Cyclospora Outbreak Raises Questions About Lettuce Safety

A cyclosporiasis outbreak initially concentrated in the Midwest and East Coast has led to lettuce recalls, with many people uncertain about buying or eating lettuce. “Cyclospora [cyclosporiasis] is actually caused by a parasite [Cyclospora cayetanensis, also known as Cyclospora], not a virus,” said Spokane Regional Health District Health Officer Dr. Francisco Velazquez. “It has only one known host, which happens to be humans,” he said. Cyclospora is not native to the United States. It is only found in subtropical climates such as Central and South America, Velazquez said.

Washington state usually sees a handful of cyclosporiasis cases a year between May and August in people who have traveled to that area, he said. However, cases across the country have been rising all summer. “We have an outbreak and the outbreak is being traced to produce from South America,” he said. According to the Centers for Disease Control (CDC), the initial outbreak was traced to lettuce from central Mexico sold by Taylor Farms, which recalled the affected lettuce in mid-July. Those products have since passed their best-by dates and should no longer be available for purchase, the CDC said.

However, new sources of Cyclospora have been tentatively identified in products such as guacamole, Velazquez said. “There have been a lot of recalls,” he said. “The goal is to eliminate the source of contamination.” The affected produce was not distributed in the Northwest. According to the CDC, the two states with the most cases are Michigan and Ohio, and the westernmost states showing an elevated level of cases are Nebraska, Kansas, and Oklahoma. Velazquez said that, while Washington state does have roughly 60 cases, all are in people who either traveled to Central or South America or traveled to one of the states in the midst of a significant outbreak.

According to the CDC, there have been 13,895 confirmed cases of cyclosporiasis since May 1 with more than 10,000 under investigation. Two deaths have been reported and approximately 400 people have been hospitalized. For comparison, there were 1,180 reported cases in the United States between May 1 and Aug. 31, 2025. The CDC reported that it is investigating “multiple clusters of cyclosporiasis cases,” not all of them linked to lettuce from Taylor Farms. However, many people who have it have probably not sought medical care and will not appear in the official count, Velazquez said. “The number is probably going to be much higher,” he said.

The most often mentioned symptom of cyclosporiasis is frequent diarrhea. Other symptoms include a low-grade fever, fatigue, and loss of appetite, Velazquez said. Some people may not show symptoms at all, while others have only mild symptoms. How it affects people depends in part on a person’s pre-existing health conditions, he said. The key is to consistently wash hands after using the bathroom, while preparing food, and while eating, Velazquez said. It’s also important to keep surfaces sanitized. Velazquez said it’s okay to keep buying produce, but to check with local stores about where their produce is from. Buying heads of lettuce is better than buying shredded lettuce because it has been handled less and it’s easy to strip off and dispose of the outer leaves, he said. Each lettuce leaf should be washed under cool running water.

Any produce that can be peeled should be, he said. Velazquez said he’s still eating produce, but he’s buying local. “It’s always a good idea to know where things come from,” he said. “We have a lot of local farmers. I’ve been buying lettuce from my local grocer.” Cyclosporiasis can be treated with antibiotics, Velazquez said. He recommends people see a doctor to be tested if they believe they have been exposed and are having symptoms. “This can go on for weeks if you don’t get it treated,” he said. “Even if you don’t feel terrible, contact your provider.”