Health authorities officially end the biggest cyclosporiasis outbreak ever recorded in the US

Five months after the first reported cases, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have officially put an end to the cyclosporiasis outbreak that hit 21 states over the summer. 

The massive health event is the longest recorded in US history, leaving behind nearly 20,000 lab-confirmed cases, 1,043 hospitalizations, and two deaths, according to CDC data. The number of infections is 16 times larger than those recorded over the same period last year, and more than four times those of 2019, in what was, until now, the biggest cyclosporiasis outbreak on record. 

Image courtesy of the Centers for Disease Control and Prevention

According to its latest update, the FDA is now moving to post-response activities, including mitigating and preventing future outbreaks. The agency stated that the investigation into Taylor Farms de Mexico, the alleged source of the pathogen, is still ongoing, and samples collected on site by FDA personnel are still being analyzed. Updates with the findings will be posted to the agency’s website as they happen. 

Cyclosporiasis: A record you don’t want to break

The first cyclosporiasis cases were recorded in early May, with patients reporting infection after eating menu items with iceberg lettuce at Taco Bell. As cases mounted across the country, health authorities officially declared a cyclosporiasis outbreak on July 16, and a day later, the fast food restaurant’s supplier, Taylor Farms de Mexico, began one of the largest voluntary food recalls in recent years. 

In August, at the peak of the event, more than 1,000 cases were reported in a single day.  Michigan was the outbreak’s hardest-hit state, reporting two deaths and over 14,000 cases, 5,762 of which were laboratory-confirmed. Ohio sits behind with 2,871 positive cases, followed by Missouri (1,071) and Indiana (870). 

The sheer scale of the outbreak led to heightened scrutiny of food-safety protocols for imported produce, shedding light on the budget and personnel cuts inflicted by the Trump Administration that may have led to a significant decline in FDA inspections.

Image by Shutterstock

“The FDA is supposed to inspect more than 19,000 international food sites annually,” news outlet Al Jazeera reported. “The agency hit an all-time high of 1,700 in 2019, less than one-tenth of the target, according to the Government Accountability Office. The FDA did not inspect the Mexican farm implicated in the outbreak until about a month after the investigation began.” 

Fresh lessons from the outbreak

Both the FDA and the CDC are confident that all iceberg lettuce linked to the outbreak has been removed from the market. However, that didn’t prevent consumer confidence from dwindling. 

Reuters reported that some shoppers were avoiding raw fruits and vegetables as well as ​dining out due to the outbreak, leading to declining produce sales in July and lower foot traffic at restaurants such as Taco Bell, Sweetgreen, and Chipotle. 

The International Fresh Produce Association (IFPA), which represents the fresh produce supply chain, welcomed the end of the outbreak and reaffirmed its commitment to support the authorities in the remainder of the investigation. 

"Our teams stand ready to support and to work alongside the agencies, and we will keep at that work. We will not rest until we identify the root cause of this outbreak so that the lessons we learn prevent another event," said Max Teplitski, IFPA chief science officer. 

The FDA’s Acting Deputy Commissioner for Food Human Foods Program, Donald Prater, posted a letter to the agency’s website urging the fresh produce industry to cooperate in the mitigation and prevention of the next cyclosporiasis outbreak. 

“While there are practices known to reduce Cyclospora risk, more work must be done,” he wrote. “We are asking you to build on industry investments in prevention and mitigation efforts and to ensure these best practices are rigorously and consistently implemented throughout this supply chain.”

*All images are referential.

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