Recent cases of the intestinal illness cyclosporiasis have been linked to shredded iceberg lettuce served at some Taco Bell locations in Indiana, Kentucky, Michigan, Ohio and West Virginia, according to the Centers for Disease Control and Prevention and the Food and Drug Administration.
The CDC and FDA warned consumers on Friday not to eat shredded iceberg lettuce sold at select Taco Bells in five states -- Indiana, Kentucky, Michigan, Ohio, and West Virginia -- after the ingredient was linked to the outbreak. The CDC said that shredded iceberg lettuce sold in grocery stores or served in other restaurants is not affected.
A traceback investigation carried out by the FDA identified a single supplier of iceberg lettuce from Mexico that supplied the Taco Bell locations where people who became sick reported eating.
In a statement on Friday, Taco Bell said it has removed lettuce supplied by vegetable produce Taylor Farms from its restaurants. Out of an abundance of caution, Taco Bell said the ingredient has been removed from its supply chain nationwide.
Earlier, lettuce supplier Taylor Farms said it is voluntarily removing all iceberg lettuce sourced from central Mexico from the U.S. market.
Taylor Farms said the FDA traceback indicated a "specific farm" that accounts for "less than 1% of the U.S.'s iceberg lettuce supply" was a potential source, and they have removed all iceberg lettuce from the region indefinitely. No other Taylor Fresh Food products have been impacted and that no branded salad kits contain iceberg lettuce, Taylor Farms said.
So far, 102 people have been hospitalized, according to the Michigan Department of Health and Human Services (MDHHS). There are more than 5,000 cases in the state, an increase of nearly 700 since Thursday, officials said.
The CDC and FDA said more than 1,644 cases in the current outbreak involve people who reported eating at Taco Bell in those five states, including 94 people who were hospitalized.
The CDC said Taco Bell is working to stop using the lettuce.
In an earlier statement, Taco Bell said it had taken "immediate action to voluntarily remove potentially impacted lettuce from a supplier in select states" following "ongoing conversations with public health officials."
The statement went on to say in part, "We believe public health is a shared responsibility among restaurants, their suppliers, and authorities, and we are proud to have consistently acted quickly and proactively to protect our guests. Taco Bell has taken precautionary action, and we encourage all relevant restaurants, retailers, and foodservice operators to do the same."
In an FDA statement, the agency said it is working directly with the identified supplier to determine if potentially contaminated shredded iceberg lettuce remains on the market.
"As part of this investigation, FDA and state partners have initiated collection of product samples for testing and analysis," the statement said. Additionally, FDA has increased screening at the border for products implicated in the outbreak.
Michigan health officials had previously said preliminary findings suggested lettuce or salad greens as a possible source of the outbreak but had not identified a specific ingredient, grower, supplier or retailer.
The new information comes as health officials continue investigating a multistate outbreak of the illness that has sickened an estimated nearly 7,000 people, according to CDC estimates -- not all of them tied to the outbreak involving the Taco Bell locations, according to the CDC.
Symptoms of cyclosporiasis include watery diarrhea, fatigue and loss of appetite, according to the CDC. Symptoms usually begin about a week after a person becomes infected.
Cases have been reported in 34 states, with the bulk of illnesses reported in Michigan. State health officials there have reported 4,312 cases and 102 hospitalizations.
In Ohio, state health officials reported 1,244 cases -- up from just under 200 cases at the beginning of July.
Earlier this week, Taco Bell said it was voluntarily and temporarily removing some limited ingredients at select restaurants as a precautionary measure.
