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The Trump administration continues to respond sluggishly to the explosive, nationwide outbreak of Cyclospora—a unicellular parasite spread from human feces that has now sickened nearly 23,000 people in 47 states, killing two and sending over 500 to the hospital.
Michigan health officials reported the two deaths Monday, and The Washington Post first reported Tuesday that federal health officials have expanded a list of states with linked cases from nine to 15. But those updates still have not appeared on public outbreak pages for the Centers for Disease Control and Prevention or the Food and Drug Administration, and Americans are struggling to understand the risk of eating fresh fruits and vegetables.
In comments to Ars Technica on Monday, a spokesperson for the Department of Health and Human Services, which oversees CDC and FDA, said the outbreak information will be updated sometime “this week.” Sources for The New York Times said that the CDC plans to set up a “ formal response team” for the outbreak sometime this week. Cases in the outbreak began in June.
Michigan has been one of the hardest hit states in the outbreak. As of August 5, it is reporting 12,218 cases since June 22. On Monday, the state’s health department reported the outbreak’s first and only deaths, which are rare for the parasite. Cyclosporiasis infections are unquestionably miserable—causing explosive watery diarrhea, abdominal pain, nausea, bloating, and gas—but they’re rarely fatal. According to medical records, the two deaths occurred in people with “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,” the state’s health department said.
Michigan’s cases are linked to those in eight other states. FDA’s traceback investigations linked the cases in those nine states to Taylor Farms’ shredded iceberg lettuce grown in Mexico and distributed to Taco Bell restaurants, as well as other restaurants, retailers, and food distributors. The nine states in addition to Michigan are: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia.
The Post reported Tuesday that the CDC is now adding six more states to the list of linked cases: Arkansas, Iowa, Missouri, Nebraska, New Hampshire, and North Carolina.
The Times independently confirmed the additions later Tuesday. Still, the new states have yet to be added to the FDA’s and CDC’s sites for the outbreak cluster, which still list nine states and no deaths as of publication time. (The CDC’s general cyclosporiasis surveillance page was updated at some point Tuesday to include the deaths.)
Controversial links
All 15 states in the outbreak cluster linked to Taylor Farms lettuce are states the company identified as having received its lettuce. In a July 17 recall, Taylor Farms identified 27 states to which its lettuce was sent. But the company has refused to provide clear information about the recalled products, including how many pounds of product the recall covered, where those products were sold, and if distributors may have distributed the lettuce to additional states.
The CDC’s updated surveillance information says 47 states have now reported cases. It’s possible that the nationwide cases encompass independent clusters with additional sources of contaminated produce. It’s also possible that as investigations continue, more states will be linked to the current 15-state cluster.
Both Taylor Farms and the Trump administration have drawn significant scrutiny for the lack of clear information about the outbreak. In July, the FDA puzzlingly announced that a sample of Taylor Farms’ lettuce tested positive for Cyclospora, only to retract the claim the next day, calling it a false positive. Taylor Farms celebrated the retraction, giving the impression that it erased the company’s link to the outbreak—it didn’t; the link was based on the traceback investigation. The company further claimed the FDA had apologized to it, which FDA officials flatly denied.
The relationship between the Trump administration and Taylor Farms has also drawn scrutiny. Amid the misleading communication, it came to light that Taylor Farms directly appealed to the White House to delay announcing the recall. Further, financial records showed that Taylor Farms donated $1 million to a Trump-supporting super PAC, MAGA, Inc., in March, just days after the Trump administration delayed an FDA rule to strengthen food traceability regulations.
Taylor Farms did not respond to Ars Technica’s request for comment on the donation, but it has updated its website to include a note saying it is not against traceability legislation.
Meanwhile, Mexico’s health minister initially pushed back on the FDA’s finding that the US cases were linked to lettuce grown in Mexico. However, the link appears to be growing stronger. Last week, the UK Health Security Agency reported a “ sharp rise” of cyclosporiasis cases in travelers returning from Mexico. Among 51 cases with travel information, 48 reported travel to Mexico, the agency said.
In the CDC’s updated surveillance data, the agency has tallied 10,468 lab-confirmed cases and more than 12,255 probable cases across 47 states. Since 2018, the US has been recording between 2,000 and 5,000 cases each year.
Beth Mole Senior Health Reporter
Beth Mole Senior Health Reporter
Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes.
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