Taco Bell announced it will remove all iceberg lettuce from its supply chain and replace it after federal health officials linked an outbreak of cyclosporiasis to a single supplier.

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The Centers for Disease Control and Prevention and the Food and Drug Administration advise consumers to avoid eating shredded iceberg lettuce at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio and West Virginia.

Health officials analyzed 190 cases of cyclospora in Michigan, where one person who became ill reported eating at Taco Bell. Officials found that 90% of those people said they ate iceberg lettuce.

More than 1,644 people sickened in this multi-state cyclospora outbreak reported eating at Taco Bell in those states as of May 13, according to the agencies. There have been 94 hospitalizations and no deaths reported.

The FDA traced this subset of cases identified nationwide to a single supplier of contaminated iceberg lettuce from Mexico, but did not name the supplier.

The FDA says it is working with the supplier to identify other locations where the contaminated lettuce has been distributed. The agency notes that this is a large group that is epidemiologically related. There are other groups throughout the country that may or may not be associated. Cases have been identified in 34 states.

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Taco Bell issued a statement on July 16 saying it had taken “immediate action to voluntarily remove potentially affected lettuce from a supplier in select states.” The statement also said the lettuce would be removed from the supply chain nationwide and replaced within 24 hours.

A wide scope for salad suppliers

The Associated Press, citing an unnamed federal official, reported that Taylor Farms was the supplier of the lettuce. NPR has not independently confirmed this and Taylor Farms has not responded to a request for comment.

A handful of large players with integrated supply chains and advanced processing infrastructure, including Taylor Farms, dominate the bagged lettuce and salad industry in the US.

With such a large reach, a single supplier can supply lettuce products to multiple retailers, so it is possible that additional cyclospora clusters across the country could be linked to lettuce from the same supplier. It is also possible that there are multiple sources and suppliers linked to other cases across the country.