Cases of diarrhea-causing parasite in Kansas continue to climb

TOPEKA – The Kansas Department of Health and Environment (KDHE) continues to investigate cases of cyclosporiasis in Kansas related to the national outbreak and Taylor Farms de Mexico iceberg lettuce, which was voluntarily recalled from restaurants and grocery stores on July 17. The U.S. Food & Drug Administration (FDA) continues to provide updates on the sources of the cyclosporiasis outbreak on its Cyclosporiasis Response page.

This map shows the resident states of the 6,707 people with laboratory-confirmed domestically acquired cyclosporiasis since May 1, 2026. Potential Cyclospora infections are typically investigated by the state or local health department where people live, even if they were exposed to the parasite in another state. Cyclosporiasis cases may not be limited to these states with known cases. The true number of people sick with cyclosporiasis was likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.

Cases of the illness continue to climb dramatically in Kansas. On Wednesday, the KDHE is reported 461 cases, up from 289 cases last week.

Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis. The parasite is spread through food or water contaminated with feces and is most commonly associated with fresh produce. It is not spread person-to-person. In the U.S., outbreaks in recent years have most often been linked to contaminated fresh produce, particularly during the summer months.

Symptoms

Symptoms typically appear 2 to 14 days after exposure and may include:

Frequent, watery diarrhea
Loss of appetite
Weight loss
Abdominal cramping
Bloating
Nausea
Less common symptoms includeVomitingLow-grade fever
Vomiting
Low-grade fever

If left untreated, illness can last anywhere from a few days to a month or longer. Anyone experiencing sudden gastrointestinal illness should see a health care provider.

Diagnosis and Treatment

Testing for Cyclospora is not part of routine stool testing or most standard GI PCR panels, so patients should ask their health care provider to specifically request Cyclospora testing if it's suspected. (Note: the Kansas Health and Environment Laboratory does not routinely perform this testing.)

The standard treatment is the antibiotic trimethoprim-sulfamethoxazole (TMP-SMX; brand names Bactrim, Septra, Cotrim). No highly effective alternative has been identified for people who are allergic to or can't tolerate TMP-SMX; providers may consider supportive care, other antibiotics with limited supporting evidence, or, for select patients, desensitization under an allergist's care.

How to Protect Yourself

There is no way to guarantee produce is free of Cyclospora — the parasite can cling tightly to food surfaces, so washing alone does not eliminate risk. Still, good food-safety habits are recommended:

Wash all fruits and vegetables thoroughly under running water before eating, cutting, or cooking
Scrub firm produce (like melons and cucumbers) with a clean produce brush
Cut away any bruised or damaged areas before preparing
Refrigerate cut, peeled, or cooked produce promptly
Choosing locally grown produce, or growing your own, may help reduce risk

Cooking produce (to at least 158°F / 70°C) can inactivate the parasite. Cooking fresh produce, or avoiding it during periods of high cyclosporiasis activity, is the safest option — especially for people at higher risk of complications, such as young children, older adults, pregnant individuals, and people who are immunocompromised (e.g., chemotherapy patients, transplant recipients).