Federal officials say recalled iceberg lettuce remains the likely source of a multistate Cyclospora outbreak, even after the FDA withdrew a positive laboratory result and warned that reporting delays will continue pushing case totals higher.
By yourNEWS Media Newsroom
Health and Human Services Secretary Robert F. Kennedy Jr. said Tuesday that federal officials have contained the nationwide Cyclospora outbreak after identifying a likely food source and overseeing recalls by the companies involved.
Kennedy made the declaration as confirmed infections and pending reports continued to rise, reflecting the lengthy delay between exposure, diagnosis and inclusion in national surveillance totals.
“We have the outbreak under control,” Kennedy said during a federal briefing on health care fraud. “We have done extensive forensics, epidemiological forensics, and we’ve identified the source of the outbreak. And the companies that are involved have all implemented a recall.”
The federal investigation remains focused on iceberg lettuce supplied by Taylor Farms de Mexico, despite the Food and Drug Administration’s decision Sunday to withdraw an earlier laboratory finding involving the product.
The FDA said experts determined that a lettuce sample initially reported as positive was a false positive.
The agency did not cancel or reverse the recall. Investigators said epidemiological evidence and product-tracing records continued to implicate the company’s lettuce in the illnesses.
Taylor Farms’ recall covers central Mexico iceberg lettuce sold under Walmart’s Marketside brand at certain stores and supplied to restaurants and institutional food-service customers in 27 states.
Consumers have been advised not to eat recalled lettuce and to discard it or return it according to instructions from the retailer or supplier.
The outbreak’s national totals remain unsettled because thousands of reports are still being reviewed.
The Centers for Disease Control and Prevention had confirmed 1,645 domestically acquired cases across 34 states as of July 13. An additional 5,100 reports were awaiting analysis.
Among the nationally confirmed patients, 141 had been hospitalized. No deaths had been reported.
Federal officials cautioned that cyclosporiasis is frequently underdiagnosed and underreported, meaning the official count may not represent the full number of infections.
The parasite can cause symptoms resembling other gastrointestinal illnesses, and some patients may recover without being tested. Others may not immediately connect their illness to food consumed days or weeks earlier.
State-level reporting can also produce dramatically different totals from federal surveillance.
According to Michigan health officials, the state’s count reached 6,571 cases Tuesday.
That figure cannot be directly compared with the CDC’s confirmed national total because Michigan uses a broader and more current reporting system. State numbers may include probable cases and reports that have not completed the CDC’s national review process.
The variation illustrates how agencies may count illnesses differently depending on testing status, case definitions and the stage of an investigation.
One major cluster has been associated with shredded iceberg lettuce served at Taco Bell restaurants.
More than 1,644 illnesses in Indiana, Kentucky, Michigan, Ohio and West Virginia have been linked to that lettuce, according to the information released by health officials.
Ninety-four people in the five-state cluster were hospitalized. No deaths were reported.
Cyclospora cayetanensis is a microscopic parasite that can contaminate fresh produce or water. Infection occurs when a person consumes food or water containing the parasite.
The illness most commonly causes frequent watery diarrhea. Other symptoms can include abdominal cramps, nausea, fatigue, reduced appetite and weight loss.
Symptoms generally begin about one week after exposure, although illness may appear as soon as two days or as late as two weeks afterward.
Without treatment, symptoms can persist for weeks and may temporarily improve before returning.
That long incubation and relapsing pattern can make outbreaks difficult to recognize quickly. Investigators must compare interviews, purchase records, restaurant supply information and distribution data to identify foods shared by patients in different states.
National reporting is also delayed well beyond the date when a person first becomes ill.
The CDC assumes an approximately six-week lag between the onset of symptoms and inclusion in federal case totals. As a result, confirmed numbers may continue rising even after contaminated food has been removed from stores and restaurants.
Kennedy’s statement that the outbreak is controlled refers to the government’s conclusion that the suspected source has been identified and recalled, rather than an expectation that the reported case count will immediately stop increasing.
Federal officials have said illnesses already in the reporting pipeline will continue to appear in surveillance data.
Kennedy also defended reductions made to the Foodborne Diseases Active Surveillance Network, commonly known as FoodNet.
FoodNet tracks laboratory-confirmed foodborne infections and works with state and local health departments to identify trends, evaluate prevention measures and estimate the broader burden of illness.
“We did cuts in the FoodNet program, but they were for redundant surveillance, and all the states will tell you that we’re still doing forensics,” Kennedy said.
The secretary rejected suggestions that the reductions had prevented federal officials from identifying the outbreak or tracing its likely source.
Kennedy had addressed the investigation the previous week, noting that Cyclospora outbreaks commonly occur during warmer months and saying that source identification would help people avoid exposure.
“There are cyclospora outbreaks every summer,” he said. “Now that we know the probable culprit, I think it’s going to be much easier for people to make healthy choices.”
The FDA’s withdrawal of the laboratory result added complexity to the investigation but did not eliminate the wider body of evidence surrounding the recalled lettuce.
A false positive means the particular sample did not reliably establish the presence of the parasite. Epidemiological and traceback findings, however, may still connect an outbreak to a product through patterns involving what patients ate, where food was purchased and how it moved through the supply chain.
Federal authorities therefore kept the recall in place while continuing to advise the public against consuming the implicated Taylor Farms de Mexico iceberg lettuce.
People who may have eaten recalled lettuce should monitor for persistent watery diarrhea and other symptoms associated with cyclosporiasis.
Those who become ill are advised to contact a health care provider, particularly if symptoms are prolonged, severe or accompanied by dehydration, substantial fatigue or weight loss.
Testing may be required because Cyclospora is not always detected through routine examinations unless a clinician specifically requests the appropriate laboratory analysis.
The continuing increase in reported infections does not necessarily indicate that recalled products remain in active distribution. It may instead represent illnesses that began earlier but are only now being diagnosed, investigated or added to state and federal databases.
Kennedy said the necessary recalls have been implemented and the source has been identified through extensive epidemiological work.
Health officials nevertheless continue monitoring new reports, reviewing the thousands of cases awaiting analysis and comparing state data with the CDC’s confirmed national figures.
The outbreak will not be considered fully resolved until surveillance shows that new illnesses tied to the implicated food have stopped occurring and the reporting backlog has been processed.
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