Federal health officials are investigating a multistate outbreak of Cyclospora infections linked to shredded iceberg lettuce that has sickened more than 1,600 people and resulted in at least 94 hospitalizations.

The outbreak has been reported in Indiana, Kentucky, Michigan, Ohio and West Virginia. As of July 19, no deaths had been reported, according to the U.S. Food and Drug Administration.

Taylor Farms de Mexico voluntarily removed all iceberg lettuce sourced from central Mexico from the U.S. market on July 17. Taylor Fresh Foods also recalled several iceberg lettuce products distributed to grocery stores, restaurants and food-service businesses across multiple states.

“Do not eat recalled iceberg lettuce from Taylor Farms de Mexico,” the FDA advised while emphasizing that its investigation remains open.

The recalled retail products include Marketside Iceberg Salad sold in 12- and 24-ounce packages and Marketside Shredded Lettuce sold in 8- and 16-ounce packages at select Walmart stores. The affected products have “Best if Used By” dates ranging from July 18 through Aug. 3, 2026.

The Marketside products were sold at select Walmart stores in Alabama, Arkansas, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Missouri, Mississippi, Oklahoma, Tennessee, Texas, Virginia and West Virginia. Other recalled Taylor Fresh Foods products were distributed between June 29 and July 16 to customers in more than two dozen states.

The outbreak was initially connected to shredded iceberg lettuce served at some Taco Bell locations in the five states reporting illnesses. According to the FDA, an analysis of food histories found that 90% of interviewed patients who reported eating at Taco Bell had consumed iceberg lettuce. The company told federal officials that it stopped using lettuce from the identified supplier on July 17.

The FDA said its traceback investigation found that the lettuce served at locations visited by people who later became ill came from a single supplier, Taylor Farms de Mexico. However, regulators have not confirmed the presence of Cyclospora in a product sample.

On July 19, the FDA reported that laboratory experts had reexamined an earlier test that appeared to detect the parasite in a lettuce sample. The agency determined that the result was a false positive. As of that date, there were no confirmed positive product samples, although epidemiological and traceback evidence continued to connect the outbreak with the recalled lettuce.

Symptoms can persist without treatment

Cyclospora cayetanensis is a microscopic parasite that causes an intestinal illness known as cyclosporiasis. People generally become infected after consuming food or water contaminated with the parasite. The infection does not typically spread directly from one person to another.

Watery diarrhea is the most common symptom. People may also experience loss of appetite, weight loss, stomach cramps, bloating, increased gas, nausea and fatigue. Less common symptoms include vomiting, headache, fever and body aches.

Symptoms usually begin about one week after exposure, although they may appear anywhere from two days to two weeks or longer after a person consumes contaminated food or water. Without treatment, the illness can continue for several weeks or longer. Symptoms may appear to improve before returning.

The Centers for Disease Control and Prevention advises people with symptoms to contact a healthcare provider and mention any recent consumption of shredded iceberg lettuce. Patients may need to specifically request testing for Cyclospora because routine stool examinations do not always include a test for the parasite.

That diagnostic challenge may be especially consequential for people who have limited access to primary care, lack adequate health coverage or cannot easily take time away from work. Language barriers and limited access to timely recall information can also make it harder for some families to identify potentially contaminated products. These barriers frequently affect low-income households, immigrant communities and communities of color, although federal agencies have not reported that any particular racial or ethnic population has been disproportionately affected in this outbreak.

Anyone who purchased the recalled lettuce should throw it away or return it to the place of purchase for a refund. Refrigerators, containers, countertops and other surfaces that may have touched the lettuce should be washed with hot, soapy water or cleaned in a dishwasher when appropriate.

Consumers who recently ate iceberg lettuce at a restaurant should ask the business about its supplier if they are uncertain whether the product was recalled. People experiencing prolonged diarrhea should stay hydrated and seek medical attention, particularly if they are immunocompromised or develop signs of dehydration.

The investigation remains active, and additional products, restaurants or distribution locations could be identified. Consumers can review the complete recall information through the FDA outbreak investigation and follow the CDC’s Cyclospora outbreak page for updated case numbers and public-health guidance.

Also Read: What Is Cyclosporiasis? The Foodborne Illness Showing Up in the News