Federal health officials asked Michiganders to stop eating iceberg lettuce from Taco Bell restaurants as they investigate the cause of a multi-state diarrhea parasite outbreak.
The Food and Drug Administration said an explosion of cyclosporiasis cases across five states, including Michigan, is linked to shredded iceberg lettuce served at Taco Bell locations.
Indiana, Kentucky, Ohio and West Virginia are also impacted, according to the FDA, which warned more states could be added.
FDA investigators tied 1,644 cyclosporiasis cases across those five states to food from Taco Bell from May 13 to July 13.
"Ingredient-level analyses on meals eaten by these cases indicate that 90 percent of those interviewed reported eating iceberg lettuce," the FDA's website says.
Officials have traced the iceberg lettuce to a single supplier from Mexico. They said Taco Bell has committed to stop using any lettuce from the supplier, while noting not all Taco Bell locations used the lettuce.
Officials were also working with the supplier to determine if any of the potentially contaminated shredded iceberg lettuce remains on the market and will increase screening at the border for any products connected to the outbreak.
The FDA did not specifically identify the supplier.
The FDA advisory comes after Michigan health officials pointed toward lettuce or salad greens as a possible cause.
The parasitic gastrointestinal illness has infected 4,312 people with 102 hospitalizations in Michigan — and thousands of others nationally.
The Michigan cases have been found in 55 counties with major hotspots in the middle and southeast portions of the state.
Michigan health officials said the state's case numbers alone likely make it the largest cyclosporiasis outbreak in U.S. history.
Cyclosporiasis can be contracted by consuming contaminated foods or water. Foods linked to past outbreaks have included a mix of greens and vegetables, such as parsley, broccoli and cilantro.
It cannot be spread person to person, as the parasite is passed through bowel movements and can take days or weeks to become infectious.
In addition to watery diarrhea, other symptoms include appetite loss, weight loss, cramping, bloating, flu-like symptoms, vomiting, and body aches, among others. Symptoms vary by person and can emerge up to 14 days after cyclosporiasis is contracted.
People who have diarrhea that hasn’t gone away on its own within a few days should see a health provider and discuss the possibility of cyclospora, officials say.
Officials said the best way to prevent infection with a parasite is to avoid food or water that may have been contaminated.
Officials recommend properly preparing fruits and vegetables by thoroughly washing them before cutting, eating and cooking.
Sign up for free local newsletters and alerts for the
Across Michigan Patch
Patch.com is the nationwide leader in hyperlocal news.
Visit Patch.com to find your town today.