Michigan Responds to Cyclosporiasis Outbreak

After Michigan reported its first cases of cyclosporiasis in late June, health officials immediately acted by alerting federal agencies and issuing a warning on July 1. The notice was aimed at both home cooks and commercial kitchens, highlighting the dangers of potentially contaminated produce. Their response continued through the holiday weekend, with no breaks since.

However, the nature of cyclosporiasis means that symptoms can take weeks to manifest, leaving officials uncertain about the effectiveness of their warnings so far.

The situation is complicated by significant funding cuts to state and local health departments, which have faced chronic underinvestment for years.

Local health departments have seen layoffs and hiring freezes due to funding issues, while federal agencies like the CDC have lost both staff and expertise in the wake of the previous administration’s cuts.

Millions have also lost health insurance through Medicaid and the Affordable Care Act, making it harder to track how widespread the parasite is. The CDC has linked cases in five states: Indiana, Kentucky, Michigan, Ohio, and West Virginia. But it’s clear that the parasite, known for causing severe gastrointestinal distress, is spreading beyond these borders.

As of Friday, Michigan reported over 5,000 cases, showing a sharp increase of 1,300 since Wednesday, along with 102 hospitalizations. In contrast, Michigan typically sees around 40 to 50 cases annually.

“If we ignore the other states and just look at the Michigan numbers, this is likely the largest cyclosporiasis outbreak in US history,” remarked Natasha Bagdasarian, Michigan’s chief medical executive.

This outbreak follows a $12 billion cut to public health funding that occurred in March 2025, impacting areas like laboratory capacity and disease monitoring. While half of US states are involved in a lawsuit seeking to recover the lost funding, the remaining states are still grappling with delays and uncertainty.

Michigan, in particular, has lost an entire regional lab and 23 staff members from its infectious diseases bureau; local health departments in the state have also been affected, losing 123 positions due to federal funding cuts.

“You might not pinpoint the loss of one team member to every missed opportunity, but the impact is there,” Kansagra stated, concerning the strains on public health due to reduced resources. “It will catch up with us over time, especially as we face multiple health threats.”

The CDC has seen about one-third of its workforce leave, with many leadership roles remaining vacant.

Bagdasarian noted the challenges faced by federal agencies during this tough year, which seems to have hindered the response to this outbreak. “Communication has been, somewhat less robust than in previous situations,” she remarked, emphasizing a lack of assistance from the CDC compared to past outbreaks.

The CDC issued a health advisory notice two weeks after the first cases were detected. The Secretary of Health, Robert F Kennedy Jr., finally addressed cyclosporiasis publicly on Friday but did not clarify the unusually high number of cases this year.

“These outbreaks occur every summer,” Kennedy commented in a podcast, adding that understanding the source might help people make healthier choices, dismissing claims that the CDC’s surveillance program was cut.

In 2025, reporting cyclosporiasis and several other pathogens became optional for FoodNet, a national illness tracking system. This change could hinder identifying foodborne illness trends over time, according to Melanie Firestone, an assistant professor at the University of Minnesota. But she emphasized that identifying outbreaks largely depends on state and local department funding.

Public health staff in Michigan have spent over 1,000 hours interviewing patients related to the outbreak. Although they have dedicated resources to this urgent response, it draws staff away from other critical projects.

“We have to prioritize what we can handle,” Bagdasarian said, recognizing the limited resources available. With various public health threats like measles and fires impacting air quality, the strains are evident.

Michigan has amassed around 2,000 samples either sequenced or pending sequencing. However, the lab has overshot its cyclospora budget at $122 per test.

Diagnosing cyclosporiasis at the doctor’s office can cost hundreds of dollars, often leading to patients forgoing testing due to high copays. “Even those insured have decreased testing, and many remain uninsured due to federal cuts,” Bagdasarian explained. This could result in an unseen number of cases.

Reports suggest that lettuce from Taylor Farms is likely connected to the outbreak. Taylor Farms, known to have issues with contamination in the past, has previously been involved in similar outbreaks, including cases linked to Olive Garden and Red Lobster.

The CDC has linked the outbreak to a shredded iceberg supplier in Mexico, naming Taco Bell as one affected chain, although they didn’t reveal the producer’s name. The outbreak appears to extend beyond any single restaurant, according to Bagdasarian. “We’re looking for where the contamination first occurred. It might be upstream, affecting multiple suppliers to restaurants and grocery stores alike,” she said.