A cyclosporiasis outbreak that has grown into the largest on record in the United States has caused its first known deaths, two people in Michigan, the state’s health department said on Monday.
Cyclosporiasis, an intestinal illness caused by the Cyclospora parasite, is generally not life-threatening. Michigan, citing medical records, said the two who died had significant underlying health conditions that may have been affected by the disease and related dehydration.
An FDA investigation linked the outbreak, now in nine states, to iceberg lettuce sourced from privately held Taylor Farms operations in central Mexico and served at Yum Brands-owned Taco Bell (YUM.N). The lettuce has been recalled, but authorities are still seeking other potential sources.
Epidemiologists suspect multiple outbreaks, and it was not immediately clear whether the people who died were sickened from Taylor Farms iceberg lettuce served at Taco Bell restaurants, or from another yet to be identified source.
U.S. cyclosporiasis cases have climbed to record levels this year with the current outbreak among the largest caused by foodborne illness in recent U.S. history.
It has also hurt consumer confidence, lowering lettuce sales and visits to restaurant chains such as Sweetgreen (SG.N), and Chipotle (CMG.N).
The U.S. CDC, whose surveillance lags state reporting by several weeks, has recorded 6,707 laboratory-confirmed cases nationwide as of July 28, along with more than 11,500 suspected cases not yet confirmed through laboratory testing. State counts run higher because the Centers for Disease Control and Prevention excludes probable cases.
MICHIGAN HARDEST HIT
Michigan, the hardest-hit state, has recorded 11,234 cases as of Monday, up 461 from Friday, with 193 hospitalized, health department data shows.
The large number of cases, gaps in reporting and people’s difficulty recalling what they ate have made it harder for investigators to determine which foods, beyond Taylor Farms lettuce, may have contributed to the outbreak, local Michigan health officials said.
“We have one clear implicated food, but it doesn’t explain everything,” said Susan Ringler Cerniglia, spokesperson for the Washtenaw County Health Department, where 875 cases have been reported.
Mixed messaging from the U.S. Department of Health and Human Services had also complicated the response, she said. Health Secretary Robert F. Kennedy Jr. has said the outbreak is under control.
“Leadership is saying things that don’t really fit with what the data is telling us, and that’s very, very problematic,” Ringler Cerniglia said. “The secretary is saying this is under control and it’s all good while you have case counts exploding.”
HHS said on Monday it was aware of the deaths.
Michigan’s Wayne County, which includes Detroit, has the highest number of cases at 1,379, state data showed.
Cases have been rising steadily across the United States in recent weeks, according to the CDC. Symptoms include severe diarrhea, which can lead to dehydration, nausea and other gastrointestinal issues.