Federal health officials in the US say the cyclosporiasis outbreak tied to iceberg lettuce has spread to three additional states.
According to the Food and Drug Administration (FDA), new cases have been identified in Georgia, Tennessee and Texas.
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The number of illnesses linked to the cyclospora parasite now stands at 11,458 across 20 states.
Two deaths have been associated with the outbreak.
The deaths were reported in Michigan, and as per the state’s Department of Health and Human Services both people had “significant underlying health conditions”.
Investigators have linked the multistate outbreak to contaminated iceberg lettuce distributed by Taylor Farms de Mexico to Taco Bell restaurants.
On 17 July, Taylor Farms said it was voluntarily removing from the US market all iceberg lettuce sourced from central Mexico.
Cyclosporiasis is generally not considered life-threatening, with common symptoms including stomach cramps, nausea and fatigue.
The Centers for Disease Control and Prevention says most people with healthy immune systems eventually recover without treatment. However, the illness can be more serious for those who are immunocompromised.
On 26 August, the FDA said it “remains confident that all recalled iceberg lettuce related to this specific Cyclospora outbreak is off the market”.
The agency added that onsite inspections and sampling at iceberg lettuce farms and the processing facility in Mexico are continuing in coordination with Mexican officials.
Meanwhile, Mexican health authorities are examining cyclosporiasis outbreaks after receiving international notifications from the US and the UK.
Early inspections and laboratory testing at a packing plant identified by US officials have not found cyclospora cayetanensis. At the same time, testing of samples collected from 16 hotels in Quintana Roo is still underway.
In a statement issued on 5 August, the Ministry of Health said the “identification of a country as the preliminary origin of a product during an international investigation does not, in itself, constitute evidence that the contamination occurred in that place, and therefore investigations continue until conclusive scientific evidence is available”.
