Health departments in Nebraska and Alabama are responding to a national outbreak of cyclosporiasis. Douglas County, Nebraska, has confirmed 27 cases, while Alabama officials report 28 cases across the state, though none are currently tied to the same restaurant chain as the Nebraska cluster.
Douglas County Investigation and Taco Bell Exposure
The Douglas County Health Department (DCHD) is investigating a cluster of 27 confirmed cases of cyclosporiasis in the Omaha area. According to a release from the agency, 12 of these infections were identified over the last four days. Local epidemiologists have focused on dietary history, finding that nearly two-thirds of the individuals interviewed reported eating at a Taco Bell location in the two weeks preceding the onset of their illness.
The DCHD is coordinating with the Nebraska Department of Health and Human Services, the Centers for Disease Control and Prevention (CDC), and the U.S. Food and Drug Administration (FDA) to determine if these infections are part of a broader multistate outbreak. Cyclospora is a microscopic parasite that causes an intestinal illness known as cyclosporiasis. People typically become ill about one week after consuming contaminated food or water.
Alabama Case Distribution and Public Health Response
As of July 20, 2026, the Alabama Department of Public Health (ADPH) has logged 28 confirmed cases of cyclosporiasis, which is caused by the parasite Cyclospora cayetanensis. Unlike the Nebraska cluster, Alabama health officials report that none of their state’s cases have been directly linked to the Taco Bell locations identified by federal investigators in Indiana, Kentucky, Michigan, Ohio, and West Virginia.
The distribution of the 28 cases in Alabama is as follows:
- Northern District: 22 cases (78.6%)
- Southwestern District: 2 cases (7.1%)
- Mobile, Northeastern, Southeastern, and West Central Districts: 1 case each
ADPH data indicates that 28.6% of these cases—a total of eight—are associated with two separate foodborne outbreaks at Mexican-style restaurants. Additionally, 14.3% of cases, or four individuals, are linked to international travel. Only two individuals in Alabama have required hospitalization, and there have been no deaths reported.
FDA Product Testing and Lettuce Supply Chain
Initially, there were reports regarding positive sample results for Cyclospora from Taylor Farms de Mexico. However, FDA laboratory experts conducted a re-review of those samples and concluded that the result was a false positive. As of July 19, 2026, the FDA reports there are no confirmed positive sample results from product testing, though the agency and state partners continue to collect and analyze samples.
Despite the false positive, Taylor Farms de Mexico and Taylor Fresh Foods are voluntarily removing all iceberg lettuce sourced from central Mexico from the U.S. market out of an abundance of caution. Products supplied to the following entities are included in the recall:
- KFC
- Pizza Hut
- Subway
- Trader Joe’s
- Walmart
- Sysco
- Cross Valley Farms
- Peak Fresh Produce
Identifying Symptoms and Clinical Care
Cyclosporiasis manifests as an intestinal illness that can persist for several weeks or longer if left untreated, and symptoms may come and go. Common symptoms include frequent watery diarrhea, loss of appetite, weight loss, stomach cramps, bloating, nausea, and fatigue. These symptoms may also be accompanied by a low-grade fever. Symptoms usually begin about one week after infection, ranging from two days to more than two weeks.
Health officials emphasize that routine stool tests often fail to detect the parasite. Individuals experiencing these symptoms are urged to contact their healthcare provider and specifically request testing for Cyclospora. The illness is typically associated with the consumption of contaminated fresh produce, including basil, cilantro, leafy greens such as lettuce, snow peas, berries, and melons, according to the ADPH.
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