The Centers for Disease Control and Prevention reported over 20,000 suspected cyclosporiasis cases this week, making this the largest outbreak of the diarrhea-causing parasite in U.S. history.So far, the CDC has received reports of 10,468 confirmed cases of domestically acquired cyclosporiasis in 47 states. Another 12,255 cases have not yet been confirmed or investigated. If the latter group of cases is confirmed, the U.S. tally of cyclosporiasis cases would total more than 22,700.Delaware, Hawaii, and Montana are the only three states that have not reported any confirmed cases of cyclosporiasis, as the CDC investigation continues.

The federal agency reportedly expanded its scope of the cyclosporiasis outbreak to 15 states, including Arkansas and Missouri. Michigan remains the hardest-hit state, with over 12,200 reported cases.Michigan health officials on Monday confirmed two infected patients died, though they noted that “both individuals had significant underlying health conditions.” These are the only fatalities so far.The multistate outbreak allegedly stems from contaminated iceberg lettuce grown in Mexico, which Taylor Farms recalled last month. An initial test of a Taylor Farms lettuce sample was a false positive, although the Food and Drug Administration maintains the produce company is still linked to the outbreak. The lettuce was traced to Taco Bell, where many of the cases originated. No other sources for the outbreak have been identified by the FDA.TWO DEATHS IN MICHIGAN LINKED TO CYCLOSPORIASIS OUTBREAKCyclosporiasis is an intestinal infection originating from the microscopic parasite, Cyclospora cayetanensis. Symptoms include diarrhea, appetite loss, bloating, extreme fatigue, low-grade fever, stomach cramps, nausea, and vomiting.The disease spreads through contaminated food or water ingested by humans. Symptoms typically begin about one week after infection, making it difficult to detect in the early days. Patients exhibiting symptoms are advised to stay hydrated.