A week ago, the three levels of government running this outbreak published three different numbers, and every one of them was six weeks behind the illnesses. That has not changed and it is not going to. What changed this week is the direction of travel. The federal counts finally started closing ground on the state counts, on one measure they passed them, and CDC moved a date that I have not seen reported anywhere.

Start with the date, because it is the news. On August 5, CDC’s investigation page said illnesses linked to this outbreak began on June 22 and continued through July 31. On August 13, the same page says they began on June 14 and continued through August 3. The window opened eight days at the front and three at the back. The back end is ordinary, because cases keep arriving. The front end is not ordinary at all. It means that as the interviews caught up, this investigation absorbed people who got sick more than a week before anybody previously placed the beginning of it.

June 14 matters because of what the recall actually reaches. FDA’s advisory says distribution of the recalled iceberg ran from June 29 through July 16, and the recall notice covers product made in that window. Symptoms of cyclosporiasis begin about a week after exposure, with a range of two days to two weeks, so the person who became ill on June 14 was most likely at a table around June 7. That is three weeks in front of the earliest lettuce in the recall. I wrote on August 8, working from FDA’s own enforcement file, that the recall window was set by shelf life rather than by contamination, because you cannot recall lettuce that has already been eaten or expired. The federal outbreak’s own start date has now moved out in front of the recall by more than two weeks.

FDA published once all week, on Thursday night, and when it did the outbreak grew by half. It went from 6,358 illnesses, 278 hospitalizations and fifteen states on August 5 to 9,481 illnesses, 398 hospitalizations and seventeen states on August 13. Maine and Massachusetts joined. Confirmed distribution went from twenty-seven states to thirty-one, with nine more named as possible, and that finally closed the West Virginia contradiction the agency had carried for weeks, in which a state was on the outbreak list and missing from the distribution list at the same time. FDA also said two things it had never said before. Inspectors are inside the plant at Doctor Mora alongside Mexican officials, and customer records from the firm show recalled product was sold to consumers in Mexico.

On the same page that raised the count by half, FDA repeated that it remains confident all recalled iceberg lettuce is off the market. That is probably true, and it is not the same sentence as the outbreak being over, and the two keep getting read as though they were. The advisory address changed for the fourth time this summer, from five-state to nine-state to fifteen-state to simply multistate.

CDC’s surveillance page went from 10,468 laboratory-confirmed domestic cases on August 4 to 13,895 on August 11, up roughly a third in a week. Hospitalizations went from 517 to 740, up 43 percent. Travel-associated cases, which are counted separately and are not this outbreak, went from 1,341 to 1,530, and their hospitalizations from 46 to 58.

The states went from 26,755 on August 7 to 30,513 today. Of that, 3,758 is eight days of growth and 10 is a correction: Mississippi and South Dakota turn out to have published counts I had been carrying as blank, 7 and 3, dated July 22 and July 16. Those are not new illnesses; they are rows that were missing. Michigan alone was 1,424 of that, moving from 12,485 to 13,909 in its single Thursday update. Ohio added 552 and crossed five thousand, with Cuyahoga County at 695 now ahead of Lucas at 690, so the center of that state’s outbreak has shifted from Toledo to Cleveland. Missouri added 482, Kansas 287, Indiana 278 to reach 1,983, with 486 of them in Allen County alone, Florida 153, New York 145 and Nebraska 127. Maine appeared on the chart for the first time at 27. West Virginia posted Friday at 304 and revised its hospitalizations down from 21 to 20, the first time any state on this chart has revised a hospitalization figure downward.

Here is where all fifty of them stand today. The last column is whether FDA has confirmed that recalled Taylor Farms de Mexico lettuce reached that state. Thirty-one are confirmed, four more than a week ago, and nine further states and territories are marked as places the product may have gone. Forty-one states now publish a 2026 count of their own, forty of which are added into the total below. 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.

Seventeen states are marked Linked, and that is the whole federal outbreak. They are the states FDA and CDC have 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 at all: Rhode Island, New Mexico, Maryland, Utah and Hawaii. New Hampshire remains the only state anywhere that has named a Taylor Farms product at a specific place, a hospital cafeteria in Keene.

That leaves twenty-six states 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. That is not a finding that the lettuce stopped at their borders. It is the absence of the question. Thirteen of the twenty-six are on the federal list of states that received the recalled product, and they are still Unknown.

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 13,895 laboratory-confirmed cases, that puts the real number near 1,155,000.