By Hola America
Iowa has confirmed 272 Cyclospora infections in 55 counties. That is nearly four times the total recorded during all of 2025. Iowa is also part of the outbreak linked to recalled iceberg lettuce.
Updated Aug. 6, 2026.
DES MOINES, IA — Iowa health officials have confirmed 272 Cyclospora infections across 55 counties. They continue to investigate one of the state’s largest increases in cyclosporiasis cases.
Since July 23, the state has added 88 infections. At that point, Iowa had reported 184 cases.
In fact, the current count is nearly four times the 69 cases Iowa recorded during all of 2025.
However, the latest figures remain provisional. The total could rise as health officials receive more reports and complete patient interviews.
Meanwhile, Iowa HHS and local health departments continue to ask patients about food, travel and other possible exposures. Those interviews can help officials identify common sources and any ongoing risk to the public.
Iowa is now part of the iceberg lettuce outbreak
The CDC now lists Iowa among 15 states with cases connected to a multistate Cyclospora outbreak. Federal investigators linked the outbreak to iceberg lettuce from central Mexico that Taylor Farms de Mexico recalled.
However, Iowa HHS has not said how many of the state’s 272 infections belong to this outbreak.
For that reason, the statewide total should not be treated as a count of lettuce-related cases. It may include infections tied to international travel, other outbreaks or unknown sources.
As of Aug. 5, the multistate outbreak included 6,358 confirmed illnesses. At least 278 people needed hospital care.
Michigan also reported two deaths. Both patients had serious underlying health conditions.
Illnesses connected to the outbreak began between June 22 and July 31. Still, the count may continue to rise.
The CDC says it can take up to six weeks to determine whether an infection belongs to an outbreak. In addition, some people recover without medical care and never receive a Cyclospora test.
Meanwhile, the CDC had received reports of 10,468 confirmed, domestically acquired infections nationwide between May 1 and Aug. 3.
That larger total covers several outbreaks, smaller clusters and individual cases. Therefore, it is separate from the 6,358 infections linked specifically to iceberg lettuce.
Recalled lettuce reached Iowa restaurants
Taylor Farms de Mexico removed all iceberg lettuce from central Mexico from the U.S. market July 17.
Before the recall, Taylor Fresh Foods sent affected food-service products to Iowa between June 29 and July 16. The products included shredded iceberg lettuce, chopped lettuce and lettuce blends.
Restaurants and other food-service customers received those products. In addition, the FDA identified Taco Bell locations in Iowa among the restaurants that received recalled lettuce.
Taco Bell stopped using lettuce from the supplier July 17.
However, that does not mean every Taco Bell location or every meal served in Iowa caused an infection. Investigators are reviewing cases involving people who reported exposure at locations that received the lettuce.
The recall also covers certain Marketside Iceberg Salad and Shredded Lettuce packages sold at select Walmart stores.
However, Iowa is not listed among the states where Walmart sold those retail packages. The recalled food-service products did reach the state.
The affected Marketside packages carried “Best if Used By” dates from July 18 through Aug. 3. Although those dates have passed, consumers may still have a package in a refrigerator.
Anyone who still has a recalled product should throw it away or return it to the place of purchase.
The complete list of products, package sizes and dates appears in the FDA’s Cyclospora outbreak investigation.
Finally, the warning applies only to recalled products. It does not cover every type or brand of iceberg lettuce sold in Iowa.
What is cyclosporiasis?
Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. People can become infected after consuming contaminated food or water.
For example, past U.S. outbreaks have involved leafy greens, cilantro, basil, cabbage, raspberries, broccoli and snow peas.
People rarely spread Cyclospora directly to one another. After an infected person sheds the parasite, it usually must remain in the environment for several days or weeks. Only then can it infect another person.
Do not use bleach, soap or detergent on produce
Bleach does not reliably kill Cyclospora cayetanensis. Neither do most routine chemical sanitizing methods.
The parasite has a thick, multilayered protective wall. As a result, it can resist chlorine and other common chemicals.
Sheiren A. Martínez, a microbiologist with a master’s degree in microbiological sciences, previously told Hola America that household disinfectants do not remove all Cyclospora. The same applies to chlorine solutions marketed for use on food.
“None of these measures eliminates the risk entirely, but together they can significantly reduce the likelihood of exposure,” Martínez said.
Even so, the FDA tells consumers not to apply soap, detergent, bleach or commercial produce washes directly to fruits and vegetables.
Produce is porous. Therefore, it can absorb soap and household detergent, even when someone rinses it thoroughly. Those residues can cause illness.
Instead, rinse produce under clean running water. You may use properly diluted sanitizing products on hard surfaces and containers, but not directly on fruits or vegetables.
How to wash fruits and vegetables
Washing cannot guarantee the removal of all Cyclospora. However, careful handling can lower the risk and prevent other types of food contamination.
- Wash your hands. Use soap and running water for at least 20 seconds before and after preparing produce.
- Remove outer leaves. Discard the outside leaves of lettuce, cabbage and other leafy vegetables when possible.
- Rinse under running water. Wash produce before eating, cutting, peeling or cooking it. Do this even when you will not eat the peel.
- Rinse prewashed produce. During this outbreak, CDC and Iowa HHS recommend rinsing fruits and vegetables even when the package says “prewashed” or “ready to eat.”
- Rub the surface. Gently rub fruits and vegetables with clean hands while rinsing them.
- Use a clean brush. Scrub firm produce, such as melons and cucumbers, with a brush reserved for food.
- Remove damaged areas. Cut away bruised sections. Throw out produce that looks rotten.
- Dry the produce. Use a clean cloth or paper towel to remove some germs left on the surface.
- Prevent cross-contamination. Keep produce away from raw meat, poultry, fish and seafood. Also clean knives, cutting boards and counters between uses.
- Refrigerate cut produce. Place peeled, cooked or cut fruits and vegetables in the refrigerator within two hours.
Washing removes dirt and some germs, but it cannot remove every Cyclospora parasite.
Therefore, cooking is the most reliable option when it is appropriate for the food. Cook produce to an internal temperature of at least 158°F or 70°C to kill the parasite.
Watery diarrhea is the most common symptom
Symptoms usually start about one week after someone consumes contaminated food or water. However, they can appear within two days or take two weeks or longer to begin.
Most patients develop frequent, watery diarrhea. Other symptoms may include:
- Loss of appetite and weight loss
- Stomach cramps or abdominal pain
- Bloating and increased gas
- Nausea or vomiting
- Fatigue
- Muscle aches
- Headache
- Low-grade fever
Without treatment, the illness can continue for several weeks or longer. Symptoms may improve and then return one or more times.
Diagnosis requires a specific Cyclospora test
People with prolonged watery diarrhea, severe symptoms or signs of dehydration should contact a health care provider. They should also mention the possibility of cyclosporiasis.
Doctors diagnose the infection through stool testing. However, routine laboratory tests do not always check for Cyclospora.
Therefore, a patient or medical provider may need to request the test specifically. Some patients may also need to provide several stool samples on different days.
Doctors most often treat cyclosporiasis with trimethoprim-sulfamethoxazole, also called TMP-SMX. However, a medical provider must decide whether the antibiotic is appropriate for each patient.
People with weakened immune systems may develop a longer or more serious illness. As a result, they may need medical attention sooner.
Additional guidance is available through the CDC’s recommendations for preventing cyclosporiasis.
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