GoKawiilBryan, a food broker from Michigan, wasn’t sure if he’d be able to make it to urgent care in time. He started feeling off on Thursday, and by Saturday, he was having to use the bathroom every 15 to 30 minutes.
“It’s no joke about the explosive diarrhea,” Bryan, who asked that his last name be withheld for obvious reasons, told me. I met him via Reddit, where I recently spent hours lurking in threads about cyclosporiasis, the explosive diarrhea illness infecting people across the country, and Cyclospora cayetanensis, the microscopic parasite that causes it, which spreads through human fecal contamination. Symptoms — including nausea, loss of appetite, cramping and bloating, and the much-discussed watery, explosive diarrhea — can begin anywhere from two days to two weeks after exposure, and experts say they can wax and wane. The explosive diarrhea may stop for a day or two, only to come back in full force. In extreme cases, patients can end up hospitalized after experiencing severe dehydration. So far, the government reports 141 hospitalizations and no deaths.
As a connoisseur of elaborate salads, I was dismayed by the news that a poop-causing parasite may have found its way into America’s summer produce. I wanted answers — and, it appeared, so did thousands of other people on Reddit, who have taken to crowdsourcing information (and misinformation) in the absence of concrete guidance from the federal government. Health agencies are being cautious about doling out immediate advice, but the gap in information has left suffering, toilet-bound Americans — and those who fear joining their ranks — to their own devices, and even made people a little conspiratorial. Online, people are speculating whether the government is trying to protect farmers or food distributors. The reality is more mundane but no more satisfying: Federal agencies won’t make hasty recommendations until they have more data, and Cyclospora infections are notoriously difficult to pin down.
Though Bryan wasn’t able to get a test to confirm it, he believes he has cyclosporiasis, making him one of more than 5,000 people across the country infected by the parasite. That figure is almost certainly an undercount, since many cases aren’t reported — and cuts to a federal program that tracks foodborne illness may be hindering investigation efforts. The “explosive diarrhea parasite” is a bigger problem than anyone has been able to grasp, though it’s not clear just how big. The Centers for Disease Control and Prevention has confirmed 1,645 cases since May 1st and is aware of at least 5,100 additional cases that require further analysis.
At urgent care, Bryan received “a full battery of tests” except for one — the one that would detect Cyclospora, which isn’t detectable by standard diarrhea tests. “The nurse practitioner said, ‘We can do one of two things: We can wait until Monday, or I can prescribe you Bactrim immediately,’” he explained. “She told me the labs were so backed up in Michigan that they can’t even keep up with the amount of people.”
Michigan has more confirmed cyclosporiasis cases than any other state: 2,640 as of Monday, according to state health officials, who said lettuce and other salad greens are a “potential source for this outbreak, although other food items cannot be completely ruled out.” State health officials haven’t traced the outbreak to a specific type of produce, or to any growers or suppliers. But The Washington Post reports that federal and state officials are investigating Taco Bell after the fast food chain voluntarily recalled lettuce, cilantro, onion, pico de gallo, and guacamole at some of its locations.
Cyclospora outbreaks are among the most challenging foodborne outbreaks to investigate
Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, explained that a lack of information doesn’t mean a lack of government action.
“Anytime we have large outbreaks like this, it’s important to remember that they take time to solve, and it’s not uncommon that it can take multiple days, especially if there’s more than one product that’s involved,” Hamilton said. “There are a lot of folks who are working on this investigation, and it’s a good demonstration around why we do need epidemiologists and disease detectives to have some support and protect our food supply in the US.”
Even under the best of circumstances, the parasite is a tricky one to track.
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