Color shows the magnitude of reported cases; the outlined states are the 20-state Taco Bell / Taylor Farms de Mexico lettuce cluster (Arkansas, Iowa, Illinois, Indiana, Kansas, Kentucky, Maine, Massachusetts, Michigan, Missouri, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, West Virginia, Georgia, Tennessee, Texas), which FDA and CDC expanded from 9 states on Aug 5, 2026 after broadening the case definition to include Taco Bell or recalled-lettuce exposure, further expanded to add Maine and Massachusetts by Aug 13, 2026, and further expanded to add Georgia, Tennessee, and Texas by Aug 27, 2026. Several of the states added on Aug 5 (notably Iowa, Nebraska, Missouri and North Carolina) had previously said their cases were not part of the multistate outbreak; those state positions predate the Aug 5 federal inclusion, and North Carolina's own page still disclaimed the link as of Aug 25 (940 cases / 32 hospitalizations). Georgia's own DPH page publishes no current count and does not dispute inclusion, unlike North Carolina. Most green states report only sporadic, seasonal, or travel-related cases. Hover or focus any state for its figure, basis, and source.
Reading this map honestly
- Two number systems, kept separate. State health departments publish confirmed + probable totals (highest, most current). CDC's weekly feed counts lab-confirmed cases only and lags, so its per-state figures (marked with the approx sign) are systematically lower. Do not compare a bold state total against a CDC-feed figure as if equal.
- The 20-state lettuce cluster (bold outline): Arkansas, Iowa, Illinois, Indiana, Kansas, Kentucky, Maine, Massachusetts, Michigan, Missouri, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, West Virginia, Georgia, Tennessee, Texas. FDA and CDC expanded the cluster from 9 to 15 states on Aug 5, 2026 (adding AR, IA, MO, NE, NH, NC), to 17 states by Aug 13, 2026 (adding ME, MA), and to 20 states by Aug 27, 2026 (adding GA, TN, TX), after broadening the confirmed-case definition to include Taco Bell or recalled Taylor Farms lettuce exposure; the cluster count rose to 11,458 cases / 495 hospitalizations / 2 deaths. Michigan's and North Carolina's larger state totals are only partly attributable to this cluster. North Carolina is a special case: it is now federally counted in the cluster, but NCDHHS's own page (updated Aug 25, weekly Tuesday refresh, 940 cases / 32 hospitalizations) still says its cases do not appear associated with the Taco Bell outbreak, an open federal-vs-state disagreement this map carries rather than resolves. Georgia is a different case: its DPH page is static and publishes no current count, and does not dispute inclusion. Tennessee's own information page carries no dated current count (last state figure 30); Texas has no discoverable state-hosted count.
- Gray means no published figure. Gray states publish no 2026 cyclosporiasis case count, which is not the same as zero cases. The five currently in this status are Montana, DC, Minnesota, North Dakota, and Vermont.
- Endemic-baseline states (Florida) carry large cyclosporiasis counts every summer, so moderate 2026 numbers there may be normal, not outbreak-driven; Texas moved from endemic-baseline framing to federal cluster inclusion on Aug 27, 2026.
Primary sources: CDC surveillance and HAN00531; state health-department releases; CDC weekly feed via the GenomicEpi aggregator for approx figures. Figures are time-sensitive and update as states report.