Health officials said on July 16 that shredded iceberg lettuce supplied by a vendor and served at Taco Bell restaurants has been linked to cyclospora infections in five states.
The U.S. Centers for Disease Control and Prevention (CDC) said it, together with the Food and Drug Administration (FDA), was investigating the lettuce sourced from a Mexico-based supplier for its possible link to the gastrointestinal disease that had sickened over a thousand people.
More than 1,644 people infected with cyclosporiasis said they had eaten at Taco Bell restaurants in Indiana, Kentucky, Michigan, Ohio, and West Virginia before falling ill, according to the agency.
The CDC urged people to avoid consuming shredded iceberg lettuce served at Taco Bell locations in those states. It did not name the supplier.
The FDA said they were working with state partners to determine if additional products may be contributing to this outbreak.
Taco Bell said on July 16 that it had removed lettuce supplied by one of its vendors in some states, but did not name the supplier or say which states were affected.
“Based on ongoing conversations with public health officials, and out of an abundance of caution, Taco Bell has taken immediate action to voluntarily remove potentially impacted lettuce from a supplier in select states,” Taco Bell said in a statement to news outlets.
The fast food chain said it would replace the lettuce within 24 hours over the possible link to the outbreak.
More than half of the states in the country have recently reported cases of cyclosporiasis, which is caused by a parasite called cyclospora that spreads through produce contaminated with feces. Michigan has reported the most cases so far, with 4,312 as of July 16.
The CDC said in its latest update that it had identified 1,645 lab-confirmed cases of the parasite as of July 13, and none reported any travel in the two weeks before they fell ill.
Of those, 141 were hospitalized, while more than 5,100 additional cases still require further analysis to confirm whether they are domestically acquired cyclosporiasis. No deaths have been reported so far.
Cyclosporiasis cases happen in the United States each summer, but the number this year is unusually high, officials said. Prior cyclosporiasis outbreaks have been caused by contaminated produce such as green onions, peas, and raspberries.
Symptoms of cyclosporiasis include loose, watery stool and abdominal pain. Diagnosis typically involves testing stool samples. Antibiotics are usually the preferred treatment.
Health agencies are advising people to wash their hands before and after handling produce, wash produce before preparing, and consider cooking produce before consumption.
Zachary Stieber and Reuters contributed to this report.