The Fifty-State Cyclospora Count Is Now 31,521. Eight States Have Posted New Numbers Since Saturday

On Saturday this chart stood at 30,523. Today it stands at 31,521. Eight states have posted new numbers since then, CDC published a full week of federal data on Tuesday, and one row of my own chart turned out to be short by more than a hundred cases.

CDC’s surveillance page updated Tuesday with data through August 17. It now counts 15,716 laboratory-confirmed cases of cyclosporiasis acquired in the United States since May 1, up from 13,895 a week earlier, with 828 hospitalizations, up from 740, and two deaths, both in Michigan. Forty-seven states, the District of Columbia and Puerto Rico have reported cases. The travel-associated series, which is counted separately and is not this outbreak, stands at 1,681 with 61 hospitalizations.

The backlog is the part worth watching. The count of additional cases awaiting further investigation went from 10,455 to 11,841. It rose by 1,386 in the same week that confirmations rose by 1,821, which means new illnesses arrived faster than the laboratory work could clear them. A week ago, that pile shrank for the first time all season and I read it as the lag finally clearing. It grew again. Confirmed and pending together now come to 27,557.

Onset dates on that page now run from May 1 through August 13, four days before the data was cut. People were still getting sick last week. CDC’s outbreak investigation page has not moved since August 13 and still carries 9,481 illnesses, 398 hospitalizations, two deaths and seventeen states, with the first illness in the outbreak dated June 14. FDA’s advisory has not moved either and still lists thirty-one states with confirmed distribution of the recalled lettuce and nine more where it may have gone.

CDC did add something new. Its page now says that it and FDA are investigating at least six other clusters of cases whose sources have not been confirmed, and it points readers to FDA’s active investigation table. Those six have been sitting on that table for weeks, at 172, 25, 18, 11, 8 and 2 illnesses. That is 236 people carrying this parasite with no food named for any of them, no recall, and no announcement of any kind. The table itself has not been updated since August 12, though FDA republished it on Monday without changing a figure.

In the states, Missouri released a Sunday figure of 1,950, up 373 in a week. Illinois turns out to have been at 1,260 as of August 11 and Iowa at 300 across fifty-five counties as of August 13, and I had been carrying both at older numbers. Indiana posted 2,069 today and crossed two thousand. New York posted 939 today in its Wednesday update. Virginia is at 214 and Arkansas at 277, both posted Monday. West Virginia holds at 304 and reports again on Friday. Michigan holds at 13,909 and reports again tomorrow.

Then there is Texas, and that correction is mine rather than anybody else’s. My chart carried 198, which is the figure the state gave a reporter on August 5. Texas does not run a dashboard. It hands a count to reporters once a week, and the most recent one published is 315 cases with 52 hospitalizations, an increase of more than a hundred in a single week. Texas is not one of the seventeen states in the federal outbreak, and the state says no source has been identified for its own cases.

Texas is also the row CDC’s new map flagged. When CDC published a downloadable state map last week the values came in bands rather than exact counts, and seven rows on my chart sat below the bottom of the band CDC had placed that state in. Texas was the first one I went back to, and it was low by 117. Louisiana, Georgia, Tennessee, Minnesota, New Jersey and Pennsylvania are the other six, and every one of them still rests on a July roundup rather than on a state page. Utah belongs in the same paragraph: this chart says 1, and Utah’s own health department reports 48 cases since May 1, of which 17 is the like-for-like figure against the rest of this table. Those rows are mine to fix, and I would rather say so than quietly restate them.

Here is where all fifty states stand today. The Lettuce column is whether FDA has confirmed that recalled Taylor Farms de Mexico lettuce reached that state. The last column is a different question and the more important one: whether anybody has tied that state’s illnesses to Taylor Farms at all.

Seventeen states are marked Linked, and that is the whole federal outbreak. They are the states FDA and CDC have attributed to the recalled lettuce, and for the nine that came first the attribution rested on Taco Bell exposure, which is to say on a customer remembering where they ate. Two more, Oregon and Washington, are marked Travel link, because their cases are residents who got sick after visiting an outbreak state rather than from anything sold at home. Five health departments have looked and said their cases are not tied to this outbreak: Rhode Island, New Mexico, Maryland, Utah and Hawaii. New Hampshire is still the only state anywhere that has named a Taylor Farms product at a specific place, a hospital cafeteria in Keene.

That leaves twenty-six states marked Unknown. Between them they have reported thousands of illnesses, and not one of those illnesses has been either tied to this outbreak or ruled out of it. Thirteen of the twenty-six are on the federal list of states that received the recalled product, and they are still Unknown. That is not a finding that the lettuce stopped at their borders. It is the absence of the question.

Forty states publish a 2026 count that is added into the total above. Hawaii publishes five and says all five are travel-associated, so they are shown and left out of the sum. Nine states publish nothing at all: Delaware, Idaho, Montana, Nevada, New Mexico, North Dakota, South Carolina, Vermont and Wyoming. South Carolina is on FDA’s confirmed distribution list and reported 45 cases in 2025, so it plainly counts this disease when it wants to. Its residents cannot look up a single number this season.

The numbers are larger than we can comprehend. Most people with cyclosporiasis never get a stool test, because the parasite is missed by the routine ova and parasite exam and has to be asked for by name, and because somebody with a diarrheal illness that comes and goes for a month often never sees a doctor at all. The standard estimate of that gap comes from Scallan and colleagues, Foodborne Illness Acquired in the United States, Major Pathogens, in Emerging Infectious Diseases in 2011, which puts the underdiagnosis multiplier for Cyclospora at 83.1. Applied to CDC’s 15,716 laboratory-confirmed cases, that puts the real number near 1,306,000.

Michigan reports tomorrow, and Michigan is forty-four percent of the number in that table. The season CDC defines runs out on August 31, twelve days from today. The counting will not.