The Centers for Disease Control and Prevention confirmed on July 24, 2026, that four additional states — Illinois, Kansas, Oklahoma, and Pennsylvania — are now linked to the multistate Cyclospora outbreak traced to shredded iceberg lettuce served at Taco Bell restaurants. They join the original five states: Indiana, Kentucky, Michigan, Ohio, and West Virginia. The same day, federal officials are managing a second, separate Cyclospora outbreak involving 72 people, announced by the FDA on July 22, with no food source yet identified.
Together, the two investigations are unfolding against a record national backdrop. More than 11,500 confirmed and probable cases of cyclosporiasis have been reported to the CDC since May 1, 2026 — compared to 2,700 cases in all of 2025 — making this the largest Cyclospora season in U.S. history.
Why This Matters
Cyclospora is not like most foodborne illnesses. It does not announce itself immediately. Symptoms typically begin one to two weeks after exposure and include watery diarrhea that comes and goes, fatigue, loss of appetite, bloating, nausea, and cramping. Untreated cases can last weeks to more than a month and may relapse after a person believes they have recovered.
That delayed and relapsing pattern means many residents in the newly added states — particularly in the Chicago and Philadelphia metro areas — may have had exposures in May or June that were misattributed to a stomach virus. Standard parasite stool testing does not automatically screen for Cyclospora, and a specific request must be made to a laboratory or clinician.
The second outbreak with an unidentified source creates a separate problem. Without a known food vehicle, residents cannot avoid it. The FDA has not disclosed the states where cases are located or the product under investigation.
What We Know So Far
The nine-state Taco Bell outbreak is linked to shredded iceberg lettuce supplied by Taylor Farms de Mexico from central Mexico. On July 17, 2026, Taylor Farms recalled all iceberg lettuce from that source. Taco Bell confirmed it completed removal of the affected product from all restaurants nationwide.
The CDC's confirmed case count for the nine-state Taco Bell outbreak stands at approximately 1,644 confirmed exposures reported across the original five states, with illnesses dating from May 13 through July 13, 2026, and 94 hospitalizations. No deaths have been reported. Michigan alone has reported more than 7,000 cases when including probable and suspected cases under investigation, according to state health officials. The total national confirmed and probable count has reached more than 11,500 as of July 21, spanning 41 states.
Investigators are still working to determine how many of those cases are part of the nine-state Taco Bell cluster and how many represent separate clusters or unrelated illnesses. In North Carolina, state officials have pointed to preliminary evidence suggesting parsley and cilantro as possible sources for illnesses there — both of which have been implicated in prior Cyclospora outbreaks.
The second outbreak, announced by the FDA on July 22, involves 72 people as of that date. The FDA has not identified the linked food product, disclosed the affected states, or provided a timeline for completing the investigation.
Where the Risk Is Highest
Illinois and Pennsylvania represent the most significant additions to the nine-state advisory based on population. Illinois has an estimated 12.8 million residents, with a dense Taco Bell presence in the Chicago metropolitan area. Pennsylvania adds roughly 13 million residents, with Philadelphia and Pittsburgh among the major urban markets.
According to Newsweek's map of state case data, the states reporting the highest Cyclospora case counts nationally include Michigan, which continues to drive the largest share of the national surge. Cases have been reported in 41 states this season, though not all are part of the nine-state Taco Bell cluster.
What Doctors and Experts Say
The CDC Health Alert Network advisory issued to clinicians earlier in July made a critical operational point that remains in effect: clinicians should specifically request diagnostic testing for Cyclospora when it is clinically suspected, because it is not included in standard parasite screening panels. Failing to order the correct test means infected patients may be treated for a general stomach illness without receiving the antibiotic that clears the parasite.
Gwen Biggerstaff, deputy director of the CDC's Division of Foodborne, Waterborne, and Environmental Diseases, told reporters at a July 14 briefing: "We anticipate continuing to see cases increase, possibly through the end of August." Cyclospora season in the United States typically runs from May through August, meaning the outbreak period is not yet over.
What the Evidence Shows — and What It Does Not
The link between the nine-state outbreak and Taylor Farms de Mexico lettuce is based on epidemiologic traceback, patient interviews, and ingredient-level analysis. Michigan officials found that 90 percent of interviewed cases who ate at Taco Bell reported consuming iceberg lettuce. The traceback identified Taylor Farms de Mexico as the supplier for the affected Taco Bell locations.
One important caveat: a Taylor Farms lettuce sample initially reported as positive for Cyclospora on July 18 was reclassified as a false positive by the FDA on July 19 to 20. The recall remains in effect, and the epidemiologic and patient-interview evidence continues to support the link despite the inconclusive environmental test.
The second 72-case outbreak has no confirmed source. The FDA's CORE investigation table has added the cluster, but no further public information is available. Consumers cannot take source-specific precautions for a source that has not been identified.
Who Faces the Greatest Risk?
The people at highest exposure risk for the nine-state outbreak are those who ate shredded iceberg lettuce at Taco Bell locations in any of the nine states between mid-May and mid-July 2026. For the second outbreak, the affected population is unknown pending investigation.
People with weakened immune systems, older adults, and individuals with chronic illness may experience more severe or prolonged symptoms. Healthy adults can recover without treatment, but cyclosporiasis is significantly more protracted without antibiotic therapy and carries a well-documented relapse risk.
Children as young as 2 and adults as old as 95 have been confirmed sick in the current outbreak season. The median age of confirmed case patients is 44, and 56 percent of confirmed cases are female, according to the CDC HAN advisory.
Symptoms and Warning Signs to Watch For
Early symptoms of cyclosporiasis include frequent or intermittent watery diarrhea, loss of appetite, fatigue, significant stomach cramping, bloating, nausea, and low-grade fever. Some people also experience vomiting and muscle aches. Symptoms typically begin one to two weeks after exposure.
Unlike most food poisoning, cyclosporiasis can relapse after initial improvement. If diarrhea that appeared to resolve returns within days to weeks, especially with fatigue and loss of appetite, Cyclospora should be considered. Untreated illness can last weeks to more than a month.
Severe or rapidly worsening diarrhea, signs of dehydration such as dizziness, reduced urination, or extreme fatigue, and symptoms in people with a compromised immune system warrant prompt medical care.
What You Can Do Now
If you ate shredded iceberg lettuce at a Taco Bell in any of the nine affected states — Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, or West Virginia — between mid-May and mid-July 2026, and developed gastrointestinal symptoms, contact a clinician and ask specifically for Cyclospora stool testing. Standard parasite panels do not include it.
Cyclosporiasis is treatable with the antibiotic trimethoprim-sulfamethoxazole, available by prescription. Do not assume symptoms have resolved permanently without treatment — relapse is common.
For the second outbreak, general food safety precautions apply: wash hands with soap and water before handling food, wash produce thoroughly, and avoid raw produce if you are immunocompromised. Cooking produce to at least 158 degrees Fahrenheit kills the parasite, but this is not practical for most fresh produce eaten raw.
Monitor the FDA CORE outbreak investigation table for updates on the second outbreak's source.
Cost and Access: What Patients Should Know
Trimethoprim-sulfamethoxazole is a generic antibiotic covered by most insurance plans and Medicaid. For residents without insurance, county and city health departments can assist with testing referrals. In Illinois, residents can contact the Illinois Department of Public Health. In Pennsylvania, the Pennsylvania Department of Health is the appropriate reporting and guidance contact.
What Happens Next
The CDC and FDA continue investigating whether additional growers or distribution channels were involved in the nine-state outbreak. Additional states could be added as investigators compare food histories and supply-chain records. The second 72-case outbreak remains without a confirmed source; the FDA has not provided a timeline for its investigation.
CDC has projected that Cyclospora cases may continue increasing through the end of August. MedicalDaily will report further updates as the CDC releases new case counts and the FDA identifies the source of the second outbreak.
The Bottom Line
Two simultaneous Cyclospora outbreaks are now under federal investigation. The nine-state outbreak linked to Taco Bell iceberg lettuce from Mexico is the largest Cyclospora outbreak on U.S. record, and a second independent cluster of 72 cases has no identified food source yet. If you ate at an affected Taco Bell location during the outbreak window and experienced prolonged or relapsing diarrhea, ask a clinician specifically for Cyclospora stool testing. Treatment is available, effective, and covered by most insurance.
Developing Story Timeline
July 24, 2026: CDC adds Illinois, Kansas, Oklahoma, and Pennsylvania to the nine-state Taco Bell Cyclospora outbreak advisory.
July 22, 2026: FDA announces a second, separate Cyclospora outbreak of 72 cases with no identified food source.
July 17–20, 2026: Taylor Farms de Mexico recalls all iceberg lettuce from central Mexico. Taco Bell removes affected lettuce nationwide. FDA reviews a lab positive, reclassifies it as a false positive; recall stands.
July 16, 2026: CDC and FDA officially link the five-state outbreak to shredded iceberg lettuce from Taylor Farms de Mexico at Taco Bell.
May 13, 2026: Earliest confirmed illness date in the Taco Bell cluster.
May 1, 2026: Start of the 2026 Cyclospora surveillance season.
