Joel Barratt, parasite expert, on ‘explosive diarrhea’ in the US: “The outbreak won’t stop any time soon”

Thousands of people across the United States have been infected or are suspected of being infected with the parasite cyclospora which causes cyclosporiasis and ‘explosive diarrhea’. The Center for Disease Control and Prevention (CDC) says that it has received reports of 1,645 confirmed cases and that there are over 5,100 suspected cases nationwide since 1 May.

This is substantially more than the 249 cases reported nationally last year. Of those who have been infected in the current outbreak of cyclosporiasis, 141 have been hospitalized, but fortunately there haven’t been any fatalities.

One source of cyclospora located, more to be discovered

Federal health authorities announced that they have traced one outbreak to iceberg lettuce that was supplied to Taco Bell by Taylor Farms. The CDC has issued a warning for people not to eat shredded iceberg lettuce from Taco Bell locations in five states including Indiana, Kentucky, Michigan, Ohio, and West Virginia.

Taco Bell has voluntarily pulled lettuce that it received from an unnamed supplier and has said that that it will indefinitely remove it from its supply chain nationwide. The FDA is working with the supplier to determine if the contaminated lettuce has been sent to other places.

Health officials are still trying to track down the source of other cyclosporiasis illnesses and outbreaks unrelated to the one linked to iceberg lettuce at Taco Bell that have occurred in other states. Currently, there are cyclosporiasis cases reported in 47 states and the District of Columbia.

“The outbreak won’t stop any time soon”

Health authorities are bracing for more cases of cyclosporiasis to appear as they work to uncover the source the various outbreaks and infections. “The outbreak won’t stop any time soon, until public-health agencies are able to pinpoint exactly where the parasite is entering our food system,” Joel Barratt, a molecular parasitologist at Emory School of Medicine in Atlanta, Georgia told Nature.

The former head of the parasite surveillance team at the CDC says that the outbreak was potentially able to spread to such an extent due to the staffing cuts implemented by the Trump administration last year in the name of reducing government waste. “The number of staff working on these outbreaks is not what it used to be”, Barratt noted.

He shared that the team he used to lead previously had 11 people but there are now just three. That means fewer hands on deck to sequence DNA and conduct interviews, slowing the agency’s ability to respond to outbreaks, which are especially time sensitive in cases such as cyclosporiasis.

Since the source is typically contaminated fruits and vegetables, this produce is perishable and thus has a limited shelf life. If investigators don’t find the produce causing the infections before it gets tossed in the trash, they cannot uncover the source.

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