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 recallediceberg 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 in seven days, 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.

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 tonight, and past thirty thousand. Of that, 3,758 is seven 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. Ohioadded 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. Maineappeared on the chart for the first time at 27. West Virginia posted this morning 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. 

Where the state governments are is a harder question than where the federal agencies are, because the states are not all in the same week. Fourteen of them added cases over the seven days. One revised down. Thirty-four published no new number at all. Kentucky is dated July 29 and Iowa July 30, both more than two weeks old. Nine states have published nothing since a press roundup on July 17. Illinois, Texas and Massachusetts did not move at all. 

Here is where all fifty of them stand tonight. 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.

30,523 is a floor, not an estimate. It is the sum of what forty health departments have published, on schedules running from daily to never, counted at the bottom of any range a state reports. Hawaii is the one state that publishes a number I do not add. All five of its cases are travel-associated by its own health department’s account, and this is a domestically acquired figure, which is the same reason CDC’s 1,530 travel cases sit outside it. Nine states publish nothing at all, and one of them, South Carolina, is on the federal distribution list and reported forty-five cases last year, so it plainly does make the disease notifiable. 

The floor is also the smallest of the three numbers in this piece, and none of them is the number of people who got sick. 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. It is an estimate with wide margins, and it is not a headcount, and I use it because the alternative is to let 30,523 stand as though it were the answer. It is not. It is the part we can count.

The date is the thing I would go looking at. Somebody at CDC changed June 22 to June 14 this week, and whoever did it was doing the job right. It also means this outbreak now officially begins two weeks before the earliest lettuce the recall reaches, and the meal behind that first illness came three weeks before it. Inspectors are finally standing in Guanajuato. The question they went there to answer just got two weeks older.