Chaos as Largest Cyclospora Outbreak in US History Causes Up to 20 Bowel Movements a Day

The largest cyclospora outbreak in history, spreading across the United States, is causing chaos in several regions, particularly in Michigan, the hardest-hit state. Many people have experienced diarrhoea, so when symptoms struck Nick Palmiter in early July, he was not overly concerned. ‘I’ll be fine,’ he thought. But the symptoms did not subside. Days turned into weeks, and his stomach cramps became increasingly unbearable. ‘I was in absolute agony,’ Palmiter said. ‘It got to the point where I was going to the bathroom about 15 to 20 times a day.’ The 29-year-old described the sensation as constant pressure and gas bubbles, ‘almost like a balloon in my stomach.’ At a colleague’s urging, Palmiter finally visited an urgent care facility, where he was told he needed to go to a hospital emergency department immediately. It was at the hospital that Palmiter learned he had cyclosporiasis, an intestinal illness that has been spreading across the US and has infected thousands of people in 41 states. This outbreak is the largest ever recorded in US history. Michigan has recorded the highest number of cases nationally, with more than 7,000 infections. In Monroe County, the rural area on the state’s eastern border where Palmiter lives, the number of recorded cases is also among the highest. ‘This illness really makes you feel terribly sick,’ Palmiter said of his experience. ‘It feels like you have absolutely no energy left.’ Monroe County has about 154,000 residents. According to state government data, 286 people in the area have been infected with cyclosporiasis, a disease caused by ingesting the Cyclospora parasite that can cause symptoms including ‘explosive diarrhoea’. The scale of the outbreak’s impact on this small community has triggered widespread ripple effects. ‘Anxious’ and ‘scared’ are the two words Palmiter used to describe the atmosphere among local residents. His mother, Michelle Palmiter, expressed a similar sentiment. ‘I see a lot of people panicking because of this,’ she said. One example was her nephew, who emptied his entire refrigerator of fresh produce and threw everything in the bin, including a watermelon Michelle believed was still perfectly good to eat. ‘Instead of washing it thoroughly and then cutting it, he just threw it away,’ Michelle said. Discussions among Monroe County residents on social media show many people are taking similar steps. One mother, for instance, wrote that ‘my toddler is practically living on chicken nuggets and Goldfish crackers since all this started.’ Michelle herself still eats fruit and vegetables, but only if they are cooked first. ‘One thing is for sure, I am absolutely not eating out,’ she said. According to Michelle, one cause of the public panic is the government’s handling of the outbreak, which is perceived as inadequate. ‘We don’t trust anything they say about this outbreak,’ she said. The first infection was detected on 13 May, according to the US Food and Drug Administration (FDA). Since then, the number of cases has continued to rise, along with the mystery surrounding the outbreak’s source. Restaurants and major retailers across the US, including Walmart, Jack in the Box, and Taco Bell, announced recalls of several food products, citing ‘an abundance of caution’. The primary target of the recalls was iceberg lettuce. However, months after the outbreak emerged, the official source of the Cyclospora parasite remains unknown. Francisco Diez-Gonzalez, Director of the Center for Food Safety at the University of Georgia’s College of Agricultural and Environmental Sciences, said the parasite can be ‘very difficult to detect’. He noted that one obstacle relates to gene sequencing technology. Another challenge is that symptoms from the parasitic infection can take several weeks to appear after exposure, making it difficult for investigators to accurately trace all the food consumed by patients to find a common factor. The FDA investigation pointed to Taylor Farms as a possible source of the outbreak. The major US food supplier then voluntarily recalled all iceberg lettuce products sourced from central Mexico, again citing ‘an abundance of caution’. The investigation appeared to be nearing a breakthrough on Saturday when the FDA announced that a sample of iceberg lettuce from Taylor Farms had tested positive for Cyclospora. However, less than 24 hours later, the government retracted the statement, declaring the result a false positive. ‘We are dealing with a pathogen that is really very difficult to study in the laboratory,’ Diez-Gonzalez said. ‘In this case, finding some Cyclospora cysts in a lettuce sample is truly like finding a needle in a haystack. It’s not easy.’ Diez-Gonzalez said a false positive result is not unusual in such testing, but what is uncommon is for that information to be released to the public. He explained that test results are typically not published before undergoing several rounds of verification to confirm the findings, ‘to make sure that a positive is truly a positive’.