07/08/2026
Hey friends I’m passing some information along that came across my desk this morning! 784 cases is significantly high enough to raise concerns and share information.
Cyclosporiasis Outbreak in Southeast Michigan
Public Health Bulletin for Health Care Providers - July 2026
Dear colleagues,
We want to bring to your attention a significant rise in cyclosporiasis cases in Michigan, particularly in Southeast Michigan, and the ongoing public health impacts. As of Tuesday, July 7, 784 cases have been reported since Monday, June 22; and are currently concentrated in Monroe, Lenawee, Washtenaw, Wayne, Shiawassee, Jackson, Oakland, Ingham and Livingston counties.
While a specific produce grower or supplier has not yet been identified as the source of this outbreak, cyclosporiasis outbreaks have previously been linked to the consumption of contaminated fresh produce, such as raspberries, basil, cilantro and bagged salad mixes. Because this enteric illness can be protracted and relapse if untreated, provider awareness and timely clinical recognition are critical to managing the ongoing public health impacts.
MDHHS encourages health care providers to consider cyclosporiasis in patients with gastrointestinal symptoms:
Testing: Standard microscopy methods such as modified acid-fast stain from concentrated specimen may have lower sensitivity due to low oocyst shedding. Molecular testing methods may be more sensitive. It is advised to contact the testing laboratory to ensure the stool order specifically targets Cyclospora. Do not rely on standard ova and parasite (O&P) test orders as Cyclospora may not be included.
Treatment: Cyclosporiasis is self-limited in immunocompetent patients but can last weeks without treatment; treatment with Trimethoprim-sulfamethoxazole (TMP-SMX) shortens illness duration substantially. Empiric treatment can be considered if testing is unavailable.
Reporting: Confirmed cases should be reported to local health departments to assist in ongoing traceback investigations. If testing is not available, suspected cases should be reported.
Please provide general advice to your patients on food safety during this outbreak, including the following information specific to preventing exposure to Cyclospora:
Wash all produce thoroughly.
Buy whole heads of lettuce/leafy greens rather than prewashed, bagged lettuce or salad mixes. Throw away the outer two to three layers of leaves and wash the inner leaves under running water.
Advise high-risk patients to cook produce when possible (heating to 158°F/70°C).
Thank you for your continued commitment to protecting the health and safety of Michigan residents.
Sincerely,
Natasha Bagdasarian, MD, MPH, FIDSA, FACP
Chief Medical Executive, State of Michigan
Sarah Lyon Callo, MS, PhD
Senior Deputy Director and State Epidemiologist, MDHHS Public Health Administration
