As of July 2026, a significant outbreak of cyclosporiasis, an intestinal illness caused by the microscopic parasite *Cyclospora cayetanensis*, has swept across the United States, with a particularly heavy impact on the Midwest. With cases soaring past 3,000 in Michigan and Ohio alone, health officials are scrambling to identify the source, while urging the public to take precautions when handling fresh produce .
## Understanding the Scope of the Outbreak
The numbers are stark. Michigan has reported **2,640 cases** as of July 13, 2026, including 44 hospitalizations, with the largest increase occurring in Southeast Michigan . Ohio has reported an additional 434 cases since June 1 . Nationwide, as of July 10, 31 states have reported cases to the US Centers for Disease Control and Prevention (CDC), signaling a widespread summer surge .
“Early information has shown lettuce as a common product that regularly comes up during the investigation,” said Dr. Natasha Bagdasarian, Michigan’s chief medical executive, in a statement. While lettuce and salad greens are currently a primary focus, health officials have emphasized that **no specific produce grower, supplier, or specific produce type has been identified as the definitive source** of this outbreak .
## Challenges in Tracking the Parasite
Pinpointing the origin of a cyclospora outbreak is particularly difficult for several reasons. Unlike bacterial pathogens like *Salmonella* or *E. coli*, *Cyclospora* has a complex life cycle and a large, complicated genome, making it harder to track through standard genomic testing .
“For the bacterial pathogens, the technology is quite mature… it’s like reading a children’s book versus reading “War and Peace” — cyclospora being the “War and Peace,”” explained Jennifer McEntire, a microbiologist and CEO of Food Safety Strategies .
Furthermore, the parasite has a long incubation period. It typically takes one to two weeks for symptoms to develop after exposure, making it difficult for patients to recall exactly what they ate weeks ago . Investigators are forced to rely on detailed interviews, grocery receipts, and shopper cards to trace back potential sources .
## Symptoms and Treatment
The infection is not usually life-threatening but can be debilitating. The most common symptom is **watery diarrhea**, which can be frequent and explosive. Other symptoms include:- Loss of appetite and weight loss- Abdominal cramping and bloating- Increased gas and nausea- Fatigue
If untreated, the illness can last from a few days to over a month, and symptoms may seemingly go away only to return again, a process known as relapse . Dehydration from the diarrhea can lead to hospitalization. If you suspect you are infected, see a healthcare provider. The standard treatment is a seven- to ten-day course of the combination antibiotic sulfamethoxazole-trimethoprim, sold as Bactrim or Septra .
## Foods to Avoid and How to Protect Yourself
While no recall has been issued and the exact source remains under investigation, health officials have provided specific, actionable guidance to reduce the risk of infection. The Michigan Department of Health and Human Services (MDHHS) has issued detailed recommendations for handling high-risk produce, as the parasite’s microscopic oocysts can cling tightly to the crevices of certain fruits and vegetables .
Here is the specific advice for preparing and consuming common produce linked to past outbreaks :
### Lettuce and Leafy Greens- **Avoid** prewashed, bagged lettuce or salad mixes.- **Buy** whole heads of lettuce.- **Preparation:** Throw away the outer two to three layers of leaves and wash the inner leaves thoroughly under running water.- **Safest option:** Cook the greens.
### Cilantro and Basil- **Preparation:** Wash thoroughly under running water, separating the leaves.- **Safest option:** Cooking is the safest choice to eliminate the parasite.
### Green Onions- **Preparation:** Trim the root end, remove the outer layer, and wash thoroughly under running water.- **Safest option:** Cook before eating.
### Raspberries- **Risk:** Their bumpy surface makes them especially difficult to clean, as the parasite can hide in tiny crevices.- **Alternative:** Consider using frozen raspberries. However, freezing may reduce but does not guarantee elimination of the parasite.- **Safest option:** Use them in cooked dishes like pies or jams.
### Snow Peas- **Preparation:** Wash thoroughly under running water and rub the surface.- **Safest option:** Cooking is the best choice.
## General Food Safety Guidelines
Beyond these specific recommendations, following standard food safety practices is crucial :- **Wash Your Hands:** Use soap and water for at least 20 seconds before and after handling fresh produce.- **Wash Produce:** Rinse all fruits and vegetables thoroughly under clean running water before eating, cutting, or cooking. Do not use soap or detergents.- **Scrub Firm Produce:** Use a clean produce brush to scrub firm items like melons and cucumbers.- **Cut Away Damage:** Remove any damaged or bruised areas on produce before preparing and eating.
The investigation into the Cyclospora outbreak continues, and as health officials work diligently to trace the source, being vigilant about how you handle fresh produce is your best defense
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