US health secretary Robert F Kennedy Jr has declared that the ongoing cyclosporiasis outbreak is "under control," despite experts warning that infections are likely to keep rising. The illness, caused by the cyclospora parasite, leads to watery and explosive diarrhea.
Kennedy made the remarks on Tuesday at a press briefing on healthcare fraud, one day after the US Food and Drug Administration (FDA) reversed a 27-state recall of shredded iceberg lettuce, calling the reported contamination a "false positive."
Kennedy's claim of control
"We have the outbreak under control," Kennedy said. "We have done extensive forensics, epidemiological forensics, and we've identified the source of the outbreak. And the companies that are involved have all implemented a recall."
However, according to the Centers for Disease Control and Prevention (CDC), 34 states have reported cyclosporiasis cases this summer, with the Midwest heavily affected. Although differing numbers from states and the CDC make comparison difficult, this is probably the largest cyclosporiasis outbreak ever documented in the United States.
Rising case numbers
The most recent national data from the CDC, from last week, reported more than 1,600 confirmed cases and 5,100 pending cases of cyclosporiasis. By contrast, Michigan alone reported more than 6,571 cases as of Tuesday. Experts have widely panned the CDC's reaction to the outbreak as slow, and the predictable outcome of severe cuts made by the Trump administration.
"We did cuts in the FoodNet program, but they were for redundant surveillance, and all the states will tell you that we're still doing forensics," Kennedy said during the briefing.
It is true that FoodNet was not meant to respond directly to outbreaks. Instead, the program was designed to assess big picture trends in food safety. In 2022, FoodNet surveillance warned that cyclosporiasis cases appeared to be increasing. The Trump administration cut the program's surveillance from eight pathogens to two, shiga-toxin producing E coli and salmonella, making surveillance of bugs like cyclospora optional.
Impact of Trump administration cuts
Additionally, the Trump administration cut $11.4bn in pandemic-era grants to state and local health departments, which had built out the capacity to investigate outbreaks, and fired roughly one-quarter of the CDC's workforce. The administration also reduced the size of a federal lab dedicated to detecting parasitic outbreaks from 11 staffers to three, lost the head of that lab in a resignation, and then all but destroyed USAID, which had worked indirectly with the CDC on cyclospora outbreaks, according to CNN.
FDA recall reversal
The FDA initiated a recall on shredded iceberg lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio and West Virginia on Friday last week. The recall then expanded to shredded lettuce sold in 27 states on Saturday, including products sold at retail establishments such as Walmart. Scientists at the FDA rechecked the products, and by Sunday had told Taylor Farms, a large producer, that the agency had made a mistake and issued a "false positive."
Cyclospora background and expert warnings
Cyclospora is a protozoan parasite that prefers warm temperatures, increases every year in the summer, and is typically spread through water and food contaminated with feces. CDC officials said last week the outbreak was expected to last through August, and that even once sources have been identified cases will probably increase because of the parasite's long incubation period. Symptoms can appear anywhere from two days to two weeks after infection.
"There are cyclospora outbreaks every summer," Kennedy said on The Ryan Gorman Show in his first public comments about the outbreak on Friday. "Now that we know the probable culprit, I think it's going to be much easier for people to make healthy choices."
