrots and red cabbage, Taylor Farms de Mexico. Twenty-one entries, 236,192 cases, nine customers, foodservice in 27 states, Marketside consumer bags at Walmart in 15 states, plus foreign distribution to Mexico. Still unclassified in FDA’s system as of this writing.

E. coli O157:H7

November 26, 2015 — celery and onion diced blend and other celery-containing products, Taylor Farms Pacific; expanded past 155,000 items.

October 22, 2024 — whole peeled, jumbo peeled and diced yellow onions; foodservice customers notified directly, no public notice.

Salmonella

May 2, 2011 — ready-to-eat salad kits containing recalled Six L’s grape tomatoes, Taylor Farms Pacific; about 22,000 pounds on the USDA side.

October 2011 — 3,265 cases of bagged salad blends under the Fresh Selections, H-E-B, Marketside and Taylor Farms labels, Taylor Farms Retail, after a random finished-package spinach test by the Washington State Department of Agriculture; 15 states and Puerto Rico. No illnesses reported.

March 2018 — three-eighths-inch diced yellow onions, Taylor Farms California Foodservice; no FDA or company notice was ever posted, only the downstream grocer’s.

October 17, 2018 — pork carnitas bowls, 276 pounds, Taylor Farms Northwest of Kent, Washington, on recalled fire-roasted diced tomatillos carrying both Salmonella and Listeria monocytogenes; Oregon and Washington.

August 2020 — diced onions, salads, stir fry and mirepoix, Taylor Farms Texas; Marketside and Taylor Farms brands at Walmart and Kroger in 11 states.

2021 — Taylor Farms brand Maple Bourbon Chopped Kit, 315 g, recalled in Canada; Class 2. A branded consumer salad kit.

February 2024 — Taylor Farms brand Mexican Style Street Corn Chopped Salad Kit, 329 g, recalled in Canada on Canadian Food Inspection Agency test results; six provinces.

December 2024 — Taylor Farms brand Sweet Kale Chopped Kit, 340 g, recalled in Canada on CFIA test results; six provinces.

August 9, 2026 — twenty salsa, dip, guacamole, pico de gallo, sandwich, salad and wrap products made with recalled Coast Citrus jalapeños, Taylor Fresh Foods; seven retail banners, 26 distribution-center states. A companion USDA public health alert the day before covered eighteen meat and poultry products, fourteen of them from four Taylor Farms establishments.

Listeria monocytogenes

October 2013 — broccoli salad kits, 5,084 pounds, on account of dressing packets under FDA recall; a companion Taylor Farms action pulled about 5,000 units of broccoli salad across 23 states.

February 11, 2017 — chicken and pork salad products, 6,630 pounds, from the Dallas and Tracy plants.

October 23, 2021 — Taylor Farms Mushroom Stir Fry, 9 oz., Kroger stores in eight states.

February 9, 2024 — Marketside Bacon Ranch Crunch Salad Kit, on the expanded Rizo-López Foods cheese recall.

Undeclared allergens and misbranding

October 24, 2014 — walnuts, Signature Café Broccoli Kale Salad with Chicken, 377 pounds.

May 26, 2016 — wheat and sesame, Wawa Thai style chicken mango salad, 151 pounds.

August 7, 2017 — milk, Taylor Farms Creamy Homestyle Coleslaw Kits, 293 cases.

October 28, 2017 — fish (anchovies), salads with chicken, Taylor Farms Florida, 732 pounds.

August 29, 2018 — egg and wheat, homestyle beef and pork meatloaf, Taylor Farms Illinois, 75 pounds.

May 14, 2019 — Caesar salad with chicken, Taylor Farms Texas, 1,079 pounds.

May 27, 2022 — wheat and egg, Trader Joe’s Lemony Arugula Basil Salad Kit, Taylor Farms Retail.

March 13, 2024 — wheat, Kroger apple walnut with chicken salad bowls, Taylor Farms Pacific, 19,976 pounds.

August 26, 2025 — sesame and soy, Taylor Farms Honey Balsamic Salad Kit, 25 states.

Processing defect

August 9, 2019 — breaded chicken products that may have been undercooked, Taylor Farms Illinois, 342 pounds.

The quiet recalls are in a database nothing indexes, and I have now run the search I told you to run.

This list is still not complete, and I want to be plain about why. FDA’s public recall page carries only the announcements a company chooses to make public. The quiet ones — the direct-to-customer foodservice recalls, the low-classification actions nobody writes a press release about — are recorded instead in FDA’s Enforcement Report Database and in the Recall Enterprise System search, which is searchable by firm and covers 2004 to the present. Anyone doing this work should run that search under every corporate name the company files under: Taylor Farms Retail, Taylor Farms Pacific, Taylor Farms Texas, Taylor Farms California Foodservice, Taylor Farms Illinois, Taylor Farms Florida, Taylor Farms Tennessee, Taylor Farms Maryland, Taylor Farms Northwest, Taylor Farms de Mexico, and Taylor Fresh Foods. Search one string and you will miss most of them. Meat and poultry recalls sit with USDA’s Food Safety and Inspection Service instead, which is why so many of the entries above point there.

When I wrote that in July it was advice. Since then I have taken it, at least partway. The search under the Doctor Mora entity is what produced Event 99453 and the 236,192 cases, and it took an evening and a spreadsheet export to total by hand. Four of the entries added to the roster above — October 2011, October 2018, and the two Canadian kit recalls in 2024 — came out of the same kind of digging. The search under the United States corporate names has not been run to the bottom, and I will say so rather than let this page imply otherwise. If a separate enforcement event exists under Taylor Farms Retail or Taylor Farms Texas, it is sitting exactly where the jalapeño entry was sitting last month.

The last time an FDA investigator walked into the plant at the center of this outbreak, it was 2019, and there is nothing to read about it.

One more thing belongs on a page about what the public gets to see. FDA has been inside Taylor Farms de Mexico three times in fifteen years — a routine inspection in 2011, the outbreak response in 2013, and an inspection in 2019 that found no violations. The only visit that produced a document anyone can read is the one that happened after 631 people were already infected. A clean inspection produces a database row. A deadly one produces a report. In the first half of 2026, five of the company’s more than 168,000 produce shipments from Mexico were physically examined at the border. None of that is concealment. It is design, and it predates this administration and the last one. But it is why almost everything the public knows about that plant was written after somebody got sick.

The two outbreaks that killed someone are the two where nobody was given a recall notice to read.

Here is the thing I keep coming back to. The two outbreaks on this page that killed someone before this year — the onions in October 2024 and the romaine in November 2024 — are also the two where the public was never given a recall notice to read. In the first, customers were told and consumers were not. In the second, nobody was told at all until we filed suit.

And now there is a third way for a recall to fail to protect anybody, which is to arrive on time, in public, at enormous scale, and still begin two days after the last of the contaminated food had been eaten. Two people are dead in Michigan. The recall that covered a quarter of a million cases of lettuce could not have reached one bag that made one of them sick. That is not a failure of speed. It is a failure of the whole idea that a recall is how the public gets protected.

Yesterday I laid out, as fairly as I could and with every citation attached, the argument that this Cyclospora outbreak came from endemic American water rather than from lettuce grown in central Mexico. Today I want to answer it, and again every link is here so the work can be checked. Same disclosure as yesterday: my firm represents people sickened in this outbreak and has filed cases naming Taylor Farms entities as defendants. Judge the argument, not the lawyer.

This parasite has no reservoir but people. Cyclospora cayetanensis infects no animal, replicates in no soil and multiplies in no lake; FDA states in its own voice that it is believed to infect only humans and to spread through human feces. Every oocyst in an American waterway came out of an American. A domestic transmission cycle therefore has to be primed by a standing population of infected people shedding continuously before anybody can catch it from the water. CDC reports that 1,180 cases were reported nationally across all of last year, with 105 hospitalizations and no deaths, against 15,716 laboratory-confirmed domestic cases this season. That is not a reservoir. It is a rounding error against a country of 340 million, and you cannot build a nationwide waterborne epidemic on top of it in eight weeks.

Water is local, and this outbreak is not. This is the question that answers itself the moment you say it out loud. CDC has cases from forty-seven states plus the District of Columbia and Puerto Rico. New Hampshire shares no aquifer, no river, no reservoir and no utility with Michigan. Neither does Kansas, or Oklahoma, or Arkansas. For contaminated American water to have done this, dozens of unconnected municipal systems and recreational waters would have had to fail in the same direction inside the same eight weeks, for the first time in the recorded history of the disease, and not one of them would have been found. That is not one hypothesis. It is forty coincidences. What actually reaches forty-seven states in a summer does so by design, on a truck, from a distribution list.

Minnesota and Wisconsin are the control group, and the pairing is better than the lakes. Both sit on the Great Lakes. Minnesota is not on the recall distribution list, and its health department has said its numbers are about what it expects in a normal summer, with no outbreak identified — against a typical annual range the state has published for a decade. Wisconsin is on the recall list, and its domestically acquired count has run far above the twenty to thirty a typical season produces. Michigan, also on the list, has reported nearly fourteen thousand cases across seventy-three counties, and not the lakeshore counties. Same lakes, same weather, same region. What separates them is the shipping manifest.

And the state holding half the cases has already answered the water question in writing. Michigan’s health department published a public FAQ saying swimming in lakes or pools is not a known way to catch this parasite, and it gives five reasons: it is not infectious when shed and needs one to two weeks in the environment first, people pass very few oocysts compared with other waterborne parasites, only humans carry it so goose and dog and cattle waste is irrelevant, dilution in a lake or pool makes a sufficient dose nearly impossible, and there has never been a documented United States outbreak from swimming. On drinking water the same document notes that municipal plants use filtering, settling and ultraviolet light beyond chlorine, which physically remove the parasite. That is not my argument. It is the argument of the agency with the most cases and the most interviews in the country.

And the Detroit and Toledo timeline does not work. This is the specific version now in public, so test it specifically. The earliest illness onset in the federal outbreak is June 14. This parasite is not infectious when it is shed — IFPA’s own page says it needs seven to fifteen days in a warm, moist environment to mature — and CDC puts symptom onset at about a week after exposure. Work backward from a June 14 onset and the contamination event has to fall in late May at the latest. Sewer overflows in mid-June are downstream of the illnesses they are being offered to explain.

Now the part that has been missing from everyone’s argument, including mine, and it answers the strongest point the other side has. If the lettuce did it, why do so many sick people say they never went near a Taco Bell? Because the lettuce did not go to Taco Bell. Almost none of it did.

I pulled FDA’s own enforcement file for this recall, Event 99453, and added up the twenty-one entries — something FDA’s system does not do on screen. The recall covers 236,192 cases of product out of the Doctor Mora plant in Guanajuato, and it names the buyers. Walmart’s Marketside label took 109,476 cases, roughly forty-six percent of everything, which at ten to twelve bags a case is well over a million consumer bags. Taylor Farms’ own foodservice label took 68,897. Cross Valley Farms, which is US Foods’ private label, took 19,016. Sysco took 11,519. Subway took 8,075, making it the largest named restaurant chain in the recall. Markon, a foodservice purchasing cooperative, took 7,459. Jack in the Box took 5,130. Peak took 720. And Yum, the entry closest to the outbreak that defines this whole investigation, took 5,900 cases.

Do that arithmetic and it is the whole ballgame. Yum is about two and a half percent of the recalled product — a figure Phyllis Entis at eFoodAlert reached independently from me on the same weekend. The federal outbreak is defined by Taco Bell exposure. Roughly ninety-seven percent of this lettuce went somewhere else: to a Walmart shelf, to a Subway counter, to a hospital cafeteria, to an independent restaurant that bought through Markon or US Foods and never saw the Taylor Farms name on the box. Every one of those people, asked whether they ate at Taco Bell, would truthfully say no.

That is not a theory. It is exactly what Michigan found and published: many of its interviewed patients never ate lettuce at a restaurant chain or other food establishment, and lettuce still came up again and again in their food questionnaires, including among people with no restaurant or fast-food exposure at all. A Walmart shopper is a person who ate the recalled product at home. The interview was built to find restaurants and the product was mostly sold in grocery stores. And note that it is not only iceberg — nearly thirty percent of the recalled volume was product blended with romaine, carrots or red cabbage, so a person who says they did not eat iceberg lettuce may have eaten it anyway. Be fair about one thing: those are foodservice packs, so the company’s statement that its retail salad kits are unaffected holds as written. The difference is pack size and sales channel, not the field. And Michigan explains the scale in the same document better than I can: cut lettuce from many heads and sometimes many farms goes into shared wash tanks, a few contaminated leaves shed the parasite into that water, and the water then carries it onto leaves that were never contaminated. A small amount of contamination in one field becomes a large amount spread across thousands of bags. No reservoir is required for that. One field is enough.

New Hampshire is the proof of concept. The state tied a cluster of illnesses to recalled Taylor Farms lettuce served in the Cheshire Medical Center cafeteria in Keene, in a state whose baseline is a handful of cases a year. Ten of the sixteen originally identified as exposed were hospital employees. They did not share a well or a lake. They shared a salad bar. Not one of them ate at Taco Bell. And New Hampshire has the highest attribution rate in the country not because its lettuce was different but because a hospital can see illness in its own workforce and report it the same week, and a grocery store cannot. The same product went to twenty-seven states and Mexico. New Hampshire is not where it uniquely made people sick. It is where the building kept an attendance list.

The affirmative epidemiology is also better than its critics allow. Michigan looked at food exposures from Taco Bell patrons and ninety percent reported eating iceberg lettuce at one of the restaurants, which is what sent the finding to Atlanta; CDC then examined data from more than sixteen hundred people who had cyclosporiasis between mid-May and mid-July. FDA has said publicly and repeatedly, including after it withdrew its own positive test, that the false positive does not change the basis for the investigation or the epidemiological data supporting the recall.

One more thing the record shows, and it cuts the same way. No use-by date anywhere in those 236,192 cases is earlier than July 19, two days after the recall was announced. The front edge of this recall is the announcement date minus the shelf life, not a finding about when contamination started. Lettuce cut in early and mid-June had already expired and been eaten. The product that sickened the first several thousand people is therefore not in the recall at all, was never counted in any of these figures, and went out to the same customer list. The distribution was wider than the recall, not narrower.

That brings me to the conspiracy question, and I want to be careful, because the honest answer cuts both ways. Nobody has alleged a conspiracy. Not IFPA, not Suslow, not the company. Anyone answering them by shouting collusion is knocking down something nobody built. But the structure of this investigation is still the answer, because attribution here was not produced in one room and the agencies kept saying inconvenient things out loud. Michigan told the public its interviewed patients often had no restaurant exposure, which undercuts the simple version of the case against the company. North Carolina says parsley and cilantro, not Taco Bell, and says openly that many of its own cases reported neither. Nebraska, Rhode Island, New Mexico and Maryland all told Reuters they found no link to the multistate outbreak. And FDA announced a positive product sample and retracted it publicly within twenty-four hours, against its own interest, in the loudest week of the outbreak. A coordinated case against one company does not look like that.

And the last piece is the one nobody wants to discuss. In 2013, CDC, state officials and FDA investigated Cyclospora outbreak traced to salad mix from the same company’s operation in the same Mexican growing region, and FDA’s environmental assessment recommended that the firm determine whether this parasite is a reasonably likely hazard there and re-evaluate the wash step. In 2020 a different processor’s bagged salad outbreak ended with no cause determined at all. Same parasite, same commodity, same unfinished sentence, thirteen years apart. Lake Erie does not explain that.

Here is what I will hold myself to. If CDC releases its 2026 genotyping and the profiles come back diverse and varying by region, the water argument is right and I am wrong, and I will write that in this space the same day. I have already been wrong once this summer, about a test result, and I wrote that down too. What I will not accept is a question this consequential being settled by whichever side files the better letter. It should be settled by the sequencer, and CDC is holding the table.

As of August 19, 2026, 431 people in 32 states have been confirmed sick with Salmonella Javiana traced to fresh jalapeño peppers grown in Sinaloa, Mexico and imported by Coast Citrus Distributors. Fifty-seven have been hospitalized. No one has died. Illnesses began between June 19 and August 2, 2026, and the outbreak has been linked to Mexican-style restaurants including Chipotle Mexican Grill and QDOBA.

CDC updated its outbreak page today, adding 86 cases and 21 hospitalizations at once, along with five states that had not appeared before: Florida, New Jersey, New Mexico, Pennsylvania and West Virginia.

Here is where the 431 sick people live.

Where sick people lived. Source: CDC, August 19, 2026.

The state-by-state numbers below come from the data published with CDC’s locations page, downloaded August 19, 2026.

StateCasesStateCasesStateCases
Minnesota129Wyoming7Virginia2
Colorado118Indiana6West Virginia2
Illinois33Nebraska6Arkansas1
Georgia28Michigan5California1
Kansas14New Mexico4Florida1
Wisconsin12Texas4Kentucky1
Oklahoma9North Carolina3Louisiana1
Missouri8Ohio3New Jersey1
Montana8Alabama2Utah1
South Carolina8North Dakota2Washington1
Tennessee8Pennsylvania2  

Two states account for 57 percent of the outbreak. Minnesota reports 129 cases and Colorado 118 — 247 between them, or 57 percent of every confirmed illness in the country. Illinois is next at 33, then Georgia at 28. Twenty of the thirty-two states report fewer than ten cases apiece, and eight report exactly one.

The epidemic curve runs from June 19 to August 2, and peaks on July 5.

Illnesses by date of onset. Source: CDC, August 19, 2026.

The first person got sick on June 19. The curve climbs through the last week of June, peaks on July 5 at 35 illnesses in a single day, and stays above twenty a day for most of the following week. Between June 28 and July 12 — fifteen days — 332 of the 431 people in this outbreak got sick. That is 77 percent of the whole thing inside a two-week window, and the crest of it sits on the Fourth of July holiday, which is when a fast-casual burrito line does its heaviest volume of the summer.

CDC publishes that curve as a picture, not as numbers. Here is the daily series read off it, day by day.

Onset dateCasesOnset dateCasesOnset dateCases
June 191July 430July 195
June 201July 535July 201
June 210July 627July 214
June 220July 719July 223
June 230July 824July 231
June 241July 924July 242
June 252July 1025July 254
June 265July 1120July 262
June 274July 1223July 271
June 2810July 1314July 281
June 2913July 1410July 292
June 3013July 1513July 300
July 120July 1610July 311
July 223July 173August 11
July 326July 186August 21

Daily illness onsets counted from CDC’s published epidemic curve, August 19, 2026. The 45 daily values sum to 431, matching CDC’s reported total.

Twenty-four people got sick on or after July 20 — after the first chain pulled the peppers. Look at the right-hand tail, because it does not stop where the earlier reporting said it stopped. Twenty-four people in this outbreak had illness onsets on or after July 20. Illnesses continued through the last week of July, and the curve carries three more days after that: one case on July 31, one on August 1, and one on August 2.

Chipotle switched jalapeño suppliers for affected restaurants beginning July 20, and QDOBA stopped using jalapeños entirely on July 28. Five people in this outbreak had onsets after July 28. Salmonella has an incubation period running from about six hours to six days, so those illnesses trace back to meals eaten in the last days of July — after both chains had acted.

I am not going to tell you what that tail means, because CDC has not published the interviews behind it and I do not know. It could be people who ate contaminated product held in a freezer or a walk-in somewhere downstream of the chains. It could be product that moved through a distributor nobody has traced yet. It could be a handful of cases related by sequence but not by that box of peppers. What I will say is that a curve running to August 2 is a different document than a curve ending July 20, and it is the first hard evidence that this outbreak did not switch off when the recall was announced.

Ninety-three percent of the people interviewed ate at a Mexican-style restaurant. Of 191 people interviewed, 177 reported eating at a Mexican-style restaurant in the week before they got sick, with meal dates from June 14 through July 14. Investigators identified 27 illness clusters at Chipotle Mexican Grill and QDOBA locations across seven states, and the ingredients people reported most often were jalapeño peppers, red onion, cilantro and avocado. FDA’s traceback ran those meals back to a single common grower in Sinaloa that supplies Coast Citrus.

Fifty-seven people have been hospitalized. Twenty-one of those hospitalizations arrived with today’s update. Salmonella Javiana is not an unusually aggressive serotype, and most people who get it ride it out at home for four to seven days — which is what makes a hospitalization count this high, in an outbreak this size, worth paying attention to.

The recall now covers roughly 164 products across eight companies. Taylor Fresh Foods (Taylor Farms) pulled twenty grocery products on August 9. Whole Foods Market recalled forty-three items its own departments had made. NatureBest Precut & Produce pulled eighteen pico de gallos, diced jalapeños and stuffed mushrooms sold in Texas and Louisiana under its own label and H-E-B’s. Albertsons Companies has published twice, covering sixty-three store-made items. Salata Dressings recalled a jalapeño avocado dressing sold at Texas H-E-B stores. Hardie’s Fresh Foods recalled five-pound bags of whole jalapeños sold at two Texas Costco warehouses. USDA’s Food Safety and Inspection Service issued a public health alert covering eighteen more meat and poultry items. Every one of those companies bought a contaminated ingredient from someone upstream and told the public about it.

The grower in Sinaloa has still never been named. Coast Citrus Distributors has still never published a recall notice of its own. Everybody downstream has put their name on paper. The two companies closest to the peppers have not.

What to do if you think this was your illness. The practical step now is a diagnosis, not a refrigerator sweep — nearly all the best-by dates on the recalled products have run out. If you ate at a Mexican-style restaurant in June or July and had days of diarrhea, fever and cramping, ask your doctor for a stool culture, and ask that the isolate go to the state public health laboratory for whole genome sequencing. That test is the only thing that turns a bad week into a case that counts. It is also why 431 is a floor and not a ceiling: most Salmonella infections in this country are never diagnosed at all, and CDC says so on its own page.

We filed the first lawsuit in this outbreak against Coast Citrus on August 14, 2026 in the U.S. District Court for the Central District of Illinois, for a woman who ate at a Springfield Chipotle in late June and spent three days in the hospital. We sued the importer alone, because the peppers arrived in every kitchen downstream already contaminated. Eighty-six more people were added to this outbreak today. Somebody grew those peppers, and we still do not know who.

There is a serious argument circulating that the largest Cyclospora outbreak in American history was not caused by shredded iceberg lettuce from central Mexico. It is not a fringe argument. It is being made by the largest produce trade association in the country, by a respected emeritus scientist, and it rests on real peer-reviewed literature. Today I am going to make that case as well as I know how, and every link is here so you can check it against the sources rather than against me. Tomorrow, I will tell you why I think it is wrong.

One disclosure first. My firm represents people sickened in this outbreak and we have filed cases naming Taylor Farms entities as defendants. Everything below is public either way. You should know where I sit before you read a word of it.

No product sample has ever been confirmed positive. The single positive FDA announced in July was retracted the next day as a laboratory error, and FDA said there were no confirmed positive product results as of July 19. Taylor Farms says on its own information hub that FDA still reported none as of August 13, and that it has sampled extensively in central Mexico without a positive. Whatever else is true, nobody has put this parasite on this lettuce in a laboratory.

The attribution is thinner than the headlines suggest. FDA’s outbreak advisory defines the outbreak as people who reported exposure to processed iceberg lettuce from Taylor Farms de Mexico served or purchased at various locations, including people who previously reported eating at Taco Bell. That is a self-reported answer in an interview. It covers 9,481 people against 15,716 laboratory-confirmed domestic cases — roughly six in ten of the confirmed, and under a third of the fifty-state floor of more than thirty-one thousand. Michigan, which holds nearly half of everything, interviewed more than 2,900 people and reported that many of them never ate lettuce at a restaurant chain or other food establishment at all.

The instrument may be steering the answer. This is the strongest part and it deserves to be understood rather than dismissed. In its comment on the federal docket for the Cyclospora hypothesis-generating questionnaire, the International Fresh Produce Association pointed out that CDC states in its own Federal Register notice that molecular typing methods for this parasite cannot independently identify genetically linked clusters. CDC’s deputy division director told The Hill the same thing: whole genome sequencing is not available for Cyclospora, so investigators fall back on targeted genotyping, useful for detection but slower and less precise. If the genetics cannot define the cluster, the interview does the work, and the interview has no water module. Nobody is alleging bad faith. The claim is that a system can converge on a wrong answer with everyone in it acting honestly, which is a harder claim to refute and a fairer one to make.

The underlying science is not invented. Cyclospora has been recovered from municipal wastewater in the United States, where conventional treatment removes oocysts only partially. A 2023 review by Chacin-Bonilla and Santin — Santin is at USDA’s Agricultural Research Service — argues for possible foci of endemicity in developed countries, particularly where sanitation is compromised. FDA’s own endemic-region footnote on its produce fact sheet lists Puerto Rico, a United States jurisdiction. This is not industry science. It is the literature.

And the argument now names a place. IFPA’s consumer page points to municipal sewage overflows in the greater Detroit and Toledo region, to drinking water and wells, and to recreational water in Lake Erie and the bodies of water around it, together with documented rainfall and combined sewer overflow activity in parts of the affected region in mid-June. Trevor Suslow, a consultant and emeritus professor at UC Cooperative Extension, went further in the California Farm Bureau this week, saying it is possible and even likely the outbreak did not come from produce at all. That same article discloses that he has consulted for Taylor Farms and visited the implicated Mexico facility last month, which you should weigh the way you weigh my disclosure above.

And here is the part I concede outright. The lettuce does not explain everything. CDC now says on its surveillance page that it is investigating multiple clusters, at least six of which have no confirmed source, and FDA has had six separate open investigations with only the lettuce one carrying an identified vehicle. North Carolina, now past nine hundred cases, says its increase does not appear to be associated with the Taco Bell outbreak and that parsley and cilantro come up repeatedly — while also conceding that many of its cases reported neither, which suggests more than one source. Anyone who tells you one salad ingredient accounts for thirty-one thousand people is not describing this summer.

Give IFPA its due on one more thing, because the careless version of the criticism loses. Its consumer page now says explicitly that for the confirmed subcluster, FDA’s traceback points to an imported product from central Mexico, a different pathway from the domestic water exposure it has raised as a question for the remaining clusters. They have scoped the water hypothesis to the cases nobody can explain, and they have not claimed it explains the recall. I wrote about that filing when it landed and I want the narrowing on the record before I argue with any of it.

That is the case. Made honestly, it is not stupid and it is not dishonest, and the people making it include scientists whose work I have cited approvingly for years. It deserves an answer on the merits rather than a sneer. Tomorrow it gets one, and I will start with the question I think ends it: how a contaminated American water supply reaches forty-seven states in a single summer, and where 236,192 cases of recalled lettuce actually went.