The Twin States have remained mostly insulated as cyclosporiasis outbreaks continue around the country, but consumers may still have questions about the illness.

As of Sunday, New Hampshire has recorded six cyclospora infections so far in 2026 with none linked to a national outbreak, according to the state Department of Health and Human Services.

There have also been no cases linked to the national outbreak in Vermont, Department of Health Spokesperson Kyle Casteel confirmed Monday. Casteel declined to say how many cyclosporiasis cases the state has seen in 2026, but said the number is “within the typical range.”

The situation progressed on Friday when Salinas, Calif.-based Taylor Fresh Foods, a national produce distributor, issued a voluntary recall for all iceberg lettuce sourced from farms in central Mexico between June 29 and July 16. The lettuce was distributed in New Hampshire but not Vermont, according to the recall.

Taylor Fresh Foods’ lettuce includes Marketside-branded products sold at Walmart, according to the U.S. Centers for Disease Control and Prevention.

Though the recall is ongoing, the U.S. Food and Drug Administration walked back a claim Sunday that a sample of Taylor Farms’ lettuce had tested positive for the parasite.

“FDA has notified Taylor Farms and continues working with the firm to ensure product implicated in this outbreak has been removed from the market,” the agency wrote.

The CDC and FDA are investigating cases around the country of the illness that comes from food and drink contaminated with feces. Last week, the agency linked an outbreak across five midwestern states with Taylor Farms lettuce sold at Taco Bell.

As of July 13, the CDC has confirmed 1,645 cases of cyclospora infection and 141 hospitalizations across 34 states. More than 5,100 suspected cases “require further analysis,” according to the agency.

Cases of cyclosporiasis are recorded annually in summer months in the U.S., but it is typically less pervasive.

The CDC recorded 717 cases of the infection in 2024 with more than 300 linked to international travel. Annual cases have been consistently on the rise since 2020.

How will I know if I have cyclosporiasis and when should I contact a healthcare professional?

Cyclosporiasis is a gastrointestinal illness caused by a parasite. 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, Dr. Gabriela Andujar Vazquez, Dartmouth Hitchcock Medical Center’s hospital epidemiologist, said Friday.

The illness can last about a month, Andujar said. Symptoms can also start to lessen and then return, so patients experiencing symptoms should seek medical attention. There is an antibiotic available to treat the infection, she explained.

“It can resolve on it’s own,” Andujar said. “(…)But, it will be painful. It will take weeks for it to run its course.”

Patients also run a high risk for dehydration which is often what brings people with cyclospora infections to the hospital, Andujar said.

How does it spread and how can I avoid getting sick?

Cyclospora is typically introduced to the U.S. in imported produce, Andujar said. The parasite can live in produce for weeks to months and cause an infection when consumed.

“Anything that’s fresh that we eat raw typically that is contaminated and we don’t clean well with running water could potentially cause a case of cyclosporiasis,” Andujar said.

The illness is not contagious if a person is sick at home. It can spread if you “don’t practice good hygiene” like not properly cleaning bathrooms or hands, Andujar explained. The parasite needs proper conditions like the right temperature to become infectious.

“It needs a perfect-storm type of situation,” she explained.

Nonetheless, patients who are sick with any kind of gastroinestinal illness should avoid handling food for themselves or others “unless you’re very good about proper safety with food handling and handwashing.”

The CDC recommends washing hands with soap and water after handling raw fruits and vegetables, washing and scrubbing produce thoroughly and cutting away damaged or bruised areas. For produce that is not consumed raw, cooking to at least 158 degrees Fahrenheit will kill the parasite.

Where is it safe to acquire produce?

While possible, the risk of contracting a cyclospora infection from local farms, farmers markets or your own garden are very low, Andujar said.

Cyclosporiasis has historically only been introduced into the U.S. food system from produce grown internationally, Andujar explained. The one risk is if a sick individual is handling food at a farm, farmers market or restaurant and not following safety protocols like proper hand washing.

Norwich Farmers’ Market Manager Nica Meiloch-Blinn said similar national health concerns typically drive up business for produce vendors.

“People like to buy from smaller local producers/owners where they know their farming practices and can speak directly to how they farm and grow,” Meiloch-Blinn said in a Friday email. “Our producers also have excellent safety and health track records and I think when the public is avoiding pre-packaged lettuce mixes what better place to look for alternatives then your local farmers market.

Ronnie Webster, deli manager at the White River Junction, Vt., Co-Op Food Store, adds lettuce to a sandwich order on Friday, July 17, 2026. The lettuce comes washed and bagged from supplier Associated Grocers of New England, and gets washed again before being added to sandwiches in the deli. JAMES M. PATTERSON / Valley News

The Co-Op Food Stores in Hanover, Lebanon and White River Junction have seen a “pretty hefty” increase in customers purchasing “ultra-local” produce available at the grocery stores, like from Plainfield’s Edgewater Farm, said Dawn Archambeault, director of marketing and consumer relations for the co-op.

While Archambeault declined to give specific numbers for the shift, she said it is clear customers “are feeling a little safer” with local produce than big brands.

As for food prepared in store, Archambeault said co-op staff will typically put together sandwiches and meals using produce from local suppliers like Black River Produce in Springfield, Vt., or grown in hydroponic systems, so “we don’t see any concern there.”

The Co-Op does carry Taylor Farms lettuce, but none of the products come from Mexico where the outbreak may be linked to, Archambeault said. Salad mixes sold at the stores come from California, Canada and Florida.

As of Monday morning, no suppliers or the Food and Drug Administration have notified the co-op of a recall for the specific products they sell, so products have not been pulled off shelves, Archambeault said.

“We try to stay the course of relying on the info that we get from the FDA and other entities like that,” Archambeault said. “But, most importantly from the distributor and the supplier and sort of letting people make their own decisions.”

Decisions like the FDA walking back positive results Sunday have made the situation even more complicated, Archambeault said.

How can I know that produce is safe?

The CDC, FDA and state agencies are continuing to monitor outbreaks and cases around the country, including testing and reporting positive cases of the illness and testing potentially contaminated products like Taylor Farms lettuce.

Consumers should throw away any recalled produce, wash surfaces that may have touched recalled produce with hot soapy water or a dishwasher and ask restaurants where the lettuce they use has come from if they don’t know the source, according to the CDC.

The co-op is keeping a close eye on the situation. If the federal government or suppliers recall co-op products, the store will contact all members and customers who bought them, Archambeault said.

“There’s daily conversations that are happening here and it’s on the forefront of our minds.”

Other local entities using large amounts of produce are also keeping an eye on the situation, like the nonprofit Hartford Community Coalition which distributes 3,800 free summer meals per week to students in Hartford and Lebanon.

Friday’s meals included caesar salad, Executive Director Emily Zanleoni said.

While she was not aware of the outbreak, Zanleoni said HCC’s kitchen director was keeping an eye on it and questioned whether ceasar salad was still the right choice for the day.

“When there’s an issue with supply we get hit pretty hard,” Zanleoni said. “I have to really think about that.”

Zanleoni said employees confirmed that the lettuce was not from Taylor Farms. Kitchen staff rinsed the produce an additional time and decided to go forward with the planned meal for the day.

“That’s why we rely on people who are experts on making sure that our food is sourced well and taken care of before it gets distributed,” Zanleoni said. “I’m grateful we can rely on our kitchen experts.”

Clare Shanahan can be reached at cshanahan@vnews.com or 603-727-3216.