Nebraska has confirmed 218 infections statewide. Health officials have linked 92 cases to the multistate outbreak associated with recalled iceberg lettuce.
Updated Aug. 6, 2026.
By Hola Nebraska
OMAHA, NE — Douglas County has confirmed 71 Cyclospora infections as Nebraska becomes one of 15 states with cases linked to a multistate outbreak associated with recalled iceberg lettuce.
The Douglas County count, current as of Aug. 1, represents an increase of 26 cases from the 45 reported July 25. The county had recorded 27 cases July 20.
Nebraska has confirmed 218 cases statewide, including 191 infections acquired within the United States. The Centers for Disease Control and Prevention has connected 92 of the state’s cases to the ongoing national outbreak, according to the Nebraska Department of Health and Human Services.
State and local health officials have not published a county-by-county breakdown of the 92 outbreak-related cases. It remains unclear how many of the 71 Douglas County infections are included in that group.
Nebraska cases are now part of the national investigation
Nebraska was added to the federal outbreak investigation along with Arkansas, Iowa, Missouri, New Hampshire and North Carolina.
The outbreak included 6,358 confirmed infections in 15 states as of Aug. 5. Federal health officials had recorded at least 278 hospitalizations and two deaths in Michigan. Both people who died had significant underlying health conditions.
Illnesses connected to the outbreak began between June 22 and July 31. The number could continue rising because determining whether an infection belongs to an outbreak can take up to six weeks.
The 92 Nebraska infections linked to the national investigation represent part of the state’s 218 confirmed cases. Not every Cyclospora infection reported in Nebraska has been connected to the recalled lettuce or the same outbreak.
Recalled iceberg lettuce reached Taco Bell locations in Nebraska
The national investigation identified iceberg lettuce sourced from central Mexico and supplied by Taylor Farms de Mexico as the shared food exposure.
Taylor Farms removed all iceberg lettuce sourced from central Mexico from the U.S. market July 17. Taco Bell stopped using lettuce from the supplier that same day.
Federal investigators determined that Taco Bell restaurants receiving the recalled lettuce included locations in Nebraska and at least 12 other states.
The investigation now includes people who reported eating at Taco Bell or being exposed to recalled Taylor Farms de Mexico iceberg lettuce before becoming ill. Reporting a restaurant visit or food exposure during an interview is one part of an epidemiological investigation and does not establish that every meal or location caused an infection.
The recall also included specific Marketside Iceberg Salad and Shredded Lettuce products sold at select Walmart stores, along with products supplied to restaurants and other food-service customers.
The complete list of affected products, package sizes and dates is available through the FDA’s Cyclospora outbreak investigation.
Nebraska DHHS considers the risk to the general public low because the recalled products have been removed from store shelves. Anyone who still has a listed product can discard it or return it to the place of purchase.
Watery diarrhea is the most common Cyclospora symptom
Cyclospora is a microscopic parasite that causes an intestinal illness known as cyclosporiasis. Infection usually occurs after someone consumes contaminated food or water.
Frequent watery diarrhea is the most common symptom. Other possible symptoms include:
- Loss of appetite and weight loss
- Stomach pain or cramps
- Bloating and increased gas
- Nausea
- Fatigue
- Vomiting
- Low-grade fever
Symptoms usually begin about one week after exposure but can appear between two days and two weeks later. Without treatment, the illness can continue for weeks or longer. Symptoms may disappear temporarily and then return.
Cyclospora is not generally transmitted directly from one person to another.
Diagnosis requires a specific laboratory test
People experiencing sudden or persistent diarrhea lasting more than three days can contact a health care provider. Diagnosing Cyclospora requires a specific stool test that may not be included in a routine laboratory analysis.
Cyclosporiasis is generally treated with trimethoprim-sulfamethoxazole, an antibiotic also known as TMP-SMX. A medical provider determines whether the treatment is appropriate based on the patient’s condition and medical history.
Douglas County residents can report a possible foodborne illness through the county’s foodborne illness reporting form.
The Douglas County Health Department Epidemiology Division can be reached at 402-444-7214. Investigators may ask patients about meals, grocery purchases and travel during the two weeks before symptoms began.
RELATED: Cyclospora cases in Nebraska: symptoms, testing and treatment
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