A disease caused by a parasite called Cyclospora has been recorded in 45 states this summer, the Centers for Disease Control and Prevention said in an update.
Delaware, Oregon, South Dakota, and Vermont have now logged cases of cyclosporiasis, the disease, the CDC said on July 28.
The CDC in its previous update had said 41 states had reported cases.
The number of confirmed cases across the 45 states since May 1 is up to 6,707, according to the CDC. More than 11,500 other cases have been reported but are pending laboratory confirmation or “further investigation and analysis, such as ruling out international travel,” the CDC said. The agency is not counting cases involving international travel or probable cases.
Patients have ranged in age from 1 to 98, with a median age of 44.
“We estimate a 6-week reporting lag between illness onset and case reporting to CDC, so we anticipate that case counts will continue to rise as data are received,” the CDC said.
Cyclosporiasis typically appears in the summer, but the number of cases this year is much higher than normal. The main symptom of the disease is diarrhea.
Cyclospora is present in produce contaminated with feces.
Federal officials have said that the cases in nine states are linked to contaminated lettuce from Taylor Farms that was served at Taco Bell, while officials in North Carolina suspect parsley and cilantro as causes in addition to lettuce.
More than 400 of the people whose cases have been confirmed have been hospitalized. No deaths have been reported.

Officials in Delaware, South Dakota, and Vermont have not provided information on the cases in those states.
Diners Avoid Restaurants
Traffic is down at Taco Bell and other restaurants in recent weeks.
Foot traffic at Taco Bell dropped by 20.8 percent on Thursday, July 23, from the Thursday average between January 1 and July 6, according to data from Placer.ai.
Foot traffic was also down by 12.2 percent at salad chain Chopt; 1.4 percent at Chipotle Mexican Grill; and 3.1 percent at Panera Bread on July 23, compared to the prior six-month average for Thursdays, the analytics company said.

Paul Sellew, CEO and founder of Little Leaf Farms, which grows lettuce in the eastern United States, said worries about infections have driven down sales by double digits.
“The entire fresh produce category at retail is down,” Sellew said. “The consumer has been motivated by fear.”
According to market research firm NielsenIQ’s data, U.S. unit sales for fresh lettuce in the week ending July 18 were down 9 percent from a week earlier and 19 percent from two weeks before.
Reuters contributed to this report.

