The Alabama Department of Public Health says the recent cyclospora outbreak tied largely to lettuce appears to be slowing in the state, though officials continue to monitor reported cases and urge anyone with persistent gastrointestinal symptoms to seek medical evaluation.
Outbreak scale and state breakdown
Alabama has recorded about 117 confirmed cyclospora cases connected to the nationwide outbreak, according to state health officials. The U.S. Centers for Disease Control and Prevention reports 9,481 confirmed cases in 17 states as of Aug. 13, and warns that total numbers are likely underreported.
| Year | Reported Alabama cases |
|---|---|
| 2023 | 139 |
| 2024 | 30 |
| 2025 | 21 |
The outbreak in Alabama has not been evenly distributed. The Northern ADPH District — which consists of 12 counties mostly north and northwest of Birmingham — reported the largest cluster with 73 cases. Other districts reported smaller totals: the Northeastern District reported 10 cases; the Southeastern District reported 8; Jefferson County and the Southwestern District each reported 7; Mobile County and the West Central District each reported 5; and the East Central District reported 2.
What officials are saying
"The cyclospora outbreak associated with lettuce, mostly we think, has now tallied about 117 cases confirmed in Alabama," Dr. Scott Harris, the state health officer, said Thursday.
Dr. Harris and other ADPH staff emphasized that while Alabama’s confirmed total is modest compared with some Midwestern states, the figure represents a meaningful number of illnesses for the state. The Michigan Department of Health and Human Services has reported nearly 14,000 cases and the Ohio Department of Health almost 5,000, reflecting the regional intensity of the outbreak elsewhere.
Symptoms, transmission and treatment
Cyclosporiasis is caused by the parasite Cyclospora cayetanensis. Common symptoms include:
- Watery or severe diarrhea
- Nausea
- Stomach cramps
The parasite is typically contracted by consuming food or water contaminated with feces that contain cyclospora. According to the CDC, the illness is not directly contagious from person to person in the ordinary way, and symptoms often develop within about 10 days of exposure. Without appropriate antibiotic treatment, symptoms can last from several days up to a month.
Hospitalizations and national context
Nationally, the CDC reported 398 hospitalizations associated with this outbreak and two deaths in Michigan. Health officials have cautioned that reported counts understate the size of the outbreak because many people with milder illness do not seek care or are not tested.
Local impact and what to do if you’re sick
Alabama’s concentration of cases in the northern district has prompted local health authorities to keep surveillance in place and work with clinicians to ensure testing and diagnosis. ADPH communications director Ryan Easterling noted the geographic pattern of reported infections.
If you have persistent diarrhea, abdominal pain or nausea, public-health officials recommend:
- Contacting your health care provider and mentioning possible exposure to cyclospora.
- Seeking testing if advised — laboratory confirmation is necessary for public-health surveillance and appropriate treatment.
- Following your clinician’s guidance on antibiotic therapy; effective medications exist to shorten illness.
- Practicing safe food handling and hand hygiene, especially after using the restroom and before preparing or eating food.
ADPH continues to track reports, coordinate with local health districts and share updates from the CDC as new information becomes available.
Residents with questions about symptoms or reporting a suspected case can contact their county health department or the Alabama Department of Public Health through official channels for guidance.
