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September 5, 2026NEJM Evidence

Cyclosporiasis Outbreak in Michigan, May–July 2026 — An Interim Report

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Authors

MHMeena N. HasanHLHeather L. LeahyJHJustin Henderson

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Overview

Epidemiological investigation reports widespread cyclosporiasis infections in Michigan residents, indicating contaminated iceberg lettuce and restaurant exposures as likely sources.

Key Points

  • Investigate and characterize an unprecedented seasonal outbreak of cyclosporiasis across Michigan to identify likely exposure sources.
  • Conducted state-level surveillance and case identification across 69 Michigan counties for illnesses with onset between May 10 and July 18, 2026 (N = 6,065).
  • Administered standardized food exposure questionnaires to infected individuals, obtaining dietary history for 51.3% of identified cases.
  • Identified 6,065 confirmed cyclosporiasis cases across 69 of Michigan's 83 counties as of July 22, 2026, substantially exceeding historical seasonal baselines.
  • Food history interviews from 51.3% of cases identified consumption of iceberg lettuce and meals from a single restaurant chain as potential exposure vehicles.

Cite This Study

Hasan et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd3c76b95aff0620eae48https://doi.org/10.1056/evidpha2600277
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