
CDC Now Counts 15,716 Confirmed Cyclospora Cases and 828 Hospitalizations. The Backlog Went Up, Not Down. And the Agency Now Says It Is Investigating at Least Six Other Clusters It Cannot Explain.
CDC updated its cyclosporiasis surveillance page today with data current through August 17, and there is more in it than a new set of numbers. The page itself changed. Three things were added and three were quietly taken away, and one of the additions is the agency saying out loud something it has not said before.
Since May 1 there are now 15,716 laboratory-confirmed cases of cyclosporiasis acquired in the United States, up from 13,895 a week ago. Hospitalizations are at 828, up from 740. Two deaths, both in Michigan, unchanged. Forty-seven states plus the District of Columbia and Puerto Rico. Another 1,681 people got sick abroad and brought it home, with 61 of them hospitalized.
A question worth setting beside that number is how many of the 15,716 anyone has actually tied to Taylor Farms. The answer is 9,481, the figure CDC carries on its outbreak page, which is roughly six in ten of the confirmed cases, about a third of the combined federal count, and under a third of my fifty-state total. CDC defines this outbreak as people who reported exposure to Taylor Farms de Mexico iceberg lettuce, including those who reported eating at Taco Bell. That is an interview, not a laboratory. Not one state publishes a breakdown of its own cases by attribution. Michigan, which has interviewed more than 2,900 sick people, reports that many of them never ate at Taco Bell, at another chain, or at any food establishment at all.
The one place in the country where that question got a real answer is New Hampshire. In July the state health department tied a cluster of illnesses to recalled Taylor Farms lettuce served on the salad bar at the Cheshire Medical Center cafeteria in Keene. It began at nine confirmed cases, with Dartmouth Health identifying sixteen people exposed, ten of them hospital employees. By early August the state was reporting sixty-nine cases and thirty-two of them tied to the recalled product, in a state that normally sees between two and nine cases in a year. That is the highest attribution rate anywhere, and New Hampshire is still the only state to have named a Taylor Farms product at a specific place that is not a Taco Bell. The reason is not that the lettuce behaved differently in Keene. A hospital can see illness in its own workforce and report it the same week. A grocery store cannot. The same product reached food service businesses in thirty-one states, and New Hampshire’s own health department says other restaurants and cafeterias in the state received it. It has never named one of them.
Here is the addition that matters most. CDC put a new section on the page headed Clusters of illness under investigation, and in it the agency states that beyond the multistate outbreak linked to iceberg lettuce, it and FDA are investigating at least six other clusters for which sources have not been confirmed. It points readers to FDA’s active investigation table and says that if sources are identified and there is something for consumers to do, it will issue outbreak notices then.
What is new is not the six clusters. What is new is that CDC has now put them on a consumer-facing page instead of leaving them in a regulatory table that almost nobody reads. That is a real improvement in transparency. It also means the federal government has now told the public, in its own words, that six groups of Americans have this parasite, and nobody can say where they got it.

My own fifty-state tally, built from what each state publishes rather than from what CDC confirms, stands at 31,342. A week ago, that number ran 6,173 ahead of the federal combined count. Today it runs 3,785 ahead. The gap is closing, which is what should happen, and it is closing because Atlanta is catching up rather than because the states are slowing down.
None of these is the number of people who got sick. Most people with cyclosporiasis never get tested, because the routine stool exam does not find this parasite unless somebody asks for it by name, and because diarrhea that comes and goes for a month often never reaches a doctor at all. The standard estimate of that gap comes from Scallan and colleagues, Foodborne Illness Acquired in the United States, Major Pathogens, published in Emerging Infectious Diseases in 2011, which puts the underdiagnosis multiplier for Cyclospora at 83.1. Applied to 15,716 confirmed cases, that is roughly 1,306,000 people. The estimate carries wide margins, and it is not a headcount. I use it because the alternative is to let the confirmed number stand as though it were the answer.
The season closes on August 31. Illnesses are still starting, the backlog is growing again, and the federal government has just confirmed in writing that six clusters of this parasite have no explanation attached to them. That is where things actually stand, and it is on a public web page that anyone can read.








