Cyclospora Outbreak Spreads: Patient Reveals Debilitating Cramps Beyond Diarrhea

Chase Strangio, a civil rights lawyer at the American Civil Liberties Union, ate lettuce and cilantro at a work lunch in New York in mid-May. A week later, he woke up nauseous and uncomfortable. The fever came next, then what he expected would be the main event: diarrhea. But as his fever broke and his bowels settled, something worse took hold. The cramps didn't leave. His appetite vanished. He couldn't eat. Five days into the illness, he learned that dozens of people from that same lunch were sick too.

Strangio didn't know it yet, but he had been infected with Cyclospora cayetanensis, a microscopic parasite that had begun its quiet spread across the country. By mid-July, the Centers for Disease Control and Prevention had confirmed 1,645 cases across 34 states. One hundred forty-one people had been hospitalized. The CDC was also investigating more than 5,100 additional suspected cases. Michigan had been hit hardest. No deaths had been reported, but the outbreak was far from contained.

On Thursday, federal health officials announced they had found a likely culprit: shredded iceberg lettuce from Mexico produced by Taylor Farms. The contaminated product had been supplied to Taco Bell locations in Michigan, Indiana, Ohio, Kentucky, and West Virginia. The FDA immediately advised consumers to avoid eating shredded iceberg lettuce from those restaurants. Taylor Farms told federal regulators it was preparing to recall products or ingredients potentially linked to the outbreak, though the full scope remained undisclosed. Taco Bell issued a statement saying that public health officials had not confirmed a definitive link to the chain or any specific ingredient, supplier, restaurant, or retailer.

Strangio's case illuminated something the public health messaging had largely glossed over. Yes, Cyclospora causes prolonged, watery diarrhea—that was the hallmark symptom, the CDC said. But the parasite also triggers severe fatigue, appetite loss, intense stomach cramps, bloating, nausea, and gas. For Strangio, the cramps were the worst part. They persisted long after the diarrhea subsided. He lost seven pounds. He needed two separate intravenous lines to restore his fluids. The fatigue was profound. "The symptoms are much more complicated than just explosive diarrhea," he told Newsweek. "This really just shook my system, both physically and emotionally."

It took more than two weeks for Strangio to get a diagnosis. He had visited doctors multiple times before anyone tested him for Cyclospora. Only after another lunch attendee tested positive did he seek the right test. On June 4, his results came back positive. By then, the damage was done. He recovered after being prescribed Bactrim, the antibiotic trimethoprim-sulfamethoxazole, which is the only proven effective treatment for cyclosporiasis. But some of his colleagues couldn't tolerate the medication. As of mid-July, they were still sick.

The parasite itself is a product of contamination at the source. Cyclospora cayetanensis originates from human fecal matter that contaminates food or water. It is remarkably resilient—nearly impossible to wash off fresh produce—though heat kills it. Contamination typically happens when crops or irrigation water come into contact with human waste during growing, harvesting, or processing. Consumers get sick by eating raw fresh produce: lettuce, herbs, berries, other fruits and vegetables. Unlike many foodborne illnesses, Cyclospora doesn't spread directly from person to person. The parasite must mature in the environment for days or weeks before it can infect someone else.

Strangio has recovered, but recovery is incomplete. He still feels anxious about eating uncooked food. The physical illness has faded, but the psychological weight remains. Across the country, thousands of others are in various stages of the same journey—some still acutely ill, some recovering, some like Strangio learning to live with the aftermath. The investigation continues. The recall looms. And the question of how human waste ended up on lettuce destined for American tables remains under scrutiny.