Cyclospora is a microscopic organism that is causing a big problem in the U.S.
Cases of cyclosporiasis have been growing throughout the summer, with about 4,000 reported cases in Ohio alone.
Federal health officials are still investigating the source. How much longer do we have to worry about the produce we eat? Have recent cuts to federal agencies played a role in the outbreak?
This episode of All Sides will discuss the public health outbreak with a public health expert, gastroenterologist and journalist who covers the CDC and FDA.
Guests:
- Sanja Ilic, food safety state specialist/professor of human nutrition, Ohio State University
- Dr. We’am Hussain, gastroenterologist, Kettering Health
- Marcia Brown, food and agriculture reporter, POLITICO
Transcript
This transcript is generated with AI. To ensure its accuracy, review the audio file.
Amy Juravich: Welcome to All Sides with Amy Juravich. The recent outbreak of cyclospora has been spreading across Ohio and across the US, coming with it some rather unpleasant symptoms. There have been more than 18,000 reported cases in the US and about 4,000 cases reported in Ohio alone. Two people in Michigan have died due to complications related to the parasite. But what was the cause of the recent outbreak and should people still be worried about the produce they eat? Joining us now to talk about cyclospora is Sanja Ilic, professor of human nutrition with Ohio State University and a food safety state specialist. Thanks for joining us today, Sanja.
Sanja Ilic: Pleasure to be here.
Juravich: So can you explain what type of parasite cyclospora is and and tell me how tiny it is, too?
Ilic: It's really small. We call it micro parasite. It is tiny. It is a little bit bigger than bacteria, which are smaller, but I've recently heard my colleague that works a lot with cyclospora say, if you put 10 cells of cyclosporas together, you're going to get a hair, a width of your hair.
Juravich: A width of your hair. Yes. All right, so there's no way we're seeing this with the naked eye. No, no.
Ilic: No, no, it's a micro parasite. It's a microorganism that causes this foodborne illness. Okay. And how does it spread? Okay, so that's a great question. And for that question, I have to start from when a person ingests something that is contaminated with cyclospora, that those are kind of infectious oocysts, and a person gets sick. When person gets sick, they Uh, they shed the cyclospora in their feces. Now, cyclospore is really tricky because it kind of, uh, reproduces in two ways. The first way is what we called asexual, like any micro-organism. It divides in your body and reinfects the host. And the other way is called sexual and, um, it produces this oasis, like eggs that shed. Uh, in infected person's feces, uh, into the environment. And then it requires up to two weeks, seven days to two weeks, uh to be in the environment to become infectious again. So it's not infections immediately. It only becomes infections in, in couple of weeks. Now what happens in couple weeks? It's a kind of a little bit of unknown there because we do not have enough research. That tells us exactly what happens during these two weeks, but you can imagine that this little microorganism gets transferred through, a lot of times, through wastewater, gets into irrigation water, and from irrigation water gets onto our produce. Once it's on produce, the next person that consumes can become sick. So it's kind of a complicated cycle and the way for us to combat cyclospora is actually to break that cycle.
Juravich: Break the cycle. Okay. And so it's reproducing or for lack of a better word, you know, like there's more and more of it, not because it's growing within our produce. It's growing in the human body, right? Exactly.
Ilic: Human is the only host for cyclospora. There are no other hosts like animals that would transmit. It's from humans, gets into, through waste water and some breaches in the sanitation system, infrastructure, gets in to irrigation water, from irrigation water onto the produce. So it's not normally found in produce.
Juravich: Okay, so we looked up in 2025, so last year, Franklin County reported 11 cases of cyclosporiasis, the infection. Well done. I said it. Okay, So in 2025 Franklin County had 11 cases. So I mean, that's some but not very many. Why are we seeing such an influx now? And obviously like it's so so it's not new. It's been around. Yeah. Tell me it tell me why
Ilic: And I have to say, since maybe 2018, we're seeing more and more cases. So it has been on our radar as researchers, but as I said, it's a little bit, the organism is difficult to work with and there are many unknowns in that complicated cycle. But, you're right, in the... Uh, uh, past several years, we had up to a couple of thousand nationally, a couple thousand cases, and this is an unprecedented outbreak. What we are, uh probably seeing over 20,000 cases nationally. It looks like we have more than one outbreak going on. So one outbreak that was linked to that shredded lettuce that ended up in Taco Bell, but other, um, uh retail as well. Uh, but also a couple of other outbreaks that may be linked to, uh, parsley, uh, maybe cilantro or some herbs like this.
Juravich: So, those 11 reported cases in Franklin County last year, were we just lucky that it didn't get bigger? You don't, you're a scientist, you don't like the word lucky. Yeah, lucky.
Ilic: Yeah, lucky is not a great word, but there has to be, unfortunately, there's not one thing that we can pinpoint as a cause of this outbreak, because in that case, it would be also very easy to kind of mitigate it. It's a convergence of different factors. Uh, probably some contaminated lots were, Uh, imported, and then that went through the food systems, et cetera, until we actually know what all is contaminated, we're not going to know. But as I said, it's on our radar since 2018, we have these increases and we're thinking, is there possibly something going on here domestically and not just related to imported? And probably it's a good time to look at many other factors, as I've said, the main route. Of cyclospora getting into the irrigation waters, the wastewater getting, so now that human waste can get into wastewater in several ways. We're very lucky that we have a really good wastewater treatment plan and sanitation around it. And that was probably protective for many, many, many years, hopefully many years to come. But it's a good time probably to look at, you know, wastewater treatment plans, What are the? The things that work and do not work against cyclospora, maybe some aging infrastructure, aging infrastructure et cetera, and also education for the growers, et cetera.
Juravich: This is All Sides on 89.7NPR News. We're talking about cyclospora with Sonia Illich, a professor of human nutrition with Ohio State University, also a food safety state specialist. So to the question that everyone wants to know, is it safe to eat lettuce right now?
Ilic: Yeah, so definitely the shredded lettuce that's been recalled and probably, hopefully removed from the shelves, it is not safe to eat and anybody should be on the look for these kind of products. For other produce, there is no evidence that we should completely avoid it. In fact, I would say avoiding fresh fruits and vegetables is probably the higher risk to human health than consuming. So, and even personally, a lot of my diet is actually based on fruits and vegetables and fresh fruits and vegetables. And I know I needed to adjust when this outbreak started. But at this point, I consume fresh fruits vegetables that that are grown locally that are not implicated in any ways in this outbreak. And also, I kind of measure that risk based on how the produce was produced, right? So for lettuces, fresh herbs, and any sort of fresh produce that has those kind of nukes and credits where cyclospora can attach and requires a lot of irrigation water, I may stay away from those. But tomato, cucumber, et cetera, that I can wash really well, I consume, I keep consuming those. Cabbage, et cetera.
Juravich: Yeah, you're you're a food safety state specialist. So are you are you doing some extra washing of everything or had you always washed?
Ilic: Always wash, so our recommendation is and what I do at home is always wash fresh fruits and vegetables. There is also an extra layer, so wash first the cleanest fresh fruits and vegetables, so like lettuce, fresh herbs, those are washed first so that you. Uh, do not cross contaminate from, uh, washing your maybe root vegetables and carrots, et cetera. Uh, so you, uh do that afterwards. Use brush, uh produce, clean produce brush whenever you can. For, uh lettuce, it is always safer to buy head lettuce when, uh things are, uh, not certain like now with this outbreak and remove outer leaves. So that will help remove that. Oh, I thought it was the insh-
Juravich: Oh, I thought it was the in so if I got ahead of lettuce, I thought it was the inside I had to worry about.
Ilic: So it's usually, it's a surface contamination and removing those outside leaves can help. Washing cannot guarantee us that if the produce contaminated from the farm, there is no one technology, even with this, in this time when we can grow produce in space, we do not have one technology that is going to be 100% guarantee that is to remove. Human pathogens, including cyclospora, from fresh produce that is going to be consumed raw.
And we're researching and we're looking into that.
Juravich: Working on it, okay. We are. So tell me about the the state's role in this versus the federal role. I mean, your title, one of your titles, is that you're a food safety state specialist. So does the state have a say in what happens with lettuce right now or is it more federal?
Ilic: Yeah, I'm a food safety state specialist as in the Ohio State University Extension. So my role as a state specialist is that I do applied research and I'm charged when translating the research in practices that can be directly useful for Ohioans, like consumers, growers, and fresh produce industry. So I'm not really a state representative. But I do know a little bit how state and federal officers go about this outbreak. So at federal level, we have CDC and FDA. At state level, We have our Ohio Department of Health and Ohio Department Agriculture that are kind of charged with fresh produce. OK. Ohio Department of Agriculture, they do a lot of grower education and regulatory. Ohio Departments of Health in 88 counties rely on their epidemiologists in local departments to follow up and to conduct the interviews with people who are sick with cyclospora. So they're on the front line collecting the information. So those are interviews when somebody's sick with cyclospora, they ask them, they give them a questionnaire and it's a set of questions that is supposed to discern and what they ate. And you can imagine with this time delay that cyclospore has like the symptoms show up within two weeks and then I can't remember what I can remember yesterday let alone yeah it's like four to six weeks before you actually get that that questionnaire administered people have to remember what they ate and a lot of times they've they've eaten shredded lettuce or cilantro parsley as a stealth food we call them stealth food not something that necessarily remember like if you had like chopped salsa. It's an extra.
Juravich: It's an extra, okay. Yeah.
Ilic: If you had salsa in a restaurant and, and there was cilantro in it, you don't necessarily even remember that. So, so, Uh, that's, that, um, Uh what our state epidemiologists are doing, taking those interviews. And from those interviews, the hypothesis is form of which foods, Uh, could be contributing and then that's tested and then FDA. Takes over and does a trace back. So they, when we have those hypotheses what foods are involved, then they trace back those foods to hopefully the source. But that's- That's proving difficult. It's very difficult. Yeah. It's really difficult because you can imagine in six weeks that those items are off shelf. So finding that positive sample, food sample is really difficult.
Juravich: So right now are we just having to wait for this to kind of run its course or is it gonna get worse before it gets better? What what's gonna happen in the next couple of weeks? I hope
Ilic: So there's a little bit of a mismatch of numbers that we're seeing, but according to the numbers, it looks like things are tapering off. It is really sad and tragic that we have had a couple of deaths already. And this is something that we all need to think about when we think about our food system. We, maybe 25%, maybe higher percentage of Americans are. Uh, have susceptible immune system. What that means is, uh, out of every 10 of us in the room, at least two or three have some sort of underlying conditions that makes them, make them prone to infections, not only foodborne infections, other infections as well. And those conditions like diabetes. Like cancer or different treatments for cancer, different treatments to immune diseases, IBD, et cetera, chronic liver diseases, chronic kidney diseases, all those contribute to your immune system not responding well. So all those are at high risk. At getting the disease and once they get the disease of that disease can run a really severe course and end up in death. So that's tragic. No one should die from consuming foods. So we have to do something. We cannot just run for it, wait for it to run its course. And I think there's a lot going on in the background and I know that people, individuals that I know and work with are working hard. To find the cause and break the cycle. Okay.
Juravich: We have been talking about the recent outbreak of the parasite cyclospora, and we've been talking with Sonia Illich, professor of human nutrition with Ohio State University and a food safety specialist. Thank you so much for joining us today, Sonia.
Ilic: Thank you. It's a pleasure to be here.
Juravich: And coming up, we're gonna talk with a doctor about what the parasite actually does to the body and how to treat it. That is when All Sides continues on 89.7 NPR News.
You're listening to All Sides. I'm your host, Amy Juravich. Cyclosporiasis is a disease caused by the parasite cyclospora, microscopic creatures that are creating a not-so-microscopic problem. About 100 of these parasites, stacked end to end, would stretch the length of the tip of a pen. If ingested, they burrow into the human stomach lining and cause some unpleasant symptoms. What are those symptoms and what do you do if you think you have it? Joining us now to talk about what this parasite does to the body and how to treat it, we have Dr. We’am Hussain, a gastroenterologist at Kettering Health. Welcome to the show, Dr. Hussain.
Dr. We’am Hussain: Hi Amy, thank you so much for having me.
Juravich: Okay, so what does cyclosporiasis do to the body? List off some of the symptoms that happen.
Hussain: Yes, so just like you mentioned, cyclospora is a microscopic parasite. And so it infects the lining of the small intestine. So it's not like a bacteria that produces toxins. Parasites end up actually invading the lining of the smaller intestine and they cause inflammation. And so that prevents the intestine from absorbing fluids and nutrients that it normally does. And so as a result, a lot of patients will have watery diarrhea, abdominal cramping, bloating, nausea, fatigue. And if it's severe, sometimes even weight loss. And unlike food poisoning, that just may last only a day or so. A lot of times we'll see with cyclospora, it can continue for weeks if it is untreated because that parasite remains inside the intestinal cells until it's completely eliminated.
Juravich: Now, you are a gastroenterologist. Have you seen any cases of it, you know, this summer or if not even like before?
Hussain: Yes, I've seen patients in the outpatient setting who do have cyclospora, they'll present with the same symptoms of severe diarrhea, abdominal bloating. So we'll treat them with Bactrum, which is an antibiotic that can treat that parasite and reduce the severity of the diarrhea symptoms and help patients feel better. So that is the positive, the silver lining.
Juravich: Yeah, well, I guess can can the parasite go away on its own? Or do you have to get the treatment, you know, that you just mentioned to have it go away?
Hussain: So like it can go away on its own, but that's only part of the story. Like healthy people can eventually recover without any treatment, but the problem is that it takes several weeks and symptoms will come and go. And many people think that they're getting better and then the diarrhea will return. And so like I mentioned, if we treat with the antibiotic backdrop, also known as trimethopim sulfamethoxazole, that shortens the illness and it clears the infection much faster. But anybody with severe diarrhea, dehydration, having prolonged symptoms, if they're pregnant or if they have a weakened immune system should seek urgent medical evaluation rather than simply waiting it out.
Juravich: How do you know you actually have the parasite versus just some other stomach issue?
Hussain: Yes. So there is a stool test that we have called a gastrointestinal PCR. And so that will specifically detect and tell us if somebody has cyclospora. So that's the test that we use. It's a stool tests that will detect it.
Juravich: Okay, so do you have to go to your doctor and get this test to actually 100, like you don't treat with this antibiotic without having a positive test, is that true?
Hussain: Yes, exactly, because there's numerous other causes of infectious diarrhea, including viruses, bacteria, and other parasites. So before treatment, we want to confirm the cyclospora diagnosis with that gastrointestinal PCR, which includes cyclosporon.
Juravich: Now we were talking earlier with a food safety specialist and I mentioned that, well, she mentioned that this has been around since 2018. So it's not new, it's just, we're hearing a lot about it now because we're having a more significant outbreak. So from your perspective, I mean, how not new is it? Have you seen it for years or is it really just right now that you're seeing a lot more of it?
Hussain: Oh no, cyclospora, I agree, is definitely not new. It's been infecting humans for many years, but it wasn't recognized as a distinct parasite until the late 20th century. But then with improvements in lab testing that we have with the gastrointestinal PCR I mentioned, it's become much easier to identify. The reason we're seeing so many more cases is what's changed is that our food supply, you know, today we're eating fresh produce year round that's transported across long distances. And because cyclospora is commonly transmitted through contaminated fresh fruits and vegetables, the outbreaks that we're identifying are much more than they were decades ago. So definitely have seen it in the past as well, but much more common now.
Juravich: This is All Sides on 89.7 NPR News. We're talking about cyclosporiasis with Dr. We’am Hussain, who is a gastroenterologist at Kettering Health. So we heard this week that two people in Michigan have died due to complications from the parasite. It's believed to be that they had other health conditions that complicated things, but the parasite is also a part of the cause of death here. Now, I read that death is unusual. With this parasite. So what do you make of that, these two deaths in Michigan?
Hussain: I know it's very sad news. It is very important to keep in mind that people who have weakened immune systems, such as transplant recipients or those who are receiving chemotherapy, they'll definitely experience more prolonged and severe illness. So like you mentioned, there have been those two cases of death with concerns for severe dehydration, and especially in immunocompromised individuals. Our immune system is not able to defend itself as well. And so it's much more risky and even more important to seek urgent medical care.
Juravich: And so there are there the most vulnerable can be more negatively affected by the parasite But does this include like because sometimes we always say, you know Like the really young and the really old need to be cautious as well. Who are you saying should be the most cautious?
Hussain: So anybody who is immunocompromised, so, you know, individuals, like for instance, if they have treatments that is killing off their immune response, like transplant recipients or chemotherapy that's killing off your own immune cells, that's even more important to be extra vigilant. Also individuals who may be pregnant with decreased immunity, those individuals definitely should have more vigilance. So I would definitely say those groups should be extra cautious.
Juravich: And you mentioned that it was in the small intestine, but typically when people have symptoms like we're talking about, they say, oh, my stomach hurts, or it's my stomach, it's my stomach. Can people tell that it's a problem? When you say stomach issues, it just everything, right? Right.
Hussain: Yes, so it specifically does target the small intestine. The parasite grabs onto the mucosa of the small bowel. So it is a small intestinal illness, but it does cause those cramping and abdominal symptoms that many people will refer to as stomach pain. So understandably so, but it is specifically targeting the small bowels. You're absolutely correct.
Juravich: Okay, are you having a lot of people come to you because they're worried they have it and it turns out they actually don't have it? Are you doing a lot tests that are negative?
Hussain: Yes, we actually have had a lot of tests that are negative. We are seeing, we have definitely seen cases and more so in the outpatient setting because in the inpatient setting, when they go to the ED, typically they're receiving IV fluids and getting antibiotics there. But in the patient setting, when we see them in GI clinic. They'll be reporting severe diarrhea that's been going on for weeks and waxing and waning in nature. So then those individuals will have higher suspicion and then when we do the stool testing, it does turn out positive, but we see all variety of cases of diarrhea. So we are definitely seeing more cases now, but it's definitely not the only cause of area in our clinic for sure.
Juravich: Yeah, I mean, is it possible, you know, Ohio has reported about 4,000 cases as of last week. Is it possible that there's actually more cases, but people are just not getting treated and tested and they're kind of dealing with it on their own?
Hussain: Oh absolutely. You know the CDC is saying that there's many individuals who are not you know being reported because they're self-managing at home. So I'm sure the number is much greater than that. Absolutely.
Juravich: Can people build an immunity to the parasite?
Hussain: So not necessarily, like they can clear the infection on their own. Like I mentioned, it's a pretty sturdy parasite. It has a pretty strong wall. So it is not something that will be cleared readily and which is why it causes a prolonged duration, but it can be cleared naturally just with a very miserable law.
Juravich: Okay, a sturdy parasite. That's what we want to hear, right? Okay. Well, so people have been, or I guess maybe the media is using this term, but we've heard the term used over and over again, explosive diarrhea. Is that a medically accurate term? Like, is it a sensationalized term? I mean, what is explosive diarrhea? The word explosive, Is that a word you would ever use as a doctor?
Hussain: So explosive diarrhea isn't an official medical diagnosis or scientific term. It's like a descriptive term that a lot of healthcare providers will use to describe diarrhea that comes on suddenly with tremendous urgency and force. So typically when people say that, it's referring to inability to hold stool or very forceful passage or large volume watery stool can also mean immediate need to go to the restroom. So, you know, it's basically the reason that it happens is because of that inflammation in the intestines causing large amounts of fluid to remain inside the bowel instead of being absorbed.
Juravich: And can a human pass it to another human, or does it have to involve eating the wrong lettuce?
Hussain: No, so it is not infectious. One person cannot spread it to somebody else directly. So it's not direct contact one person to another because the parasite is passed to the stool. So it has to go and mature in the environment over days to weeks before it can infect somebody else. So it is directly contagious. So that is the other good news. It's only spread at this time through directly eating produce that is infected. So for instance, if somebody has infected cilantro, basil, lettuce, bag salads, raspberries, or snow peas, those are the foods that are currently being investigated. So those are foods that can, you know, harvest cyclospora and then consuming that can cause the infection. But there is no direct person-to-person contact that will cause this infection.
Juravich: So the the list of foods that the parasite can live on coincidentally are very healthy foods. They're fruits and vegetables They're things that people need to eat to maintain a healthy diet So what are you telling your patients about what to eat and miss this parasite problem?
Hussain: Absolutely. So this is a really important question because people should not stop eating fruits and vegetables. Like I mentioned, cyclospora has been linked to all these healthy foods, and the issue isn't that these foods are unhealthy. The issue is that the contamination somewhere is during, it's like growing, harvesting, and processing. Growing, harvesting and processing these foods that's not being done well with contaminated water or contaminated soil that's causing the cyclospora infection. So fresh produce is one of the healthiest parts of our diet. So I definitely tell my patients not to avoid healthy foods. Instead we're saying, you know, pay attention to FDA recall notices. If there's an outbreak that involves a specific product, like definitely avoid that product until the recall is over. Refrigerate perishable produce. And then unfortunately routine washing doesn't completely remove cyclospora because that parasite adheres so well to produce. And the CDC guidelines are saying that physical friction can help dislodge some surface contaminants. So, you know, using some sort of specific produce brush can help maybe decrease the amount of parasites. But other things you can do is discard outer layers. So peel away and throw out the outermost leaves of lettuce, cabbage, onions before washing the inner sections. Um, you know, like I said, use frictions or rinse items under running water. Um, so not just keeping it in a water, um, soaked in water, but having it under running, water and rinsing it thoroughly. Um, And basically, you know, using scrub, firm skins, using a vegetable brush to aggressively scrub, uh, firm skin produce like melons and cucumbers before cutting them. And then obviously, you know, just maintaining good hygiene, like washing your hands with soap and water. At least 20 seconds before and after handling fresh produce. And something that I wanted to mention, you know, is alcohol-based hand sanitizers, they don't work against cyclospora. So that's something to keep in mind. And also there've been some things by the FDA that strictly advise against washing produce with soap or bleach as these can also leave harmful chemical residues on the food. So are important things to keep mind. And I also wanted to mentioned. The only way to really destroy this parasite is heat. So cooking, baking, boiling contaminated produce to at least a temperature of about 158 degrees Fahrenheit, which is about 70 degrees Celsius, will break down that oocyte wall that's protecting the parasite and destroy the parasite.
Juravich: So you as a gastroenterologist, I mean, you know, you just mentioned all of this extra washing and using a scrub brush. I'm sure that you are doing all of this because you're seeing this. But it's just, oh, it sounds like so much extra work. Right? I mean if I'm buying like the container of lettuce that says on it, thoroughly pre-washed, should I not trust that?
Hussain: Unfortunately, in this time frame, I would still recommend going ahead and washing and you know, taking extra precautions to prevent infection. Absolutely.
Juravich: Okay, so and should we do you think we should worry at all about eating at at a restaurant? I mean, are you are we hoping that the restaurant is doing all of this extra washing too?
Hussain: We can hope, I always say it's safer to, when you do meal prep at home, you know exactly what's going into your food. So I think definitely makes it less of a risk. As we know, the spread started at Taco Bell with the lettuce that was there. So there's always a risk when we eat out. So there is a little bit more protection preparing meals at home.
Juravich: We have been talking about cyclosporiasis, and that is the disease caused by the parasite. And we've been talking with Dr. We’am Hussain, a gastroenterologist with Kettering Health. Thank you so much for joining us today, Dr. Hussein.
Hussain: My pleasure. Thank you so much for having me.
Juravich: Coming up, we're going to talk about the CDC and the FDA and what those agencies are doing to figure out where this parasite problem is coming from and hopefully stopping it. That is when All Sides continues on 89.7 NPR News. You're listening to All Sides. I'm your host, Amy Juravich. Most people hadn't heard of cyclospora before this summer, but it turns out the parasite has existed for a while. There have been cases of the parasite and infection for years in the past across the U.S., but this outbreak is unprecedented. Can the CDC and the FDA work together to work out this parasite problem? We are talking about what those federal agencies are doing to help contain this outbreak with Marcia Brown, food and agriculture reporter for Politico. Welcome to the show, Marcia.
Marcia Brown: Thanks so much for having me, Amy.
Juravich: So the CDC and the FDA exist to prevent outbreaks like what's happening right now with cyclospora. What have those agencies been doing to try to track down the parasite source and with talking to the public?
Brown: So like you said, the CDC and the FDA, they work together to both keep the public informed and to also find the root of an outbreak. So the FDA will begin an investigation, they'll initiate trace back, they'll do interviews with patients and all of that is designed to figure out like where is this coming from? How are people getting sick? What is their common source? And then the CDC is also looking at cases reported by states. So they're doing laboratory tests to confirm and investigate that those cases are in fact cases. So for example, right now you can see on the CDC website, the CDC is reporting 6,000 lab confirmed cases, and they say they're aware of another 11,000 cases that they're working to investigate and confirm. So that's some of the pieces of what those two agencies they're doing to put this together.
Juravich: Now, initially, things were linked specifically to iceberg shredded lettuce, and it was linked to the company Taylor Farms, who happens to be a supplier for Taco Bell, among other places. Is that still the leading theory? Because there's been so much reporting back and forth on this.
Brown: Yeah, I'm glad you raised that. It's been really confusing. And a lot of people I've talked to have said that this has been really a not great example of communication from federal agencies. I think what you're referring to is there was a false positive test that the FDA reported. And the reason that was confusing is because the FDA actually, as part of their investigation, initiated additional testing at the southern border to look for more sources of this parasite. And when they did that, they thought that they had found another batch of lettuce that could make people sick. So that's why they released this positive test. Then they walked it back because they got more test results that indicated that it wasn't, in fact, positive. But they never backed away from their investigation, which still, right now, is still pointing toward Taylor Farms and iceberg lettuce. There is an ongoing recall. It's now been expanded to nine states, including, you know, Michigan, which has been the... The sort of ground zero of a lot of this outbreak. And they're still looking for more sources of cyclospora. We've seen states like New York reporting hundreds of cases, but they're not part of the multi-state outbreak. And this is seasonal. We do see cyclospore cases every year, but this is certainly a record-breaking outbreak.
Juravich: Yeah. So is Taylor Farms going to end up being the culprit of this? I mean, I know you can't predict the future, but I know that when that false positive came out, Taylor Farman's actually asked for an apology from the federal government. So.
Brown: Yes. It was, again, I think that they're messaging really confused consumers. They said that the FDA had apologized to them and the FDA told reporters, I was on this press call two days later and they told reporters no, we did not apologize. We were just providing factual information to the company. But yes, Taylor Farms is still the focus of the investigation. It is where most of the FDA's evidence is pointing. And when I say that, what I'm talking about is these interviews. So often, you know, cyclospora is so hard to find that we don't even get test results. And so the FDA will link the parasite to an outbreak based on, you know, epidemiological evidence and then trace back. And so they weren't actually able to say. This multi-state outbreak, they're pointing to a single farm in central Mexico that produced iceberg lettuce. So yes, Taylor Farms is still part of the investigation. We are expecting that there will be additional sources, but this does not exonerate Taylor Farms.
Juravich: We talked with a food safety expert earlier in the show and she basically said that this could be a breakdown in an irrigation system or something like that, like where the water is coming from and it could just be old equipment. She was just saying that these checks and balances need to be more thorough in this day and age. Have you heard that too from food safety experts you've talked to?
Brown: Absolutely. I think most people view this summer cyclist for outbreak as a disaster. I mean, there are just so many cases, so many people getting sick. And now there have been two deaths in Michigan related to this. This is normally not, you know, a deadly disease, but still really scary and can cause severe dehydration gastrointestinal discomfort. And so yes, I think there's been a lot of calls for both federal regulators to step up and require companies to meet higher standards. The way that this spreads, it's really disgusting, but it spreads through human feces and it could be coming from contaminated irrigation water. It could be come from nearby facilities in a specific field. Right now, we don't really know. That's one of the challenging things about public health is we don't have a great answer right now, Bye. You know, yes, if farm workers are not given bathroom breaks, if they're not given adequate bathroom facilities, that could be, and again, this is an example we don't know right now, but that could a possible source of this. And this is both domestic cases and international cases. So that's definitely something that I think a lot of folks are calling for because they're worried that, you know, could it be this bad every summer? That really would be... I think that's something a lot of consumers would not want to accept.
Juravich: Yeah, this is All Sides on 89.7 NPR News. We're talking about the CDC and the FDA and what those federal agencies are doing when it comes to the recent parasite outbreak. We are talking with Marcia Brown, food and agriculture reporter for Politico. The U.S. Imports food from many places around the world and they all might not have the same types of sanitation facilities. They may not all have the similar types of regulations. I mean, how does the US vet the produce it imports.
Brown: Great question. So the FDA is responsible for 80% of the US food supply and they work with partners, both at the state level and with local authorities to do inspections. And, you know, I think one of the criticisms of the FDA, is that they have long been underfunded. This is not a new problem that they're not doing enough inspections and enough sampling right testing for this this parasite and for other potential pathogens, which is, you know, we mentioned earlier in this conversation, the false positive, that is the kind of sampling that we would expect. And yeah, I think a lot of people think that there should be more of that, there should be more testing at their border. And I think this has also raised questions about how much food the U.S. Actually imports. And we do import a lot of our fruits and vegetables from Mexico, from Canada. That's why we get to enjoy a lot of berries year round, because they come from countries with different growing conditions. But I think it does raise a lot questions about whether or not the U.S. Is doing adequate inspections to protect consumers from fresh produce that could be from contaminants.
Juravich: In fresh produce. You mentioned the funding. So a lot of people have been, you know, hypothesizing that under the Trump administration, there's been cuts at the FDA and the CDC, and that this outbreak is related to extra cuts. So even less funding, even less people doing the work. Have you found that to be true? Or like, would this have happened anyway, no matter the funding and the president?
Brown: This is a question I think everybody is trying to get to the bottom of, and I think, you know, I don't want to give you a middling answer, but that's, I think kind of what I'm hearing when I talk to food safety experts. A lot of them are pointing to cuts in food safety funding in surveillance, and a lot of the point out that the way our food safety infrastructure works our public health infrastructure works is that if you, you trim a part of it, it has all these ripple effects. Um, and so that could be something that we're seeing. A lot of people have pointed to cuts, um, to Foodnet, which is a surveillance system that tracks pathogens like cyclospora, and they decided to not track cyclosporas as part of Foodnet anymore. But people I've spoken to have said that that really would not have addressed to this outbreak because that is more tracking cases over time. So it wouldn't really help, you know, find the cause of this. But there is something that a lot of people have pointed to, which is something called the food traceability rule. It's a regulation that has not yet been finalized, and it would require food companies to keep better track of how food products are moving through the supply chain. So like from the farm, through logistics, trucking, all the way to the grocery store. Um, and that rule was delayed earlier this year. Um, And that's, you know, the second time it's been delayed, people have been waiting actually years for this rule to go into force, um, the food industry has lobbied against finalizing that rule. And so a lot of people are saying this would be, you know, something that could help in outbreaks like this. That
Juravich: I mean, you know, there were a lot of jokes in the media because everyone was calling it explosive diarrhea and that kind of thing. And it was, you know, it was determined that it was you know it it's a it's a bad parasite. It causes stomach issues. But but then this week two people died. And so it just it became suddenly it became more serious instead of everyone just like kind of like joking around using the word explosive. So I mean can you talk about that about how like Are we going to, I mean, if this is going to not go away anytime soon, do we all need to take it a little more seriously?
Brown: So I mean, I think a lot of the guidance remains the same, that this can cause severe dehydration. It certainly causes severe gastrointestinal distress. But for most people, this is not going to be deadly. But certainly, the FDA, everyone I've spoken to, if you feel like you have this parasite, you should seek medical attention, not just because it's risky, but also because it is severely unpleasant and it can last for weeks and months without treatment. So I think that's something I want to emphasize for listeners.
Juravich: Yeah. And then the tracing of it is also causing a problem because the food safety expert we talked to earlier said it takes 7 to 10, even sometimes 14 days before you realize you have it. And no one can remember what they ate three days ago, let alone two weeks ago. So yeah, they figured out it was shredded iceberg lettuce and Taco Bell, but if it's more than that, are they ever going to really figure it out?
Brown: That's absolutely a question. I think I'm getting a lot from my friends and family as well. And there have been outbreaks where the FDA never found the source of the outbreak. Again, I do want to emphasize they did link part of this outbreak to iceberg lettuce. We are expecting additional sources. Historically, these outbreaks have been linked to produce lettuce, herbs, and berries. Um, and I think, you know, there are ways you can try to protect yourself. Um, you can wash your food. That's not fail safe. Um, cause it's kind of a sticky parasite. You can cook your produce. Um, You know, a lot of people recommend if you're able to, you have access to shopping local at your farmer's market. Um, there haven't been any documented outbreaks linked to small farms. Um, if you go out to eat, ask where the lettuce is from. Um, you can, and if they don't know, you can exercise more caution. Um, and I, you know, I want to emphasize I'm still eating produce. I'm still eating fresh produce. Um, I realized that it's, it can feel really daunting to people because there's not, you know, a great answer right now. Um, but I'm trying to be responsible, but I also love, you know, fresh produce, I love the summertime. I love berries and peaches. And, um, so I think that's maybe the best way to think about it.
Juravich: Yeah, well, you as someone who's reporting on all of this, are you washing it a little extra or because I just I just talked with the doctor and I said that the amount of washing she just described to me sounded exhausting.
Brown: Yes, I am washing it a little bit more. And you know, we also cook our produce and we are thankfully, you know near a farmer's market. So I'm able to, you know, buy from a local farmer. But you know this reminds me I was, I'm actually from outside of Cleveland and I was talking to a lettuce farmer in a Cleveland farmer's market and I asked him how this was affecting his business and he said you know unfortunately even though my produce is safe, he grows hydroponic lettuce. Um, it's really affected his buyers, you know, people are not buying as much lettuce. So these kinds of outbreaks, especially if they become regular and they're at this really, you know high level of cases can have long lasting effects.
Juravich: Yeah. And then there's the whole thing with people being worried about it and eating less healthy food whenever it's the healthy food that has the outbreak. So I think we're in a vicious cycle here, Marcia.
Brown: Absolutely.
Juravich: We have been talking about the outbreak of cyclosporiasis caused by a parasite believed to be found in lettuce, but perhaps other produce as well. And we've been talking with Marcia Brown, food and agriculture reporter for Politico. Thank you so much for your time today, Marcia. Thanks so much having me, Amy. Enjoyed the conversation. And this is All Sides on 89.7 NPR News. Thanks for listening. Thanks for joining us. I'm Amy Juravich.