Just because you haven’t eaten Taco Bell lately doesn’t mean you’re safe from cyclosporiasis, a gastrointestinal disease that causes symptoms like explosive diarrhea.
On July 17, Taylor Farms voluntarily recalled its lettuce grown in central Mexico, which was sold through several businesses, including Taco Bell.
Jill Roberts, a professor of environmental health biology at the University of South Florida College of Public Health, said there are several layers to the cause of the outbreak, and avoiding a repeat might take some intervention into other countries’ crops.
Cyclosporiasis is caused by cyclospora, a microscopic parasite that contaminates produce and water. It’s a seasonal disease, Roberts said, and cases usually trend up in the summer.
Michigan leads in the nation with cases, with over 11,500 reported as of Tuesday, including two deaths of people who had underlying health conditions. Florida has reported over 250 cases since June 1, with almost 100 recorded in the most recent recorded period, July 18-25.
This outbreak “is unprecedented,” Roberts said. She’s been teaching about cyclospora for years, and in the past when she spoke about significant outbreaks, “I was talking about 100, 120 cases.”
“This is just unreal,” she said. “(I’ve) never seen anything like this before.”
Growing numbers — despite recalls
The increase in cases was expected, Roberts said, because of the parasite’s incubation period. The amount of time it takes for a person to feel the effects of cyclosporiasis varies per person, she said. Some people get symptoms right away; others can take weeks.
“We don’t know a whole lot about cyclospora-infective doses,” Roberts said.
It’s unclear how much of the parasite a person needs to consume to get sick, she added, because there aren't a lot of researchers studying cyclospora.
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More people are likely seeking medical help for the disease if they’ve had diarrhea for several weeks and haven’t gotten better, Roberts said. When a person gets treatment, their case gets reported, she added, which is why there is a lag in reported case numbers.
The worst-case scenario, Roberts said, is the food causing the outbreak still being on the market. It takes a long time to figure out what products were infected because it requires investigation, she added.
Though Taylor Farms lettuce grown in Mexico was identified as a likely cause, the U.S. Food and Drug Administration reported the lettuce used in Taco Bells were linked to cases in nine of the 45 states that reported cases.
Florida isn’t included in that number, even though it was included in states that received Taylor Farms iceberg lettuce products for food service and retail stores.
“The question now becomes, 'are there multiple cyclospora outbreaks actually occurring?’ ” Roberts asked.
The Taylor Farms lettuce recall includes the product sold under various names, she added, which can make it easy for consumers to miss it. The names include Sysco, Walmart’s brand “Marketside,” Subway and Peak Fresh Produce.
Finding a solution
It’s probable that cyclospora outbreaks will be traced to the same growing region, Roberts said, which leads to “a very, very interesting question:” how will the U.S. move forward?
“We know that thousands of people in the United States can become sick from imported produce,” she said. “We know where it came from, right? What do we do? Ideally, we work with that growing region and we actually help them build a food production system that is safe.”
Funding cuts scaled back the CDC’s FoodNet surveillance network, which tracks foodborne illnesses. As of last year, such reporting is optional.
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“We’ve known for years that we’re importing cyclospora into the U.S.,” she said. “For years, we saw this trend increasing through 2024.”
Instead of working with Mexico and testing the foods coming in from that region, Roberts said, “we just shut it down right in the middle of us seeing all these trends going up.”
The U.S. depends on imported produce, Roberts said, which is why it should consider helping out regions importing food into the country.
Until the cyclosporiasis season is over, which sees the parasite thrive in the warm weather, Roberts said to avoid eating produce grown abroad. Instead, stick to locally grown food, she said, and be wary of food you eat outside of your home.
Roberts suggested to wash all your produce — though it doesn’t kill cyclosporiasis, “it can get rid of 80% of cyclospora off,” alongside other pathogens like listeria and salmonella. The only way to ensure your produce isn’t contaminated is through cooking it, she said, because cyclospora isn’t resistant to heat.
What’s most important, she added, is to reach out to a healthcare provider if you think you might have symptoms of cyclosporiasis.
Michigan reported two cyclosporiasis-related deaths. Both people had underlying health conditions, according to the Michigan Department of Health and Human services.
The deaths are more than likely linked to dehydration and losing fluids from diarrhea, Roberts said, which eventually compounds the effects.
“Don’t wait to get to the point where you’re seriously ill,” Roberts said. “Just go ahead and reach out.”
