Cyclosporiasis cases in Pennsylvania have been linked to a multistate outbreak of the intestinal illness spread by a parasite that causes “explosive” diarrhea, state and federal health officials said Friday.
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Earlier this month, the Centers for Disease Control and Prevention linked cyclosporiasis cases in five states to lettuce grown by Taylor Farms and sold at Taco Bell. Now, investigators say they’ve identified illnesses in nine states in people who ate at Taco Bell and later became sick.
Cyclosporiasis is caused by a single-celled parasite, Cyclospora cayetanensis, that spreads through fecal material. It can infect a person’s gut after consuming food or water contaminated by feces, and in the past has spread through fresh produce like leafy greens.
The CDC has identified 1,947 people in Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia who were infected with Cyclospora and reported eating at Taco Bell. At least 98 people have been hospitalized, the Food and Drug Administration said.
It’s likely that case counts are much higher than reported, the CDC says, because many people recover from cyclosporiasis without seeking medical care or getting tested.
Nationwide, the agency is tracking 4,173 confirmed cases of the illness and another 7,400 cases that haven’t been confirmed by lab testing, including many cases in Michigan and Ohio.
Pennsylvania health officials said they have confirmed 45 cases in the state so far this year and are monitoring three additional suspected cases. In all of 2025, the state saw 40 cyclosporiasis cases; Pennsylvania reported 87 cases in 2024.
State officials said “several” of this year’s cases have been linked to the multistate outbreak, but added their investigation is ongoing.
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In New Jersey, health officials recorded 46 cases between May 1 and July 16. Cases typically rise in the late spring and summer months, and officials said last week that this year’s are in line with a typical year’s case count.
Both Pennsylvania and New Jersey were among the 27 states affected by a recall of lettuce sold by the California-based Taylor Farms.
Last weekend, a sample of Taylor Farms lettuce that wasn’t part of the recall, taken from a shipment at the U.S.’s southern border with Mexico, tested positive for Cyclospora. The results turned out to be a false positive.
Still, the Food and Drug Administration tweeted, there is “overwhelming epidemiological data supporting the current voluntary recall” from Taylor Farms.
The FDA has listed products affected in the recall on its website. People who bought affected lettuce should throw it out immediately and not eat it, the CDC says.
They should wash items and surfaces that might have touched the lettuce with hot, soapy water, and avoid recalled lettuce at Taco Bell or other restaurants. Customers should ask restaurants about the source of their lettuce before ordering it.
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