KEENE, N.H. — Officials have linked the first New Hampshire cases of cyclosporiasis to a national outbreak of the gastrointestinal illness.
Though no cases have been confirmed yet in the Upper Valley, the New Hampshire Department of Health and Human Services linked nine new cases of cyclosporiasis Thursday to recalled lettuce served at Cheshire Medical Center in Keene, a Dartmouth Health affiliate.
The cases are the first in the state to be associated with the national outbreak.
Taylor Farms, a national distributor of produce including lettuce, has been linked to an outbreak of the illness that causes gastrointestinal symptoms including diarrhea and nausea that can last up to a month. The company issued a voluntary recall last week for products containing iceberg lettuce grown in central Mexico.
The nine patients consumed Taylor Farms lettuce served at the Cheshire Medical Center cafeteria, according to DHHS. The hospital is no longer serving the recalled lettuce.
“Anyone who ate lettuce at Cheshire Medical Center from the beginning of June through July 20, 2026 who develops severe or persistent watery diarrhea should contact their health care provider for evaluation and testing for Cyclospora infection,” DHHS advised in the Thursday news release.
There have been 20 confirmed cases of cyclosporiasis in New Hampshire this year, including the nine acquired in Keene, according to DHHS. Eight other cases were picked up domestically but not linked to the national recall and three are associated with international travel.
The DHHS is “not aware” of any recalled produce sold in New Hampshire stores, but food service businesses like restaurants and cafeterias in New Hampshire have received the recalled Taylor Farms produce.
Vermont has yet to report any cyclosporiasis cases linked to the national outbreak and no affected lettuce was distributed in Vermont, according to the state Department of Health. The agency is reporting that the overall risk to Vermonters remains low.
The illness is caused by consuming a parasite called cyclospora that comes from fecal matter. It is not found domestically and often comes from international produce, Dr. Gabriela Andujar Vazquez, Dartmouth Hitchcock Medical Center’s hospital epidemiologist told the Valley News last week.
Common symptoms include watery diarrhea, loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue. It usually takes about a week to develop symptoms after consuming the parasite and they can last for a month, Andujar said.
Patients experiencing symptoms should seek medical attention, Andujar advised. Doctors can prescribe an antibiotic to treat the infection before it runs its course.
The outbreak has also surged nationally as federally reported cases are catching up with state-level data.
As of Tuesday, there have been more than 4,000 laboratory-confirmed cases of cyclosporiasis across the country, according to the U.S. Centers for Disease Control and Prevention, a massive jump from the 1,600 cases reported up to that point. The agency also reports that there are more than 7,400 possible cases that have not yet been confirmed.
There is roughly a six-week lag between when people become sick and when cases are reported to the CDC, so the numbers will likely continue to rise.
Seven new states are also reporting cases of the illness, bringing the total from 34 to 41.
The CDC and Food and Drug Administration are continuing to investigate the outbreak and expect that not all cases are linked to the same product.
The FDA opened a separate investigation Wednesday into 72 cases of cyclosporiasis not yet linked to a specific product and is also investigating four more outbreaks that have not been linked to specific products, totaling 38 cases.
The CDC has also linked four new states — Illinois, Kansas, Oklahoma and Pennsylvania — to the Taylor Farms outbreak associated with lettuce served at Taco Bell, the largest known outbreak in the country, the Washington Post reported Friday. The update brings the total to nine affected states. The new states join Indiana, Kentucky, Michigan, Ohio and West Virginia.
