Michigan
Cumulative preliminary cyclosporiasis cases per 100,000 population reported during the outbreak investigation (as of Jul 16, 2026, starting July 1, 2026).
Cyclosporiasis is a diarrhea-causing infection from the parasite Cyclospira, spread through contaminated food and water. While cases typically spike during the summer months, the CDC's National Notifiable Diseases Surveillance System (NNDSS) is reporting almost 2,000 cumulative cases this year, making it the largest outbreak on record. In comparison, the U.S. typically saw about half as many by this time in previous years. Although reporting is mandated in 47 states, the exact total number of cyclosporiasis cases is difficult to pin down. Local health departments track and submit case counts to states, which then notify the CDC. Additionally, not everyone with diarrhea seeks medical care, most people with diarrhea are not tested for cyclosporiasis, and diarrhea has many causes beyond cyclosporiasis, which complicates case tracking.
This dashboard tracks reported cases, combining CDC's NNDSS data and additional data at the county level from Florida, Michigan, and Ohio with clinical insights from Epic Cosmos. Data reflected below are current as of Jul 17, 2026.
Note: State data are the authoritative source for case reporting. NNDSS data may lag or differ due to submission timing variations.
Trends over time
National total shown by default; start typing a state name to switch to a specific state.
Cumulative weekly cyclosporiasis cases
About this chart
Chart shows cumulative cyclosporiasis cases reported to NNDSS by calendar week, one line per year, for the selected state (national total by default). 2026 data are preliminary and incomplete. States that have reported zero cyclosporiasis cases in every year from 2022 onward are considered 'missing' and not plotted. Not all states mandate cyclosporiasis reporting; states with zero cases may lack reporting requirements rather than having no cases. Territories are excluded. Standardized data can be found on our GitHub. The raw NNDSS data from CDC are found here.
Geographic distribution
Use the toggle to switch between cumulative cases of cyclosporiasis from CDC/NNDSS, percent of emergency-department (ED) visits due to diarrhea from any cause from Epic Cosmos, and percent of all healthcare encounters due to diarrhea of any cause.
Cases by state
About this chart
NNDSS view: cumulative cyclosporiasis cases reported to NNDSS by state for the selected year (cases per 100,000). 2026 data are preliminary and incomplete. States that have reported zero cyclosporiasis cases in every year from 2022 onward are considered 'missing' and not plotted. Not all states mandate cyclosporiasis reporting; states with zero cases may lack reporting requirements rather than having no cases. Territories are excluded.
Standardized data are on our GitHub; the CDC presents its NNDSS data here.
Epic diarrhea view: percent of ED visits and all healthcare encounters attributable to all-cause diarrhea (ICD-10-CM A00-A09, R19.7). Insights are drawn from clinical electronic health records (EHR)from facilities using the Epic EHR and participating in Epic Cosmos. Epic Cosmos captures varying amounts of the population in different regions, so the data may be mroe representative of diarrhea in the community in some areas than others. This is a measure of diarrhea activity in the ED, not a cyclosporiasis case count. Counts fewer than 10 are suppressed and excluded (shown unfilled). Standardized data are on our GitHub.
As noted above, data from NNDSS for this year may not be the most up-to-date. Below are totals reported by states for 2026:
| State | Number of cases | Cases per 100,000 | Last updated |
|---|---|---|---|
| Michigan* | 6,919 | 68.8 | Jul 16, 2026 |
| Ohio | 1,229 | 10.4 | Jul 11, 2026 |
| Florida | 108 | 0.5 | Jul 11, 2026 |
*Michigan's count reflects cases reported since July 1, 2026, not a full-year total.
MI, OH, and FL: county-level detail
These three states display case counts at the county level collected from state health departments. Hover over a county to see its case count. Most states only report cases at the state level. Oregon also reports at the county level, but its data are suppressed due to small sample sizes because Oregon is not currently experiencing a large outbreak.
Ohio
Cumulative year-to-date preliminary cyclosporiasis cases per 100,000 population as of Jul 11, 2026.
Florida
Cumulative year-to-date preliminary cyclosporiasis cases per 100,000 population as of Jul 11, 2026.
About these charts
Cyclosporiasis cases are obtained from individual state health departments. Rates are calculated using county-specific population denominators from the 2021 census. Standardized data can be found on our GitHub. Raw data from FL are found here; raw data from MI are found here; and raw data from OH are found here.
Epic Cosmos Trends
Epic Cosmos captures broader diarrhea activity in health care facilities and how often clinicians order a cyclospora lab test. These are population-level signals of disease activity, not case counts. National total is shown by default. Start typing a state name to switch to a specific state.
Epic diarrhea and Cyclospora testing trends
Start typing a state name to filter (national total by default). Hover any point for the underlying value. Epic diarrhea points also report the share of the population Epic covered that week.
Epic diarrhea trends compared to cyclosporiasis cases (NNDSS)
Five panels share the same time range; each has its own y-axis scale.
Epic Cosmos: % of ED encounters due to diarrhea
Epic Cosmos: % of all encounters due to diarrhea
Cyclosporiasis cases (NNDSS)
Stool and cyclospora testing: % of diarrhea encounters tested for cyclospora
Stool and cyclospora testing: % of cyclospora tests positive
Positive Cyclospora test counts are suppressed in a large majority of the states and are not plotted if suppressed.
About these charts
NNDSS data: cumulative cyclosporiasis cases reported to NNDSS by state for the selected year (cases per 100,000). NNDSS cyclosporiasis is reported as a cumulative year-to-date count, so it is de-cumulated into weekly incident cases. 2026 data are preliminary and incomplete. Not all states mandate cyclosporiasis reporting; states with zero cases may lack reporting requirements rather than having no cases. States that have reported zero cyclosporiasis cases in every year from 2022 onward are considered 'missing' and not plotted. Territories are excluded. Standardized data are on our GitHub; the CDC presents its NNDSS data here.
Epic insights: percent of ED visits and all healthcare encounters attributable to all-cause diarrhea (ICD-10-CM A00-A09, R19.7). Insights are drawn from clinical electronic health records (EHR)from facilities using the Epic EHR and participating in Epic Cosmos. Epic Cosmos captures varying amounts of the population in different regions, so the data may be more representative of diarrhea in the community in some areas than others. This is a measure of diarrhea activity, not a cyclosporiasis case count. Counts fewer than 10 are suppressed and excluded (shown unfilled). Standardized data are on our GitHub; the weekly file is weekly.csv.gz.
Cyclospora testing insights are also drawn from Epic Cosmos by searching for the following tests: Cyclospora SP AG in stool by immunoassay 38403-2, acid fast stain 10659-1, safranin stain 50313-6, cayetanensis presence 10850-6, cayetanensis DNA presence by NAA with non-probe detection 82206-4, and cayetanensis DNA presence by NAA with non-probe detection 41436-7. The two weekly cyclospora testing measures have different denominators: % of diarrhea encounters tested for cyclospora (cyclospora tests ÷ all-cause diarrhea encounters that week) and % of cyclospora tests that are positive (positive results ÷ tests). All Epic values with a suppressed count (fewer than 10) are excluded.
Epic diarrhea by age group
Weekly share of emergency-department and all healthcare encounters attributable to all-cause diarrhea. National total shown by default; start typing a state name to switch to a specific state.
Epic diarrhea by age group
About this chart
The percent of ED visits and all healthcare encounters attributable to all-cause diarrhea (ICD-10-CM A00-A09, R19.7) are obtained from facilities using the Epic electronic health records platform and participating in Epic Cosmos. Use the toggle to switch the denominator between ED visits and all healthcare encounters. Epic Cosmos captures varying amounts of the population in different regions, so the data may be more representative of diarrhea in the community in some areas than others. This is a measure of diarrhea activity, not a cyclosporiasis case count. "Total" (navy) is the all-ages line. Counts fewer than 10 are suppressed and excluded, which is why some state/age lines have gaps. Standardized data are on our GitHub; the weekly file is weekly.csv.gz.
Epic Health Alerts: elevated cyclosporiasis detected
Epic Health Alerts has identified Michigan and Ohio as currently experiencing elevated rates of cyclosporiasis, with cases significantly above historical levels for this time of year. Data are current through July 15, 2026.
| State | Location | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Michigan | State-Wide | 6/22/2026 | 12.8* |
| Ohio | State-Wide | 6/22/2026 | 18.8* |
Stay Updated
These numbers are preliminary and subject to change as more data arrive. Visit the Epic Health Alerts dashboard regularly for the latest information.
How alerts are triggered
Health Alerts are generated based on analysis in Epic Cosmos, based on data from Epic Cosmos participating organizations. They do not reflect complete case counts for a condition but rather evaluate population level trends of disease activity. The data can be viewed at https://www.epicresearch.org/health-alerts/.
Epic Health Alerts flag conditions when three criteria are met:
1. Current rates exceed those from the same period last year
2. The proportion of affected patients shows accelerating growth
3. The increase is statistically significant compared to the prior three years
See more in Epic Health Alerts' methodology section.