Two Michigan residents have died from cyclosporiasis, state health officials confirmed Monday, August 3, marking the first fatalities in the nationwide outbreak that has now sickened more than 11,000 people in the state alone.
Oakland County has recorded 1,043 confirmed cases as of the most recent county-level update on July 30, making it the second-hardest-hit county in Michigan behind Wayne County's 1,379 cases.
The Michigan Department of Health and Human Services said both people who died had significant underlying health conditions that may have been worsened by the parasitic infection and dehydration. The agency declined to release their ages, counties of residence, or other identifying details. MDHHS noted that death from cyclosporiasis is uncommon in the United States.
Statewide, the case count reached 11,234 on August 3, an increase of 461 since July 31. The number has more than doubled in two weeks. Michigan remains the hardest-hit state in the outbreak, reporting the highest total cases and cases per capita. The CDC has confirmed 6,707 laboratory-confirmed cases across 45 states as of July 28.
Metro Detroit accounts for 2,950 of Michigan's cases: Wayne County (excluding Detroit) at 1,379, Oakland County at 1,043, Macomb County at 282, and Detroit at 246. As of July 30, 193 Michigan residents had been hospitalized. Cases have been detected in 71 of the state's 83 counties.
As we reported July 31, Oakland County crossed the 1,000-case threshold last week. The two deaths are the first fatalities linked to the outbreak nationwide.
What caused the outbreak
The state's investigation has pointed to lettuce and salad greens as the most likely source. Taylor Farms issued a voluntary recall of iceberg lettuce products sourced from central Mexico on July 17. That lettuce had been sold at Walmart and used in Taco Bell restaurants in Michigan. Investigators have not completely ruled out other produce or identified a specific grower beyond Taylor Farms.
"We don't have to go all out on an avoidance. We don't have to be afraid of produce," Wade Syers, a food safety specialist at Michigan State University Extension, told Harvest Public Media during the outbreak. Syers said cooking vegetables thoroughly to 158°F kills the parasite.
How to reduce risk
MDHHS recommends buying whole heads of lettuce rather than pre-washed bagged lettuce or pre-mixed salad kits, discarding the outer two to three layers of leaves, and thoroughly washing remaining inner leaves under clean running water. The parasite is resistant to routine chemical disinfection, so washing alone cannot guarantee its removal.
Symptoms include watery diarrhea, loss of appetite, weight loss, cramping, bloating, nausea, and fatigue. They can appear between two days and two weeks after exposure. The illness is treatable with antibiotics, rest, and fluids but can take weeks to resolve without treatment.
MDHHS especially recommends testing for people who are immunocompromised, older adults, young children with significant symptoms, and anyone experiencing dehydration or weight loss. Anyone with sudden and ongoing diarrhea should contact their health care provider and local health department.
The Cyclospora season typically runs through August, and Michigan is still reporting hundreds of new cases daily. MDHHS issues daily statewide updates and weekly county-level breakdowns on Thursdays; the next local report is expected later this week.
