Most of these persons—293 (59%) of 495—experienced onset of illness on or after May 1, 2015, and did not have a history of international travel within 2 weeks before illness onset. These 293 persons were from the following 23 states: Arkansas (3), California (2), Connecticut (3), Florida (10), Georgia (23), Illinois (8), Iowa (1), Kansas (2), Maryland (1), Massachusetts (10), Michigan (2), Missouri (1), Montana (3), Nebraska (1), New Jersey (6), New Mexico (2), New York (excluding NYC) (9), New York City (21), North Carolina (1), Texas (168), Utah (1), Virginia (3), Washington (2), and Wisconsin (10).
Clusters of illness linked to restaurants or events have been identified in Texas, Wisconsin, and Georgia. Cluster investigations are ongoing in Texas and Georgia. Cluster investigations in Wisconsin and Texas have preliminarily identified cilantro as a suspect vehicle.
Previous U.S. outbreaks of cyclosporiasis have been linked to imported fresh produce, including cilantro from the Puebla region of Mexico.