The Centers for Disease Control and Prevention and the Food and Drug Administration advise consumers to avoid eating shredded iceberg lettuce at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio and West Virginia.
Health officials analyzed 190 cases of cyclospora in Michigan where a person who fell ill reported eating at Taco Bell. Officials found that 90% of those people said they ate iceberg lettuce.
More than 1,644 sick people in this multi-state cyclospora outbreak reported eating at Taco Bell in those states starting May 13, according to the agencies. There have been 94 hospitalizations and no deaths reported.
The FDA traced this subset of cases identified nationwide to a single supplier of contaminated iceberg lettuce from Mexico, but did not name the supplier.
FDA says it's working with the supplier to identify other locations where the contaminated lettuce has been distributed. The agency notes this is one large cluster that is epidemiologically related. There are other clusters across the country that may or may not be associated. Cases have been identified in 34 states.
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Taco Bell issued a statement July 16 that it took "immediate action to voluntarily remove potentially impacted lettuce from a supplier in select states." The statement also said the lettuce would be removed from the supply chain nationwide and replaced within 24 hours.
A wide reach for salad suppliers
The Associated Press, citing an unnamed federal official, has reported that Taylor Farms was the supplier of the lettuce. NPR has not independently confirmed that, and Taylor Farms has not responded to a request for comment.
A handful of big players with integrated supply chains and advanced processing infrastructure, including Taylor Farms, dominate the bagged lettuce and salad industry in the U.S.
With such a big reach, a single supplier can provide lettuce products to a number of retailers, so it's possible that additional clusters of cyclospora around the country could be linked to lettuce from the same supplier. It's also possible that there are multiple sources and suppliers linked to other cases around the country.
The FDA and CDC say the investigation is continuing.
How to protect yourself
The symptoms of the illness include watery diarrhea, loss of appetite and fatigue, and people contract it by eating or drinking contaminated food or water.
To protect yourself from the parasite, the CDC advises people to follow standard food safety handling protocols. "Wash your hands and any fresh produce thoroughly under running water before eating, cutting or cooking. This will reduce the risk of infection. Cooking kills the parasite, so heating food to 158 F or 70 C or higher is effective," said Dr. Gwen Biggerstaff with the CDC's Division of Foodborne, Waterborne, and Environmental Diseases.
If people do develop symptoms, health officials advise people to contact their healthcare providers to be tested specifically for cyclospora. Routine stool tests often don't include that test.
"People with symptoms should stay well-hydrated and avoid preparing food for others while acutely ill, out of general caution, even though person-to-person spread is very unlikely," Biggerstaff said.
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