NEW YORK,NY— For New York City residents craving tacos, burgers or sandwiches, one topping has become the biggest question on the menu.
A multistate Cyclospora outbreak linked to shredded iceberg lettuce has spread to include New York and several other states, prompting recalls, supplier changes and warnings from health officials.
Federal investigators traced the outbreak to shredded iceberg lettuce supplied by Taylor Fresh Foods and served in Taco Bell menu items.
Cyclospora cases rise annually in the U.S. during spring and summer, particularly from May 1 to Aug. 31, with regular outbreaks since the mid-1990s.
However, 2026 is notable for an unusually high case count, including 1,947 illnesses linked to one specific source, compared to just 249 confirmed cases at this time last year.
New York has recorded 447 confirmed cases of cyclosporiasis since May 1, according to the NYC Health Department.
On Friday, the Food and Drug Administration expanded the number of states with illnesses linked to the recalled Taylor Farms iceberg lettuce to include Pennsylvania, Kansas, Oklahoma, and Illinois.
They join five other states, Michigan, Ohio, Indiana, Kentucky, and West Virginia, that have reported illnesses linked to the iceberg lettuce from central Mexico.
The agency said it expects to "continue to see the number of confirmed cases rise, despite the recall, due to the fact that it can take as long as six weeks for CDC and state officials to determine if a sick person is part of this outbreak."
Customers concerned about the recall can ask restaurants whether menu items contain raw shredded lettuce, choose cooked vegetables instead and follow recall updates from public health agencies.
In its July 17 statement, Taco Bell said it acted voluntarily "out of an abundance of caution" and urged other restaurants, retailers and food-service operators that received the lettuce to do the same.
The Jack in the Box burger chain told Consumer Reports it learned of the potential issue with the lettuce before the FDA's July 17 announcement and immediately notified restaurants that had received the product to remove it.
There have been no known cyclosporiasis illnesses associated with food served at Jack in the Box, the company said.
Chipotle told Restaurant Business Online that it is aware of the cyclospora investigation but doesn't believe any of the ingredients used in its menu items are associated with the illnesses.
The company said its romaine lettuce and Supergreens salad mix are not sourced from Mexico
A Qdoba spokesperson told the outlet there is "no data suggesting any connection between Qdoba restaurants and the reported cases."
Wendy's said its restaurants were not affected by the outbreak, according to a Reuters report.
Subway, KFC and Pizza Hut received the recalled lettuce in Alabama, the state's public health department said, adding that more businesses are likely to be added.
Dustin Carlson, president of SRA 831(b) Administration, which works with small businesses on risk management and alternative insurance solutions, said the impact of a foodborne illness outbreak can extend far beyond removing a contaminated ingredient.
"Foodborne illness is absolutely one that can devastate a business, especially if a business isn't prepared to manage this type of event," Carlson told Patch.
Restaurants can lose customers even when the contamination originated elsewhere in the supply chain.
"There are many different ways it can financially impact the business," Carlson said. "Maybe you have to pivot and find new suppliers because your supplier has been tied to an outbreak."
Carlson said business owners should review their insurance coverage before an emergency occurs.
He said businesses that recover most effectively are often those with the resources to respond quickly, including investing in crisis communication, public relations and efforts to rebuild their reputation.
For restaurants affected by a supplier recall, Carlson said rebuilding trust can also require transparency with customers and changes behind the scenes, such as finding new suppliers or adjusting purchasing practices.
"Being able to plan ahead and have these things in place really positions the business to weather that storm," Carlson said.
He pointed to Chipotle's series of foodborne illness outbreaks in the mid-2010s as an example of how reputational damage can follow a company long after an incident ends.
The outbreaks affected the company's sales and stock price, Carlson said, and the brand continues to be associated with those events years later.
"Even today there's sort of this lingering perception of Chipotle as a company because of those events that happened over a decade ago," Carlson said.
Dr. Neal Shipley, medical director of Northwell Health-GoHealth Urgent Care, told Patch that cooking produce to at least 158 degrees is the most effective way to eliminate Cyclospora.
"Washing helps, but it isn't foolproof," Shipley said.
Michigan State University Extension food safety specialist Wade Syers told ABC News that restaurant customers should ask where shredded lettuce comes from and how it is prepared before ordering.
Symptoms typically begin about one week after exposure and may include:
Anyone whose symptoms worsen, continue for more than a few days or lead to dehydration should seek medical care.
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