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Cyclosporiasis outbreak: Michigan probes lettuce link — AI-generated representative image of lettuce being examined during a foodborne illness source investigation amid a cyclosporiasis outbreak.

Editorial Team

Michigan health officials say lettuce or other salad greens could be the source of the state’s outbreak of cyclosporiasis, a parasitic infection that can cause intense diarrhea. The Michigan Department of Health and Human Services said the information was shared Monday as investigators try to determine how residents are being exposed.

Federal health officials have reported a broader national outbreak across 31 states, with total cases near 3,000 and at least 86 people hospitalized, according to the U.S. Centers for Disease Control and Prevention (CDC). Michigan has recorded 2,640 cases so far, the highest of any state.

The update matters because cyclosporiasis can lead to severe gastrointestinal illness and dehydration, and because lettuce and salad greens are widely consumed and often eaten raw, which can increase the risk of exposure if they are contaminated.

Health officials stressed that the investigation is still developing. Michigan’s indication that lettuce is a common thread applies only to cases being examined in the state, and officials said they do not yet have enough evidence to identify a specific type of produce, grower or supplier.

Michigan’s chief medical executive, Dr. Natasha Bagdasarian, said early investigative information has repeatedly pointed toward lettuce. In a statement, she said:

“Early information has shown lettuce as a common product that regularly comes up during the investigation,”

The Michigan Department of Health and Human Services said it is not yet possible to pinpoint the specific produce item, the grower, or the supplier involved, and that other food items cannot be ruled out based on the information available so far.

At the national level, the CDC has reported that the foodborne gastrointestinal illness has been identified in 31 states and that 86 people have been hospitalized. Health experts noted that reported case totals can lag because it can take about a week for symptoms to appear.

Michigan health officials also issued consumer guidance aimed at reducing risk while the source remains unconfirmed. They urged people to avoid prepackaged salads, choose individual heads of lettuce, rinse them thoroughly, discard outer layers, and cook vegetables when possible.

Cyclosporiasis is a foodborne gastrointestinal illness caused by a parasite. In this outbreak, the illness has been described by health officials as involving intense diarrhea, which can be severe enough to disrupt daily activities and require medical care.

Investigations into foodborne outbreaks typically focus on identifying foods that repeatedly appear in patient interviews and exposure histories. Michigan officials said lettuce has come up often in the state’s investigation, but they cautioned that a single product has not been conclusively identified and that other foods could still be involved.

The outbreak is not confined to Michigan. The CDC has described a multi-state event spanning 31 states, with total case counts near 3,000. Michigan’s 2,640 cases represent the majority of reported illnesses so far, making the state a central focus of the ongoing investigation.

Health authorities also note that case reporting can trail the real-time spread of an outbreak. Experts cited the incubation period, saying it can take a week for symptoms to appear, which can delay when illnesses are recognized, diagnosed, and added to official tallies.

Because lettuce and salad greens are commonly consumed raw and appear in both home-prepared meals and ready-to-eat products, identifying whether and how they are linked to an outbreak can have significant implications for consumers and for the food supply chain. Michigan officials have not yet linked the illnesses to a particular grower or supplier.

Michigan’s update was based on what officials described as early information collected during the state’s investigation. Dr. Natasha Bagdasarian, the state’s chief medical executive, said in a statement:

“Early information has shown lettuce as a common product that regularly comes up during the investigation,”

The Michigan Department of Health and Human Services said the evidence is still insufficient to determine the precise product involved, and emphasized key unknowns, including the specific type of produce, as well as the grower and supplier. The department added that investigators cannot rule out other food items at this stage.

National outbreak figures cited by health agencies show the scale of the problem. The CDC said total cases are near 3,000 across 31 states and that 86 people have been hospitalized. Experts noted that the number of reported cases may increase as additional illnesses are identified after the typical one-week period before symptoms develop.

Health officials described the illness as potentially starting with flu-like symptoms such as severe fatigue and body aches, followed by watery diarrhea that can sometimes be uncontrollable. They said other symptoms may include unusually bad gas, stomach cramps and nausea.

Officials warned that dehydration can be one of the most serious complications. They said treatment can include fluids and an antibiotic.

As a precautionary measure, Michigan officials advised consumers to avoid prepackaged salads, select individual heads of lettuce, rinse them thoroughly, discard outer layers, and cook vegetables when possible.

Michigan officials have identified lettuce as a frequently reported item among people who have become ill in the state, but they have not confirmed a specific produce variety, grower, or supplier. The state also said other foods remain possible sources and have not been excluded.

Nationally, the CDC continues to track the outbreak across 31 states, including hospitalizations. Health experts have warned that reporting can lag because symptoms may take about a week to develop, and additional confirmed case updates are expected as investigations and reporting continue.