Thursday Afternoon Update: Michigan Alone Reports 193 Cyclospora Hospitalizations. CDC’s Outbreak Page Says 98 for All Nine States. The Fifty-State Head Count Is Now 19,330.

This morning this table said 18,687. Six hours later it says 19,330, and almost none of that is the parasite moving faster. Two states posted new numbers this afternoon, and I found a third I had been carrying wrong for eleven days. That is the honest cost of counting an outbreak one state at a time, and it is still a smaller error than the one the federal government is making on purpose.

Start with the hardest number in the file. Thursday is the day Michigan updates hospitalizations, and this afternoon MDHHS moved from 160 to 193. CDC’s outbreak page says 98 hospitalizations across all nine outbreak states, and it has said that since July 24. One state is now reporting nearly twice as many people admitted to hospital as the federal government attributes to the entire nine-state outbreak. The two figures are built differently: CDC’s 98 counts only the 1,947 who reported eating at a Taco Bell, and Michigan’s 193 is self-reported across all 10,386 of its cases. But hospitalization is the hardest endpoint in this dataset. It does not depend on whether somebody remembered a questionnaire.

Michigan’s case count went to 10,386 today, up 309. It was 174 total on June 30.

Now the correction, which is mine. This table has been carrying Missouri at 216 since July 19. On July 27 the Missouri Department of Health and Senior Services posted its weekly update and the state was at nearly 600— reported by St. Louis Public Radio, KCUR and KBIA. Not up a little. Nearly tripled in a week, in a state that logs about a dozen cases in an ordinary year. I published a number this morning that was three days stale and roughly 380 low.

There is a wrinkle, and it belongs in the open. Missouri has not published an exact figure. All three outlets say only “nearly 600,” and the St. Louis Public Radio account is internally inconsistent — its headline says nearly 600 while its text calls that roughly double the 216 from the week before, which would be 432. Missouri therefore goes into this table the way Georgia, Louisiana, Tennessee and Utah already do: as a range, counted at the low end. I am counting 550. The state posts again Sunday and I will replace it with whatever the state actually says.

With Missouri corrected and Michigan updated, the fifty-state total crosses nineteen thousand. It was 17,812 on Monday.

Ohio’s regional number moved again too. The Toledo-Lucas County dashboard reports 2,926 cases across northwest Ohio and 1,194 in Lucas County as of today. The Ohio Department of Health’s statewide figure is still 2,574 and has not moved since July 24. A corner of Ohio now reports 352 more illnesses than Ohio.

Two caveats about Michigan’s curve, and they point in opposite directions. MDHHS says the July 27 total included roughly 475 cases not previously reported because of delayed laboratory reporting, which inflated a single day and does not reflect a sudden increase in illness. Going the other way, the state’s chief medical executive has said some health systems are now limiting testing to patients who are severely ill or immunocompromised, because of laboratory backlogs and supply limits — which means milder cases are going uncounted.

The nine outbreak states now hold 16,143 of the 19,330. CDC’s outbreak count for those same nine states is 1,947. That leaves 14,196 people sick with this parasite, in the nine states the government has already named, who are not in the number the government publishes — because they apparently did not report eating at a Taco Bell. Eighty-eight percent of the illness inside the outbreak states still sits outside the outbreak count.

CDC says 45 states have cases. Fourteen states publish no count at all. Three of those — Alabama, Mississippi and South Carolina — are on the FDA’s own list of states that received the recalled lettuce. And we can now name more of the rest: alongside South Dakota, Vermont and Delaware, the states with confirmed cases and no published number include Maine, Nevada, New Mexico and North Dakota. A blank cell in the table below has never meant no illness. It has only ever meant no answer.

One limit on the total, stated before somebody else states it for me. CDC’s 6,707 counts only people who did not travel internationally; the fifty-state total does not make that cut, because most states do not publish the split. Where they do, it matters — Virginia reports 31 of its 126 as travel-associated, Illinois said 96 of 216 in mid-July. It cuts harder the other way, though: a six-week reporting lag, a parasite that is missed unless a clinician specifically orders the test, and everybody who got sick and stayed home. The comparison that survives all of it is inside the nine states, where state-reported illness is measured against state-reported illness. 16,143 against 1,947. Both halves counted the same way.

Every case number below, whether that state received the recalled Taylor Farms lettuce, and a link to where the number came from. Where a state publishes on a fixed schedule, the schedule is noted, because a number is only as fresh as the day its agency next opens the file.

Receiving the recalled lettuce does not prove the lettuce sickened anybody in that state and not receiving it does not prove the opposite. The table shows where product went and where illness was counted. What it keeps showing is that the government’s outbreak number is not tracking the outbreak. It is tracking the questionnaire. Michigan added 33 hospitalizations today. CDC’s outbreak page has not moved since July 24.