Louisiana’s Cyclospora Cases Climb as National Lettuce Outbreak Raises Unanswered Questions

Louisiana is seeing an unusually high number of Cyclospora infections this year, but one important question remains unanswered: Are the state's cases connected to the massive multistate outbreak linked to recalled iceberg lettuce, or are Louisiana residents becoming sick from another source?

State health officials have reported 125 cases of cyclosporiasis in Louisiana this year, including six hospitalizations. East Baton Rouge Parish has recorded the largest number of cases, with 25, followed by Jefferson Parish with 18 and Orleans Parish with eight.

The numbers are significant because Louisiana typically sees far fewer infections. The state's current total has already surpassed historical levels, according to health officials.

At the same time, Louisiana was among the states that received the iceberg lettuce at the center of the nation's record-setting Cyclospora investigation.

The Food and Drug Administration confirmed that recalled Taylor Farms de Mexico iceberg lettuce was distributed to food-service customers in Louisiana between June 29 and July 16. Recalled Marketside-brand lettuce also was sold at select Walmart stores in Louisiana.

Yet Louisiana is notably absent from the federal list of states with cases specifically connected to the Taylor Farms lettuce outbreak.

As of Aug. 27, the FDA said 11,458 illnesses, 495 hospitalizations and two deaths had been associated with the multistate outbreak. Those cases were reported in 20 states: Arkansas, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maine, Michigan, Missouri, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas and West Virginia. Louisiana is not on that list.

That does not mean Louisiana's 125 cases have been ruled unrelated to the broader outbreak.

It means federal investigators have not publicly established that connection.

Louisiana received the recalled lettuce

The distinction is particularly important for Louisiana consumers.

Taylor Farms recalled iceberg lettuce sourced from central Mexico after the FDA's traceback investigation found that its shredded lettuce was connected to illnesses reported by people who ate at Taco Bell locations.

The company voluntarily removed all iceberg lettuce sourced from central Mexico from the U.S. market on July 17. The FDA later classified the recall as Class I, its highest-risk designation, meaning the agency determined there was a reasonable probability that exposure could cause serious health consequences or death.

The FDA said the epidemiological evidence connecting the lettuce to the outbreak was unusually strong and that the scale and severity of the outbreak were unprecedented compared with previous Cyclospora incidents.

But investigators have not identified a confirmed contaminated lettuce sample.

In July, FDA scientists determined that a lettuce sample initially reported as positive for Cyclospora was actually a false positive. The agency said that finding did not change the broader epidemiological evidence connecting the outbreak to Taylor Farms lettuce.

East Baton Rouge stands out

For Louisiana, perhaps the most significant local number is 25.

That's the number of cases reported in East Baton Rouge Parish — the highest parish total identified in the state's current outbreak.

That makes Baton Rouge an important area to watch as investigators continue determining where Louisiana's infections originated.

The available information does not establish that the East Baton Rouge cases came from recalled lettuce.

That unanswered question is precisely where the Louisiana story becomes more significant.

If the state's infections are unrelated to the Taylor Farms outbreak, health officials could be dealing with a separate source of contamination at a time when Cyclospora infections are already surging nationally.

If some Louisiana cases eventually are linked to the recalled lettuce, however, that could expand the geographic footprint of an outbreak that already has affected thousands of Americans.

Why the investigation can take weeks

Cyclospora investigations are difficult because the illness is not always immediately identified.

The parasite can cause prolonged or recurring diarrhea, abdominal cramps, nausea, fatigue, loss of appetite and weight loss. Some infected people do not develop symptoms at all.

Federal officials also warn that cases can continue to be added after a recall because it can take as long as six weeks for health officials to determine whether an individual's illness belongs to a particular outbreak.

That means Louisiana's current numbers may not tell the entire story.

The question Louisiana should be asking

The most important question now is not simply how many Louisiana residents have contracted Cyclospora.

It is where they got it.

With 125 cases already reported, six hospitalizations and East Baton Rouge leading the state in infections, Louisiana has enough cases to warrant close attention.

And because recalled lettuce was distributed in Louisiana, the possibility of a connection cannot simply be dismissed.

For now, however, the evidence supports a careful conclusion: Louisiana is experiencing an unusually high number of Cyclospora infections, but federal investigators have not publicly connected those cases to the Taylor Farms lettuce outbreak.

That distinction should remain at the center of the story until Louisiana health officials or federal investigators identify a common source.

For consumers, the FDA says the recalled lettuce should no longer be available for sale. Anyone experiencing symptoms consistent with cyclosporiasis should contact a health care provider, particularly if they recently consumed shredded iceberg lettuce.

For Baton Rouge and the rest of Louisiana, the next piece of this investigation may be the most important: determining why the state is seeing so many cases — and whether any of them are connected to the lettuce that was already on Louisiana plates.