Michigan is grappling with an unusually large outbreak of cyclosporiasis that has left state and local public health agencies stretched thin as they try to identify and halt ongoing transmissions. The nine-state cluster continues to produce new cases, and Michigan remains the hardest hit - reporting more than 8,100 cases - even as federal authorities have issued guidance and focused on possible food sources.
Public health officials in Michigan say the workload is intense and growing. Officials in two counties and a third source familiar with the state response told reporters that federal funding reductions, along with what some described as limited or lagging communication from federal agencies, have constrained the state and local response. In response, Michigan and its counties have been borrowing staff from other programs and recruiting volunteers to perform time-consuming interviews and investigations to find potential causes beyond the bagged lettuce already linked to Taylor Farms and Taco Bell.
Outbreak scope and federal findings
The U.S. Food and Drug Administration on July 17 linked part of the outbreak to iceberg lettuce served at Taco Bell restaurants that was sourced from Taylor Farms operations in central Mexico. The agency said it is continuing to investigate additional sources. Taco Bell, which is owned by Yum Brands, has stopped using iceberg lettuce supplied from Taylor Farms nationwide, and Taylor Farms has removed lettuce sourced from central Mexico from store shelves. The Centers for Disease Control and Prevention has reported 4,173 laboratory-confirmed domestic cases of cyclosporiasis and said there are more than 7,400 unconfirmed cases nationwide.
Michigan’s own investigation has not pinpointed a single fast-food chain as the definitive state-level source, according to the state’s chief medical executive. Officials noted approximately 12% of the patients have no clear connection to eating lettuce or dining at a fast-food chain.
Staffing shortfalls and funding cuts
State officials say Michigan is operating with fewer public health investigators than it had in the recent past. The state has 23 fewer infectious disease workers and 123 fewer county health staff after the Trump administration in 2025 canceled around $12 billion in COVID-era grants to states, officials said. Those lost positions have reduced surge capacity at the state and county levels as the caseload rose rapidly.
"We have had to pull in dozens of staff from other areas, from hepatitis C and interns who are working on gun violence prevention," said Dr. Natasha Bagdasarian, Michigan’s chief medical executive. The comment underscores the scope of redeployment required to sustain contact tracing and exposure interviews while maintaining other public health services.
Former CDC officials and food safety experts noted additional impacts tied to budget and staffing changes at federal agencies. The Trump administration’s cuts to the U.S. Agency for International Development also eliminated $40 million in funding that supported a CDC laboratory that investigates parasitic diseases, a resource officials say has been important for past parasite investigations. Resignations and staffing cuts last year were also cited by former senior CDC staff as factors that have reduced federal bench strength.
Local response: interviews, redeployment and volunteers
The work required to investigate cyclosporiasis is labor intensive because the parasite cannot be identified through advanced trace testing. Investigations rely heavily on detailed interviews with patients that can take up to 45 minutes each, and those interviews are a major driver of staffing needs.
Ingham County, which includes most of Lansing and has a population of about 290,000, has reported roughly 700 cases. The county’s health department, however, is operating with only five nurses responsible for investigating cases, and those staff have been able to follow up on about half of the reported cases. Anne Barna, deputy health officer for Ingham County, said officials have decided to stop pursuing older cases in order to focus limited resources on recent incidents. "That way we can try to help the state and the feds understand what is still causing people to get cyclospora," she said.
Oakland County, which has nearly 1.3 million residents, reported 710 cases as of July 24. There, a team of four communicable disease nurses and three epidemiologists is conducting interviews. During the COVID pandemic the county had 12 additional staff members to assist with outreach; those positions have since been eliminated and included four nurses who were let go this past spring. The county has pulled nurses from hepatitis C and HIV programs to assist with the outbreak interviews, according to county officials.
Washtenaw County’s health department is investigating more than 770 cases, and officials say the high caseload has reduced time available for other clinical responsibilities and illness management. One county spokesperson described the situation as puzzling for investigators because the outbreak is large and investigators do not yet have definitive answers about the underlying cause for all cases. "We’ve got this huge volume (of cases) and so many people working on it and it’s not getting clearer," the spokesperson said.
In rural Shiawassee County, with a population near 68,000, health department leadership said the local office has recruited qualified volunteers to help investigate about 450 cases. "This really just hit us so fast," the county health director said. "It was like, ‘Boom, here it is.’"
Coordination with federal agencies
Officials described variations in how federal agencies are coordinating with states. In the past, the CDC often took a lead role in organizing and coordinating multi-state outbreak responses, with at least weekly meetings among involved state health departments and the CDC. Some Michigan local officials said they first learned new information through media reports rather than direct federal briefings. A former CDC food safety expert said that, for large outbreaks, states typically meet with CDC at least weekly.
A source familiar with Michigan’s response, who was not authorized to speak publicly, said state officials were receiving prompt technical answers to questions sent to the CDC and the FDA but were not engaged in regular formal meetings with federal partners. The U.S. Department of Health and Human Services, however, rejected that characterization and said the CDC was meeting daily with FDA and state officials nationwide to share updates and collect information about the outbreak. HHS also said the CDC sent a team of epidemic intelligence experts to Ohio on July 22 for a three-week deployment.
Implications for public health operations
Public health agencies handling the outbreak have had to reallocate limited staff and resources, and county officials say that those movements have consequences for other public health priorities. State and local leaders are attempting to maintain routine services while executing a time-intensive outbreak response, relying on staff who normally work on other disease prevention programs.
The size and continuing spread of the outbreak, combined with missing links for a subset of cases and reduced federal and laboratory capacity, have left investigators facing a complex and resource-heavy task. Officials continue to collect epidemiological information and perform interviews in hopes of narrowing sources of exposure and protecting the public.
What officials say next
Federal and state agencies continue their investigations. Federal officials have linked part of the outbreak to iceberg lettuce from Taylor Farms supplied to Taco Bell, while Michigan officials continue to explore a wider range of exposures in the state’s caseload. Local health departments say they will continue to shift resources and recruit help as needed to sustain the investigative work that cannot be automated or accelerated with laboratory testing.