Cyclospora Cases Rise in Hamilton County as Taco Bell Lettuce Fuels Nationwide Outbreak

Hamilton County Cases Continue to Climb

Confirmed cases of cyclosporiasis are increasing in Hamilton County and across the U.S. As of July 15, there are 12 confirmed, one probable, and four suspected cases of cyclosporiasis, according to the Hamilton County Health Department. That's a jump from the 10 confirmed cases reported just days earlier, and health officials warn the true number is likely higher. Some people recover without medical care and are never tested for Cyclospora.

There are 1,645 reported cases of cyclosporiasis across 34 states as of July 13, according to the CDC. Kentucky and Indiana — both neighboring Hamilton County — have anywhere from 31 to 80 cases each. Ohio, which includes Hamilton County, is squarely in the outbreak's geographic center, making local residents particularly vulnerable.

A Fast Food Chain and a Lettuce Supplier at the Center of It All

Investigators have traced the suspected vehicle to shredded iceberg lettuce grown by Taylor Farms and served at Taco Bell, as reported by the Washington Post on July 16, citing two people familiar with the investigation. The thread runs through all four of the hardest-hit states: a high share of the sick had eaten at Taco Bell, lettuce was the menu item they had in common, and when the FDA asked the chain where that lettuce came from, the answer — in Michigan, Ohio, West Virginia, and Kentucky alike — was Taylor Farms.

The Michigan Department of Health and Human Services analyzed food exposure details from 190 cases who reported eating at Taco Bell — and found that 90% of those interviewed reported eating iceberg lettuce. On July 17, Taylor Farms de Mexico announced they are voluntarily removing all iceberg lettuce sourced from central Mexico, and informed the FDA that they would initiate a recall. Taco Bell said it has removed Taylor Farms lettuce from its restaurants and its nationwide supply chain.

Shredded iceberg lettuce sold in grocery stores or served in other restaurants is not affected. Still, health officials are also investigating other cyclosporiasis illnesses and outbreaks in other states that are unrelated to the one linked to Taco Bell.

What the Illness Does — and What to Watch For

Cyclosporiasis has been called an "explosive" diarrheal illness. It is a gastrointestinal disease caused by the microscopic parasite Cyclospora, according to the CDC. Once infected, it can take days to weeks for people to develop symptoms. The main symptom is frequent, watery diarrhea. Loss of appetite, cramping, bloating, gas, nausea, fatigue, and weight loss can also occur. Though the illness rarely causes serious complications, symptoms can sometimes linger for a month or more if untreated. Antibiotics are the main treatment.

People who suspect they may be infected may need to specifically request testing for Cyclospora, as routine stool tests don't always screen for this parasite. Michigan — the apparent epicenter of the current outbreak — is reporting more than 5,000 cases, and more than 100 people in that state have been hospitalized. No deaths have been reported. If this holds, the concentrated, sharp increase in cases strongly suggests this could become the largest cyclospora outbreak in the U.S. on record.

What You Can Do Right Now

Wash your hands and any fresh produce thoroughly under running water before eating, cutting, or cooking. Cooking can kill the parasite — produce should be heated to at least 158°F (70°C) since washing alone cannot guarantee Cyclospora removal. If people do develop symptoms, health officials advise contacting a healthcare provider to be tested specifically for cyclospora, as routine stool tests often don't include that test.

With cases still rising in Hamilton County and investigators still working to determine whether the contaminated lettuce reached additional vendors beyond Taco Bell, this outbreak is far from over. The CDC is investigating other outbreaks and illnesses of cyclosporiasis nationally that are unrelated to the Taco Bell cluster — meaning multiple sources may still be driving infections across the country. Residents should stay alert, monitor symptoms, and check for any updates to the Taylor Farms recall as the investigation continues to unfold.