Health Officials Zero In on Lettuce in Explosive-Diarrhea Outbreak Probe
Health department in Michigan, where there are thousands of cases, points to prewashed salad kits as a possible culprit
- Michigan health officials identified bagged, prewashed salad kits as a possible culprit in a rapidly expanding cyclospora outbreak.
- Michigan is the hardest-hit state, with more than 3,300 cases of the parasite reported as of Tuesday.
- The Centers for Disease Control and Prevention reported that 34 states have documented cases of cyclosporiasis, with more than 140 hospitalizations.
Michigan state health officials are narrowing in on lettuce as a possible culprit in the rapidly expanding explosive-diarrhea outbreak.
Top health officials in Michigan said bagged, prewashed salad kits could be a particular risk, based on the state’s review of cases. “The early signals are telling us that lettuce does seem to be implicated,” said Dr. Natasha Bagdasarian, the state’s chief medical executive.
Donald Prater, the Food and Drug Administration’s acting deputy commissioner for food, said lettuce is one of multiple produce items under investigation as officials race to identify the outbreak’s origins.
Michigan is the hardest hit by the cyclospora parasite with more than 3,300 cases as of Tuesday, more than double the number on Friday.
So far, 34 states have reported cases of cyclosporiasis, a foodborne-illness that can cause explosive diarrhea and vomiting, according to the Centers for Disease Control and Prevention. The CDC said there are more than 5,100 possible cases under investigation. More than 140 people have been hospitalized, the CDC said Tuesday.
Suzi Pasquinzo, a 47-year-old Michigan mom of four, said she developed terrible diarrhea and cramping last Friday, days after eating a soft Taco Supreme with lettuce and tomato and a crunchy taco with beef, cheese and lettuce from Taco Bell.
Pasquinzo has been taking antibiotics, which has eased the diarrhea, but she still had stomach cramping Monday and has been weak, missing two days of work at a new job and her niece’s graduation party. She said she has started feeling better Tuesday and has tolerated eating a potato and some soup, but is debating whether to cancel long-held plans to go away this weekend for a concert.
“It takes a lot to recover from that much diarrhea,” she said.
Taco Bell has voluntarily and temporarily removed limited ingredients at select restaurants as a precautionary measure, but said public health officials haven’t confirmed a link to the chain’s food or any specific ingredient, supplier or retailer.
“We will continue to closely monitor the situation and follow the guidance of public health authorities,” Taco Bell said.
Lettuce is a tricky ingredient to track in an outbreak because the same supplier can serve restaurants and supermarkets. Suppliers often handle lettuce from various farms, making it hard to pinpoint a single source.
Michigan’s health department said its early findings weren’t conclusive and that its investigation into the outbreak was continuing.
It can take up to two weeks for cyclosporiasis symptoms to develop, so health departments have been asking people who get sick to document what they ate over a two-week period to find commonalities.
Michigan’s health department is pulling staff off other projects to assist the cyclospora outbreak response, Bagdasarian said. Over the last year and a half, funding cuts at the federal level trickled down to the state health department, she said, resulting in layoffs and lost funding for well-established programs.
“Public health is doing far more than ever before with far fewer resources in 2026,” Bagdasarian said.
The CDC stopped routinely reporting data for cyclospora and several other pathogens last July under a federal-state partnership known as FoodNet. Gwen Biggerstaff, deputy director of the Centers for Disease Control and Prevention’s Division of Foodborne, Waterborne, and Environmental Diseases said the shift didn’t impact national surveillance, and that the program is instead designed to look at trends over time to inform policy and prevention activities.
There are 10 participating FoodNet sites, including eight states and certain counties in California and New York, and it doesn’t include some of the hardest-hit states such as Michigan.