Cyclospora Infections See Historic Increase
Hawaii is witnessing a significant rise in Cyclospora infections, contributing to a national surge in cases of this foodborne illness. Federal officials have indicated that products linked to the largest outbreak are no longer in circulation. Updated data from the Centers for Disease Control and Prevention (CDC) revealed 18,445 confirmed cases since May 1, a sharp increase from 17,180 reported the previous week. Currently, 49 states and the District of Columbia have reported confirmed cases.
Hawaii Joins CDC’s National Map
Initially absent from the CDC’s national map, Hawaii now reports confirmed Cyclospora cases. Hawaii’s Department of Health has confirmed multiple infections. Although the CDC’s data now includes Hawaii, Delaware remains an outlier. The state has identified 13 probable cases, but these have not been confirmed through whole-genome sequencing, which is uncommon there. Specimens from recent Delaware cases await CDC analysis for confirmation.
Contaminated Produce Linked to Outbreak
Despite assurances that the iceberg lettuce responsible for the outbreak has expired from the market, cases are rising. The Food and Drug Administration (FDA) and CDC affirm the implicated products are no longer sold. More than 11,400 cases, 495 hospitalizations, and two deaths have been tied to the lettuce, with reports suggesting other Cyclospora clusters unrelated to this product are under investigation.
Health officials indicate rising numbers don’t necessarily signify ongoing exposures at the same rate. Reporting delays often complicate real-time understanding with Cyclospora. It typically takes up to six weeks for cases to progress through the diagnostic process and be included in national databases.
Understanding Cyclospora and Cyclosporiasis
Cyclospora cayetanensis is a microscopic parasite causing the illness cyclosporiasis. Infection occurs through contaminated food or water, primarily fresh produce consumed raw. The parasite is not directly transmitted between people, as it requires time in the environment to become infectious. Most U.S. cases manifest in spring and summer, with the domestic cyclospora season defined as May 1 through August 31.
Recognizing Symptoms and Treatment
Symptoms of cyclosporiasis include prolonged, watery diarrhea along with cramps, bloating, nausea, fatigue, and weight loss. Vomiting and low-grade fever can also develop. Symptoms usually appear one week after exposure but can range from two days to two weeks. Without appropriate treatment, symptoms can persist and may recede before recurring.
Product Recalls and Investigation
The processed iceberg lettuce linked to this largest known outbreak came from central Mexico, distributed by Taylor Farms. A recall was initiated in July. While no positive cyclospora tests have been directly tied to Taylor Farms’ products, federal agencies insist that such products should no longer be in circulation. Hawaii health officials confirmed the recalled lettuce was not distributed in the state and continue to investigate possible connections with other outbreaks.
Comparing Cyclospora Cases to Past Years
This year’s outbreak is significantly larger than recent ones. The CDC has reported 18,445 confirmed cases since May, accompanied by 990 hospitalizations and two deaths. This contrasts with 1,180 cases reported over the same timeframe in 2025. Public health experts believe actual numbers may be higher, as many infections are undiagnosed or untreated.