CDC acknowledges two Michigan deaths in Cyclospora outbreak

The CDC has acknowledged two Michigan Cyclospora deaths associated with an ongoing foodborne outbreak, a development that puts fresh attention on a recall of iceberg lettuce from central Mexico. The agency said Aug. 3 that the two people had underlying health conditions, while Michigan health officials said cyclosporiasis and dehydration may have affected those conditions.

The CDC is investigating an open outbreak of Cyclospora infections tied to iceberg lettuce across nine states with the Food and Drug Administration and state health departments. Cyclospora is a parasite that causes cyclosporiasis, an intestinal illness. The agency said its Aug. 3 update will be revised to include laboratory-confirmed cases, hospitalizations and deaths.

What should consumers do about the Cyclospora lettuce recall?

The CDC says consumers should not eat recalled iceberg lettuce from Taylor Farms de Mexico that was sourced from central Mexico. The company began recalling all such lettuce on July 17. The products were sold in multiple lots and package types and distributed to consumers, restaurants and retailers in at least 27 states, according to the CDC.

Anyone who has the recalled lettuce should discard it or return it. The CDC also advises washing items and surfaces that may have touched it with hot, soapy water or in a dishwasher.

People who develop symptoms should stay hydrated and contact a health-care provider, the CDC said. Symptoms can include watery diarrhea, fatigue, loss of appetite, weight loss, cramping, bloating, increased gas and nausea. Illness usually begins about a week after infection, though symptoms can start from two days to more than two weeks later. Routine stool tests do not always screen for Cyclospora, the agency noted.

What do the outbreak counts cover?

The CDC's nine-state iceberg-lettuce investigation listed at least 1,947 cases and 98 hospitalizations on Aug. 3. Its Fast Facts panel still displayed zero deaths, but a separate notice on the same CDC page said the agency was aware of the two cyclosporiasis-related deaths in Michigan. The CDC did not explain the difference and said it would update its data.

Michigan's investigation is broader and should not be treated as the same count as the CDC's lettuce-linked cluster. The Michigan Department of Health and Human Services said lettuce or salad greens may be a potential source, but other food items have not been ruled out and no specific produce type, grower or supplier has been identified.

Michigan's outbreak page listed 10,773 total cases as of July 31 and 193 reported hospitalizations as of July 30. The department said those figures can change as information is reported. It has not released further details about the two deaths, according to the Associated Press.

This story draws on original reporting from CNBC.