Two people in Michigan have died in what state health officials say are the first confirmed US deaths linked to the ongoing Cyclospora outbreak, marking a significant development in a nationwide foodborne illness surge that has sickened more than 20,000 people.
The Michigan Department of Health and Human Services (MDHHS) announced on Monday that both individuals had underlying health conditions that may have been worsened by severe intestinal illness and dehydration caused by the infection.
The deaths come as federal health authorities continue investigating a large outbreak linked to contaminated lettuce served at Taco Bell restaurants in multiple states.
Here’s what we know.
What is Cyclospora?
Cyclospora is a microscopic, single-celled parasite that infects the small intestine and causes an illness known as cyclosporiasis.
According to the US Centers for Disease Control and Prevention (CDC), the parasite spreads when people consume food or water contaminated with human feces containing Cyclospora.
Unlike many foodborne bacteria, Cyclospora infections are most commonly associated with fresh produce rather than meat or dairy products.
What are the symptoms?
Symptoms usually appear about a week after infection and can last for days or even weeks if left untreated.
Common symptoms include:
Watery diarrhea
Frequent or explosive bowel movements
Loss of appetite
Weight loss
Stomach cramps
Bloating
Nausea
Fatigue
Low-grade fever
The illness can lead to dehydration, especially in older adults or people with weakened immune systems.
Who is most at risk?
While most healthy people recover completely with treatment, serious complications are more likely in:
Older adults
Young children
People with weakened immune systems
Individuals with chronic medical conditions
People who become severely dehydrated
Michigan officials said both people who died had underlying health conditions that may have contributed to the severity of their illness.
The CDC notes that deaths from cyclosporiasis are extremely rare, making these the first confirmed fatalities linked to the parasite in the United States.
How widespread is the outbreak?
The CDC says it is aware of more than 18,000 confirmed or suspected cases during the current outbreak.
However, because federal data often trails state reporting, health officials estimate the nationwide total has already surpassed 20,000 cases.
Cyclosporiasis cases typically increase during late spring and summer, when fresh produce consumption is higher.
What food has been linked to the outbreak?
Federal investigators have traced a major portion of the outbreak to lettuce imported from Mexico that was served at Taco Bell restaurants in nine US states.
As of late July:
1,947 illnesses had been linked directly to the contaminated lettuce.
At least 98 people were hospitalized.
The CDC says the investigation remains ongoing and additional foods, restaurants, retailers or distributors could also be connected to the outbreak.
How does Cyclospora spread?
Cyclospora is not usually spread directly from person to person.
Instead, infection occurs when people consume contaminated food or water.
Fresh produce can become contaminated if irrigation water or washing water contains human feces carrying the parasite.
Foods previously linked to Cyclospora outbreaks include:
Lettuce
Cilantro
Basil
Raspberries
Snow peas
Salad mixes
Because the parasite requires time to become infectious after being shed in feces, direct person-to-person transmission is considered uncommon.
