United States health authorities have officially declared the country's largest recorded outbreak of cyclosporiasis over, after contaminated iceberg lettuce sickened nearly 13,000 people across 21 states.
The Centers for Disease Control and Prevention (CDC) said on Friday it is confident that all recalled lettuce linked to the outbreak has been removed from the market.
The CDC recorded 12,883 cases tied to the outbreak, including 570 hospitalisations and two deaths. Michigan was the hardest-hit state and accounted for both fatalities.
The outbreak was traced to iceberg lettuce sourced from central Mexico by Taylor Farms de Mexico, which recalled all of its iceberg lettuce from the region on July 17. It initially drew attention to lettuce served at Taco Bell locations, but federal investigators later traced the implicated lettuce to Taylor Farms, which distributes its products to restaurants and retailers across the US.
At its peak, more than 1,000 infections were reported in a single day. By August, the CDC said reported infections had fallen to fewer than two per day on average.
Symptoms of a cyclosporiasis infection typically appear about a week after a person eats contaminated food or drinks contaminated water, though they can develop as early as two days or as late as two weeks after exposure. The most common symptom is frequent, watery diarrhoea. The infection can also cause loss of appetite, weight loss, stomach cramps, bloating, gas, nausea and extreme tiredness.
The outbreak was part of an unprecedented rise in cyclosporiasis cases nationwide this year. Since May 1, nearly 20,000 laboratory-confirmed cases have been reported in the US, more than 16 times the number recorded during the same period last year. The previous record year was 2019, when approximately 4,700 illnesses were reported.
The outbreak has renewed scrutiny of US food-safety controls, including the government's ability to identify contaminated produce before it reaches consumers. FDA inspections of foreign food facilities have declined substantially in recent years.
The FDA is required to inspect more than 19,000 international food sites annually. According to the Government Accountability Office, the agency reached an all-time high of 1,700 such inspections in 2019, less than one-tenth of the target. The FDA did not inspect the Mexican farm implicated in the outbreak until approximately one month after the investigation began.
The Trump administration has also scaled back FoodNet, stopping the programme's mandatory tracking of Cyclospora and five other pathogens. At the same time, a Food Safety Modernization Act rule designed to improve traceability of high-risk foods, including leafy greens, has been delayed until 2028.
The FDA said it has completed on-site inspections and sample collection at iceberg lettuce farms and a processing facility in Mexico, though laboratory analysis of those samples remains pending. The agency said it will continue working with state and federal officials in Mexico to investigate the outbreak.
