America Has Explosive Diarrhea. Is Donald Trump to Blame?
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Nick Florko doesn’t want to brag or anything, but more than a year ago he wrote an article that has come to seem prescient. Its title: “ Now Is Not the Time to Eat Bagged Lettuce .”
Florko, a staff writer at the Atlantic, made that pronouncement long before the multistate outbreak of Cyclospora cayetanensis , a parasite that is associated with explosive diarrhea and has spread across 34 states and counting. Back then, he was focused on leafy greens because they’re the most common cause of foodborne illness, and he worried that the Trump administration was weakening the U.S. food safety system.
We don’t yet know what’s causing this outbreak of cyclosporiasis, but it’s apparent that lettuce is suspect. ( Taco Bell specifically is being investigated, or scapegoated, by the White House.) Cyclospora has also been known to hang around in raspberries and cilantro. A key thing is that it’s tough, if not impossible, to wash off. And you can ingest the parasite and not feel the impact of it for weeks.
Luckily, the illness resolves with antibiotics, and it’s not fatal. But symptoms can last for weeks. “It seems to go in waves,” Florko said. “You get really sick, you think you’re fine, you go about your day, you get sick again, and it keeps going. You keep riding that wave until you get it treated.”
On a recent episode of What Next, Mary Harris spoke to Florko about Cyclospora summer: how the parasite spreads, how much faith to place in our country’s public health infrastructure, and whether you can actually eat that lettuce. This conversation has been edited and condensed for clarity.
Mary Harris: So what is this “explosive diarrhea” bug? What is Cyclospora ?
Nick Florko: It’s a parasite that is spread by human feces, specifically feces that is left out in the environment to mature and gets infectious. If it touches food, that food gets contaminated, and if you eat the food, you get explosive diarrhea.
How is a pile of poop sitting out for two weeks and then getting on the food? Can you draw me a picture here?
Yeah. A water source gets contaminated in some way, and that water is then used to irrigate a field. It’s a small amount of poop, and it gets onto the food. That’s most likely how this happened. It’s not something you can see.
It was only recently that this parasite was found to be domestic, right?
Exactly. That’s the part of this that, as a science nerd, I’m the most interested in. We used to think that this parasite was endemic to tropical regions. Then we started to see cases that were homegrown here. We still don’t know why that is. We don’t have a long history with this parasite—we discovered it in the 1990s, as I understand it. That was when the first outbreaks we were noticing happened. Science is still catching up here, and Cyclospora is harder to track than other foodborne outbreaks.
Why is it so hard to track? My understanding is that this is because of the lifespan of the organism: It takes a while to develop into something infectious. Once it’s inside you, it takes a while to show symptoms.
That’s part of it. The other part is: There are genetic tests that can be done for most pathogens where you essentially create a genetic fingerprint of that pathogen, either from food or stool that was collected, and public health officials will track all those cases together and say: Those are all exactly the same genetic fingerprint. They are definitely related. Let’s go talk to those people and find out exactly what they ate . Then you’d find the common source there. You can’t do that with this pathogen. You can’t grow it in the same way in the lab, and there’s just not enough of it in the stool to make it easy to study.
This outbreak seems to be in the sweet spot where a really bad outcome is possible if you get infected, but you’re probably going to be OK. It allows people to both be scared and think, This is kind of funny .
I feel like that’s what’s going through the public health officials’ minds when they’re thinking about advice here. When we see something that’s potentially deadly, usually we see the public officials being like: “We think it might be this. Do not eat this right now.” That’s not what they’re saying. They’re not saying to avoid anything, really. Earlier this week, the Centers for Disease Control and Prevention held a press call, and they were essentially telling people to wash their vegetables.
Even though washing won’t get rid of it.
Exactly. It drives me crazy, hearing them say that over and over again. But I guess it’s the best advice you can give in the moment.
I’ve heard critiques of the Trump administration, specifically its scaling back of funding for programs like the Foodborne Diseases Active Surveillance Network. FoodNet used to monitor and track Cyclospora and other pathogens, like Listeria . Now it’s looking only for Salmonella and E. coli . Do you think that’s a reasonable criticism?
It’s certainly reasonable. The thing about FoodNet specifically, though—and I’ve heard this from folks who aren’t in the government as well—is that it’s used to develop intelligence about these bugs, but it’s not an active surveillance system in an outbreak. It’s not as if we don’t have tracking anymore. That’s a good thing. Those systems still exist.
At the same time, we’ve been talking about how this is a bug that we don’t know much about, that didn’t use to show up on our shores. Scaling back any sort of surveillance or intelligence system related to that bug is not going to be good. There’s also a legitimate critique over the fact that the CDC and the Food and Drug Administration have both experienced major turmoil over the past year or so. What do things look like at those…
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