Two dead in record-breaking Cyclospora outbreak as federal response lags

Two people have died amid the ongoing record-breaking outbreak of explosive diarrhea from the foodborne parasite Cyclospora, Michigan health officials announced Monday.

Cyclosporiasis fatalities are extremely rare, and despite the massive size of the outbreak, some experts were still surprised by the deaths. The Michigan Department of Health and Human Services on Monday said that medical records of both individuals indicated that they had “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration.”

MDHHS noted that both fell ill with the diarrheal infection before Taylor Farms recalled its shredded iceberg lettuce grown in Mexico, which has been linked to thousands of cases in at least nine states. Cyclospora is a unicellular parasite that spreads in human feces and is often transmitted via contaminated fresh produce, such as lettuces and other fruits and vegetables that have uneven surfaces for the parasite to grip. Past culprits have included fresh herbs, raspberries, green onions, and snow peas.

While news of the deaths made widespread headlines Monday, federal health agencies under the Trump administration were mostly silent. The Food and Drug Administration—which is conducting traceback investigations to identify foods contaminated with the parasite—has not updated its outbreak investigation page since July 24, nearly two weeks ago, as of publication time.

The Centers for Disease Control and Prevention, meanwhile, added a banner notice on its outbreak update webpage saying that the agency was “aware” of the two cases. But its reporting data was not updated to include the two deaths as of this publication.

Sluggish data

Ars Technica contacted the US Department of Health and Human Services about the un-updated numbers to ask if the CDC was still awaiting confirmatory data on the two deaths. In a response, HHS Press Secretary Emily Hilliard confirmed the information provided by Michigan’s health department on the two deaths and said that “FDA and CDC plan to update overall illness numbers, hospitalizations, and deaths this week.”

Outside experts have speculated that the agencies’ sluggish responses to the outbreak may stem from harsh budget and staffing cuts, along with widespread upheaval at the agencies. Anti-vaccine Health Secretary Robert F. Kennedy Jr. has generally tried to shift focus away from infectious diseases and outbreak prevention—aligning with his longstanding efforts to disparage vaccines and downplay their need—and instead redirect attention to wellness campaigns, such as improving diet and exercise.

Two weeks ago, Kennedy confidentially told reporters that the Cyclospora outbreak—linked to lettuce and other unidentified fresh produce—was “under control.” Last week, he announced his own cooking show on YouTube and released the first episode in which he helped prepare a meal that included a fresh salad.

With the CDC and FDA not keeping pace with the outbreak, there is no up-to-date official nationwide tally. Outside experts have been tracking counts from individual states, and local health departments have tallied case numbers of between 17,000 and nearly 23,000. These counts include both confirmed and probable cases. At least 45 states have reported cases. Michigan alone has reported over 11,000 cases, with 193 hospitalizations. Over the past several years, annual counts of cyclosporiasis cases have been between 2,000 and 5,000.

While officials in Michigan are hopeful that the outbreak has peaked in their hard-hit state, others are still seeing jumps. Missouri, for instance, reported on Sunday that its case count nearly doubled, from 593 on July 26 to 1,095 on August 2. Missouri is not one of the nine states that the CDC and FDA have tied to the multi-state outbreak linked to Taylor Farms lettuce, which was sold at Taco Bell restaurants, among other locations. However, Taylor Farms’ recall indicates that Missouri is among the 27 states where its lettuce was distributed.