Massive Lettuce-Linked Cyclosporiasis Outbreak Highlights Public-Health Strains

On July 16, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) announced that a cyclosporiasis outbreak had sickened over 11,000 people in 20 states and caused two deaths. The agencies traced the source to shredded iceberg lettuce served at Taco Bell restaurants, which originated from the Mexico operations of produce company Taylor Farms. Michigan’s Washtenaw County saw cases rise from a few per day in late June to about 80 cases daily by mid-July. By late August, neighboring Ingham County, home to roughly 290,000 residents, had logged 915 cases, with new infections falling to three or four per day after the peak.

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Michigan health officials alerted the FDA and CDC in late June about the surge, prompting the state on July 4 to advise residents to avoid lettuce and several other produce items. The warning likely averted additional infections, according to the state’s chief medical executive, Dr. Natasha Bagdasarian. The outbreak forced Washtenaw County’s 108-person health department to reassign staff; a nurse stopped giving vaccinations, and a colleague halted blood draws to conduct patient interviews. In Ingham County, communicable-disease nurses and even restaurant inspectors were pulled into case investigations, while some labs exhausted their cyclosporiasis test supplies.

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An FDA spokesperson explained that the agency could identify the contaminated commodity only after receiving supplier information on July 13. The CDC said it held weekly calls with states and met daily with the FDA and state officials, providing direct support at least four times each week. Taylor Farms issued a recall of the implicated lettuce on July 16 and hired independent experts to review its safety protocols. Taco Bell voluntarily removed the lettuce from its restaurants.

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• “It was a lot of exhaustion, phone calls and clicking of the keys,” — Dea Lancaster

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• “We used to have one hand tied behind our back and now we have both,” — Barbara Kowalcyk, a food safety expert at George Washington University

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• “I have never talked to so many people who have pooped their pants in adulthood,” — Adrienne Walling

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• “It was so scary. I literally thought I was going to die on more than one occasion. It’s been a nightmare,” — Kellye O’Hara

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