The rise in cyclosporiosis cases goes beyond Taco Bell

Brian, a food broker from Michigan, wasn’t sure if he would be able to get to urgent care in time. He started feeling unwell on Thursday, and by Saturday, he had to use the bathroom every 15 to 30 minutes.

“It’s not a joke about the severe diarrhea,” Brian, who asked that his last name not be used for obvious reasons, told me. I met him via Reddit, where I recently spent hours researching topics about cyclosporiasis, the explosive diarrheal disease that affects people across the country, and Cyclospora caitanensisIt is the microscopic parasite that causes it, which is spread through human fecal contamination. symptoms – including nausea, loss of appetite, cramping and bloating, and the much-discussed explosive watery diarrhea – can start anywhere from two days to two weeks after exposure, and Experts say They can wax and wane. Severe diarrhea may stop for a day or two, then return in full force. In extreme cases, a patient can end up hospitalized after becoming severely dehydrated. yet, Government reports 141 hospitalizations and no deaths.

As a connoisseur of elaborate salads, I was dismayed by the news that a fecal-causing parasite may have found its way into America’s summer produce. I wanted answers — and so it seems for thousands of other people on Reddit, who have resorted to crowdsourcing information (and misinformation) in the absence of concrete guidance from the federal government. Health agencies are cautious about offering spot-on advice, but the information gap has left suffering and toilet-staying Americans — and those fearful of joining their ranks — to their own devices, and even made people a bit conspiratorial. Online, people Speculation Whether the government is trying to protect farmers or food distributors. The truth is more mundane but no more satisfactory: Federal agencies won’t make hasty recommendations until they have more data, and Cyclospora The infection is notoriously difficult to identify.

Although Brian couldn’t get a test to confirm it, he believes he has cyclosporiasis, making him one of more than 5,000 people nationwide infected with the parasite. This number is almost certainly an undercount, as many cases go unreported — and cuts into the federal program that tracks foodborne illnesses It may hinder investigative efforts. The “explosive diarrhea parasite” is a problem too big for anyone to understand, although it’s not clear how big it is. The Centers for Disease Control and Prevention has confirmed 1,645 cases since May 1, and is aware of at least 5,100 additional cases that require further analysis.

At urgent care, Brian received “the full battery of tests” except for one — which would detect Cyclosporaany It cannot be detected By standard diarrhea tests. “The nurse practitioner said, ‘We can do one of two things: We can wait until Monday, or I can prescribe you Bactrim right away,'” he explained. “She told me that the labs are so crowded in Michigan that they can’t even keep up with the number of people.”

Michigan has more confirmed cases of cyclosporiosis than any other state: 2,640 as of Monday, according to state health officials, who He said Lettuce and other salad greens are considered “a possible source of this outbreak, although other food items cannot be completely ruled out.” State health officials did not trace the outbreak to a specific type of product, or to any growers or suppliers. but The Washington Post Reports that federal and state officials are Investigate Taco Bell After the fast food chain The reminder was done voluntarily Lettuce, cilantro, onion, pico de gallo, and guacamole are available at some of its locations.

Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, explained that a lack of information does not mean a lack of government action.

“Any time we have a large outbreak like this, it’s important to remember that it takes time to resolve, and it’s not uncommon for it to take several days, especially if there’s more than one product,” Hamilton said. “There are a lot of people working on this investigation, and it’s a good demonstration of why we need epidemiologists and disease investigators to get some support and protect our food supply in the United States.”

Even under the best conditions, the parasite is a difficult thing to track down.

“Cyclospora The outbreak is among the most difficult foodborne illness outbreaks to investigate, said Rodney E. Rudd, head of the medical laboratory sciences program at Texas State University. Edge. The parasite’s long incubation period—usually about a week—and the short lifespan of most fresh produce make it difficult to determine which foods are making someone sick. Even when the culprit is identified, test foods Cyclospora It’s difficult.

“Another challenge is that pathogens are often present in very low numbers and may be unevenly distributed throughout the amount of food,” Rudd said, so a laboratory may analyze a 25-gram sample from thousands of pounds of product without getting a conclusive result. Even when a contaminated batch is confirmed, “traceability remains difficult because fresh produce often passes through multiple growers, packers, distributors and retailers before reaching consumers, and contaminated quantities may no longer be available once illnesses are identified,” Rudd explained.

But there are some additional hurdles to that. Annie Waldman for ProPublica He pointed out That the Food and Drug Administration It lost more than 240 consumer safety professionals Last year amid President Donald Trump’s cuts to federal health agencies. Last July, the C.D.C Reduce the program Which tracked foodborne illnesses in partnership with the U.S. Food and Drug Administration, Department of Agriculture and state health departments. Prior to July 2025, the Centers for Disease Control and Prevention’s (CDC) Foodborne Illness Active Surveillance Network (FoodNet) worked with 10 state governments to track… Campylobacter, Cyclospora, Listeria, Shigella, Dhamma, Yersinia, SalmonellaAnd the production of Shiga toxins Escherichia coli. FoodNet has stopped requiring state health departments to track most pathogens, incl Cyclospora.

“Basically, the Centers for Disease Control and Prevention is rolling back one of its best surveillance systems,” said Dr. J. Glenn Morris, director of the Emerging Pathogens Institute at the University of Florida. NBC News at that time. In a list of talking points submitted to the Connecticut Department of Public Health, the CDC said financial constraints led to decreased surveillance: “Funding has not kept pace with the resources required to maintain continued FoodNet surveillance for all eight pathogens.”

In a press call Tuesday, CDC officials distinguished between FoodNet and the more robust national surveillance program. “The data we have on cyclosporiasis for this outbreak is the same as we have for all other seasons,” said Gwen Biggerstaff, deputy director of CDC’s Division of Food, Waterborne and Environmental Diseases. “We use the same systems and the same process, so it hasn’t changed.”

FoodNet “is designed to be a sentinel system,” said Hamilton of the Council of State and Territorial Epidemiologists. “It was not designed to be the primary outbreak detection system. The primary way we detect outbreaks when it comes Cyclospora Or cyclosporiosis is really tied to making it reportable within states, and that reporting process, and then sharing the data with the CDC, is what really allows us to figure out Cyclospora Inflammations.”

The Centers for Disease Control and Prevention (CDC) has identified an epidemiological link between four states: Michigan, Ohio, West Virginia, and Kentucky. Cases have been reported in 34 states, although it is not clear how many cases are linked. The administration has not identified the source of the outbreak, and tracing efforts are continuing. Where does that leave Americans who want to be extremely cautious? The Centers for Disease Control and Prevention and the Food and Drug Administration do not currently recommend that people avoid eating certain foods, and both Hamilton and Rudd stressed the importance of practicing proper food hygiene, including: Wash well And dry all fresh produce.

In light of recent reports that lettuce may be a potential vector for infection, Rudd suggested avoiding it and other products linked to past outbreaks, especially if you are immunocompromised or live in a state with a high number of cases.

“Fruits and vegetables are obviously important to a nutritious diet, but one must be careful and pay attention to ongoing local, state, and federal health reports specific to your geographic area,” he told me via email. If that means avoiding weeds in the height of summer, so be it.

Previous cyclosporiasis outbreaks have been traced to lettuce and other leafy greens. After more than 640 people in 11 states became ill with cyclosporiosis in 2020, the Food and Drug Administration announced He gestured to the prepackaged salads They are sold at Aldi, Walmart and other retailers under the names Fresh Express, Giant Eagle, Walmart Marketside and others. The FDA and CDC reportedly traced the infection to a Fresh Express plant in Illinois. Other outbreaks have been traced to snow peas, berries, and herbs such as parsley, basil, and cilantro.

“Ultimately, prevention depends more on reducing contamination during production rather than at home,” Rudd said.

Desperate for lush greens, I asked if the farmers marketing their produce represented a safe alternative. Rod’s answer was disappointing but helpful. He explained that preventing future outbreaks of the disease means reducing pollution at the source, that is, on farms and distribution networks. “Farmers’ markets may be not connected to any type of shared agricultural water supply that could be a potential source of contamination. So, in that sense, they may be safer. But if one is in a ‘geographic hot spot,’ I would still be cautious.”

Although expert opinions on the matter are mixed, and will likely remain so until more information about the outbreak emerges, I’ll be avoiding raw vegetables for now, lest I succumb to Brian’s fate.

After about a week, he said, he began to feel much better — but the road to recovery was long and bumpy, punctuated by Prep H wipes and many, many trips to the bathroom. He said: I would not wish this on anyone.