The Cyclospora Mystery: How Human Poop Got on So Much Lettuce

From The New York Times, I'm Michael. Barbaro. This is The Daily. >> So, look. I had a little. diarrhea bugs, closest diarrhea bug last. week, y'all. Can't eat lettuce, caught me off guard. I was sicker than a dead dog on the side. of the river, man. I ain't lying to you, bro. No lie. >> I don't know where I got it from. I. think it was lettuce. I'm not 100% sure. where I got it. >> [music]. >> I would get nauseous here and there. I.

had such like low appetite, and I'm a. girl that loves to eat. >> [music]. >> On Wednesday, US health officials linked. six more states to what's now the. largest outbreak of Cyclospora in. American history. An outbreak that has contributed to at. least two deaths, sickened thousands of. people, and has left the rest of us. increasingly scared of salad. >> [music]. >> When I tell you I went 32 times in one.

day, I'm not being dramatic. I'm not. making that number up. I'm being so. truthful. >> I feel like every day the FDA got a. whole new recall. Like, they can barely. keep up with what's getting recalled, and they can. >> Today, two public health reporters who have. covered the parasite, Christina Jewett. and Caroline Hopkins Lagasse, on what. we've learned about where it comes from, >> [music]. >> how it spreads so quickly, and why our.

food safety system seems so powerless to. stop it. >> Do Do you know something? If you know. something, or you know somebody that. knows somebody that knows something, let. me know. Is it okay to eat the lettuces? Because I really I really. I really want to eat lettuce. I need my greens. Please. Thank you. >> [music]. >> It's Thursday, August 6th.

So, we're just going to test both of. your mics real fast and. tell us what you have for breakfast. That's how we do this. >> Pistachio muffin, no iceberg. Not on the. side, not on the muffin. >> No iceberg. Okay. >> Yep, no iceberg lettuce in my yogurt and. granola, either. >> Okay. And I, as usual, had eggs and sausage. Okay. So, Christina, Caroline, thank you. for coming in the studio for what I. admit will be a somewhat.

stomach-churning at times conversation. >> Glad to be here. >> Yeah, thank you for having me. >> So, I just want to begin with the. observation that. it's genuinely surprising, at least to. me, that we are still living with. and talking about this outbreak because. it began in June, late June, but June. And it's still somehow expanding. How. can that be? >> Yeah, this really is expanding. So, in a. typical year, you would see about 3,000.

cases of cyclospora done. But right now, we're in August and federal officials. are still looking at 10,000 confirmed, 12,000 possible. So, you're looking at. potentially 22,000 cases. >> Which is from your math, seven times a. normal year's worth of outbreak. >> Yeah. But you can see why this would. pile up. For one, you do your typical. washing procedure at your kitchen sink, that's not going to kill the cyclospora.

I mean, you can kill it by cooking it, but I mean, who's cooking their iceberg. lettuce, right? >> Mhm. >> And it's been on the shelf for a while. The lettuce that was potentially. infected, that was good all the way out. through August 3rd. So, you're just now. starting to see that get a little brown. and mushy in the back of the fridge. So, for the cases to continue popping up is. really not that surprising. >> Fascinating. >> And it can take weeks after you consume. something contaminated with Cyclospora. to start feeling symptoms. Scientists. call this long incubation period. So,

you might not even start to have the. diarrhea until a couple weeks after. eating the thing. And then after that, you might not go to the doctor to get. your stool sampled and tested for. Cyclospora for another few weeks. So, this can be really a long process from. when somebody eats the contaminated. thing to when they get diagnosed. And. then there's even more time between that. diagnosis and when a public health. official would officially report the. case. >> Got it. So, there's a long tail to this. and based on what you just said, Christina, people may just be getting.

around to eating the lettuce that makes. them sick. So, this is going to be with. us for a while. >> Yeah, this could last. >> Well, the reason you're both here is. because you've somewhat unwillingly. become authorities on this outbreak. So, let's talk about how the outbreak has. played out, what we've learned about its origins, and ultimately what we've learned about. our food safety system in the process. So, so where does this outbreak begin? >> [music]. >> So, this begins across the country, but.

mostly in the Midwest back in the. beginning of the summer. People started. to report [music]. severe diarrhea and stool samples. testing showed that it was this parasite. Cyclospora. And more and more cases. began to mount, which got the attention. of state public health agencies followed. by the CDC. And on July 14th, the CDC officially. announced it's it's opening an. investigation into this outbreak. >> And this is the moment where.

all of us are like, "Cyclo, huh?" Like, tell us about this parasite. [music]. >> This is a parasite that spreads through. food or water that's just I'll just say. it, it's contaminated by human feces. So, that's pretty much the only way that. it spreads, um, at least that scientists. are aware of. So, somewhere, somehow, there's a food. source that has human fecal matter on. it. Somebody eats it, and this parasite, it enters the body in these little pods.

called oocysts. And [music] they're kind. of like eggs, um, but they make their. way down into the intestines where they. burrow into the wall of the intestine, and the parasite emerges from these. oocysts. and starts to infect the cells that line. your intestine. And so, this whole. process can take anywhere from a few. days to. >> [music]. >> 2 weeks as this parasite comes out of. these little oocysts and begins to. reproduce. First, you know, just asexual.

reproduction, then it's reproducing. sexually, so with each other, and just. exponentially, there's more and more and. more of these. >> neglected the trigger warning that was. required to have this conversation. because now we're talking about sexual. reproduction of a parasite in our. bodies. Okay, but I need you to keep. going, sadly. >> Yes, so [clears throat and music]. at that point when these Cyclospora. parasites have infected your intestinal. walls to the degree that you can't. absorb the nutrients and the fluids that. you're eating and drinking, that's when.

you start to see this really, really bad. diarrhea that people describe as. explosive, debilitating. [clears throat]. They can't go to work, they can't go to. birthday parties, they're just sitting. on their toilet, and they're miserable. >> It's a very nasty parasite. And as you. said, if you've somehow gotten. Cyclospora, you have somehow ingested. remnants of human fecal matter. So, I'm. guessing it's at this moment that the. race begins to figure out how on earth.

that fecal matter got on food. So, Christina, maybe pick up the story from. there. >> Yeah, so this is where epidemiology. comes in. You have state public health. officials, local officials, they want to. do a 90-minute interview with you. They. want to know everything you ate weeks. ago, especially fresh raw produce that. maybe hasn't been washed. They want your. loyalty you know, number for the grocery. stores where you shop routinely.

>> They're going through the Safeway. shopping records. >> Yeah, and they want to know what's on. your credit card and your debit card, if. you ate at Taco Bell, if you ate at. Subway, where you ate. And they do these. interviews with dozens and dozens of. people and they're looking for. commonalities. They want to create a big. Venn diagram and see, you know, exactly. what pops out. >> Mhm. And where does that Venn diagram. ultimately point? >> So, these interviews are tricky because. few people can remember exactly what.

they ate for, you know, >> weeks. >> weeks. Um, and if they do remember, they. might remember I had a taco, not I had a. taco with shredded iceberg lettuce and. cilantro and peppers. But with enough of. these interviews, you can sort of start. to tease that out and that's how. investigators landed on shredded iceberg. lettuce from Taylor Farms grown in. Mexico sold at Taco Bell. >> Okay, I think we should focus on Taylor. Farms because it seems they're the. distributor of this food, but tell us.

everything you know about Taylor Farms. >> Taylor Farms is a huge company, very, very big in fresh produce. They have. contract growers all around the country, outside the country in Mexico as well. And essentially they ship bags of. shredded lettuce to middlemen and. middlemen of middlemen and it goes out. to cafeterias, mom-and-pop restaurants, chain restaurants, >> Mhm. >> all the way through the food chain. >> One way or another you've probably eaten. lettuce that Taylor Farms touched even.

if you didn't know it. >> Absolutely, yes. >> And and those bags of salad mixes that. you see on the grocery store shelves or. you know, washed pre-cut lettuce, that's. often from Taylor Farms as well. >> So, the way to think of Taylor Farms is. that they're getting a lot of lettuce. from a lot of farms and the authorities. are suspicious of, it sounds like, Mexico as the source of this problem. What do they think? What do they suspect. may have happened in Mexico? >> So, we don't know what happened on this. farmer farms in Mexico and we honestly.

might never know because a lot of these. outbreak cases end up as cold cases, they're never solved. But, we can look. to some of the cases that have been. solved in the past as examples and sort. of tease some hints out of those of what. might have happened. And a lot of that. points back to agricultural water. So, the water that's used to irrigate the. plants, to wash the lettuce, to spray it. with pesticides, any of those uses of. water, you're distributing potentially a. contaminated water source over all of.

the crops. So, >> that water has to be contaminated. >> Exactly. So, that's where you go back to. nearby bathroom facilities, latrines, sewage overflow, any of these. explanations for how poop water, essentially, can get onto these plants. >> Yeah, yuck. >> Yuck is right. For example, in the late. '90s, there were a series of outbreaks. that they were able to trace back to. some farms in Guatemala that grew. raspberries. >> Mhm. >> And in those cases, the leading theory. was that this. water source that they had used to mix.

with a powder pesticide to make it a. liquid solution they could spray all. over the raspberries, that water source. had been contaminated. And similarly, in. 2020, they traced an outbreak that. affected iceberg lettuce and cabbage and. carrots back to some farms in. Florida that had been contaminated with. water from a canal. >> Interesting. >> And this also means that when you're in. the grocery store looking at pre-washed. bags of lettuce, they're probably. at an even greater risk than the whole.

heads of lettuce. And the reason for. that is that the agricultural water that. could have been contaminated is being. used to wash this lettuce. So, you know, you're seeing triple washed, you might. think that's safer, but in reality, it's. kind of ironic. That bag of pre-washed. lettuce might have been exposed to the. contaminated poop water three times. over. >> Right. Not what you. think of when you think of washed three. times. >> Exactly. >> Exposed three times. >> Right. And a lot of people at this point. say, "Well, why can't we just treat the.

water with chlorine or with, you know, whatever standard?" But Cyclospora is a. really tricky bug cuz this parasite is. really resilient and those standard. techniques don't kill Cyclospora. >> does not kill Cyclospora? >> Right. >> Does that mean that people who have this. parasite are putting it into our sewage. system and it's potentially spreading. that way or no? >> We don't have any reason to believe that. that's what's happening. I mean, Cyclospora does not pass from person to. person.

>> Got it. Okay. So, Christina, at a. certain point. after epidemiologists have figured out. this is Cyclospora and they have. determined that the leading suspect is. Mexican farms that are used by Taylor. Farms, that's when a recall comes in. Can you just describe that recall and. how it worked or didn't work? >> Yeah, essentially the FDA leans on the. company to do a voluntary recall. And we. saw that in mid-July with Taylor Farms.

But what we saw come out from Taylor. Farms was a little bit confusing. >> Hm. >> So, basically the supply chain of a. company like Taylor Farms is sort of. considered a corporate secret. I mean, it's considered a trade secret because. it's the company's sort of relationships. with vendors and suppliers. And that's. something the company wants to protect. >> Mhm. >> So, the company put out information. about what was being recalled. You see 4. and 5-lb bags of shredded lettuce. You.

see some 16-oz bags, and then there were. a whole lot of codes. >> Codes? >> Codes. Yeah, it was. >> were these codes? >> PK SY. M A R K J [music] B C V. So my colleague Julie Cresswell in the. business department, [music]. all of us really just went to try to do. some detective work and figure out what. are these codes. >> Mhm. >> I mean my first step was saying, "Hey. Taylor Farms, what do these codes mean?".

Radio silence. No answer. Yeah. >> They don't want to say, for proprietary. reasons, who's getting their lettuce. >> Right. Right. >> Even though this is the moment when. presumably the public very much wants to. understand that. >> And they don't even have to tell the. FDA. And they sit on top of quite a food. chain. I mean, we did find out that, you. know, some of the lettuce went to bag. salad sold at Walmart. under the Marketside um brand. We found. out that some went through Sysco, which.

is a pretty sophisticated, kind of a. middleman company that supplies. >> college cafeterias, corporations, etc. >> Yeah, [clears throat] lots of different. sites. So this was something that I ran by a. food safety expert, and she said, "Yeah, this is something food safety advocates. have been talking about for years saying. FDA needs to have the authority to tell. companies that you need to, in no. uncertain terms, disclose your supply. chain in the event of a recall like. this, so everybody knows what's what.

Because if you're a mom-and-pop. restaurant and you're looking at this. recall, you might be throwing your hands. up and not even know if your regional. supplier has been affected by this.". >> So because of the way Taylor Farms. communicates. this recall through literally coded. language, you're saying a bunch of people probably. wouldn't necessarily have understood. that they were subject to a recall and. they could be sitting on and serving. these bags of potentially contaminated.

lettuce that Taylor Farms is recalling, but these folks wouldn't necessarily. even know to take them off their. shelves, not serve this lettuce. >> That's right. >> And that's how you potentially end up. with a very long tail of this outbreak. >> And that's how you end up with people. standing in the produce section of their. grocery store saying, "I'm not buying. any lettuce.". >> Hm. My instinct is to question how. something like iceberg lettuce could. ever be a trade secret for anybody. because it is iceberg lettuce, but also. that an exception wouldn't be made in.

the middle of a very dangerous foodborne. illness outbreak to put aside worries. about trade secrets and just tell. everybody who has this lettuce. >> Yeah, you would hope so, you would think. so. I mean, in this case, a very. high-profile. outbreak that has turned deadly, there. was no high-powered US government. pressure to make them disclose [music]. that. You know, I'm looking at this recall. page right now and it's still a big list.

of codes. >> All these weeks later. >> All these weeks later. >> Well, Christina, what you're describing. I think begins to hint at how much our. entire food safety system. ends up making it harder to. get to the bottom of this outbreak and. we are going to talk about that in a lot. more detail. right after the break. >> [music].

>> We'll be right back. So, Christina and Caroline, we're going. to talk now about the government systems. in place that in theory might have. caught this outbreak, but clearly. didn't. And Kristen, I want to start. with you and the farms in Mexico where. it's suspected this all started. Who's. responsible for inspecting the. conditions there?

>> So, it's the Food and Drug. Administration. They inspect the food. processing facilities and they have. inspectors who go out all around the. world. And when you're talking about the food. processing facilities that this has been. traced back to, it was Taylor Farms. plant in northeast Mexico. The FDA. actually has not set foot there since. 2019. >> Wow. >> Mhm. >> US inspectors [snorts] haven't been to. that facility in 7 years. >> That's right. And you know, that's not.

that surprising. >> Why not? >> 300,000. is the number of FDA registered. international food facilities that the. US government has an eye on. >> Mhm. >> But they don't have that many. inspectors. >> How many do they have? >> There's 450 and that's for the United. States and the world. >> Wow. >> Roughly 450. >> Yeah, that math doesn't really add up. >> It really doesn't. So, you're seeing. facilities not getting visited for years.

and years. >> The number of inspectors you're. describing and the number of facilities. that they're responsible for suggests. that the US government must understand. that it's not going to catch every. contamination. So, what's the logic. there? >> I mean, that's really sort of a. reflection of the funding that FDA's. gotten over the years from Congress. And. while that funding sort of stagnated, the FDA's passed rules for food.

processors to follow. And they really. put a lot of reliance on the companies. to know their business and take care of. it. Basically, like you know what you. make, you know what the risks are. So, the test your products, be very. careful and control your risks. >> That's interesting. Carolyn, this. reminds me. of the US government's reliance on. several industries to kind of. self-police. And we've covered, for. instance, the airline industry on the.

show a lot. The thinking is that. airlines are deeply invested in the. safety of their passengers. If there's. an airline crash, it's terrible for the. reputation of an airline. Obviously, it's terrible for the people who died. Everyone's incentives are aligned to. keep airline safety really strong. Is that basically the argument here when. it comes to food suppliers? Every farmer. and farm in Mexico wants food to be. safe, too. >> Right. And these farms want buyers like.

Taylor Farms to want to buy their. lettuce. And then Taylor Farms and. similar companies don't want people to. get sick from their produce because that. would injure their business. Right. >> So, in that case, incentives are. aligned, but. do we know if any or all or some of. these farms are testing for cyclospora? >> We really don't know right at this. moment. I mean, the FDA is going to be. investigating this, and they will issue.

reports that are made public. But, on a. farm-to-farm level, we really at this. time have no idea. >> It is important to note that it's really. hard to test for cyclospora in the. environment. >> Why? >> So, it was described to me as a needle. in the haystack scenario. So, you're. looking for something that might not be. evenly distributed across an entire. batch of lettuce. So, you take a sample, that sample might not have these. microscopic oocysts on it. The same goes. for a water source. It's sort of like. testing the ocean, right? If you're. looking for a certain fish, it's not.

going to be in that necessarily in that. little bit that you're testing. >> Right. I'm I'm to guess there are. listeners out there thinking to. themselves, you know, we can test for. cancer in the blood, we can send men to. the moon, we can find poop in the water. on a farm in Mexico. >> This is really where science comes into. play. I mean, I've covered a number of. outbreaks and sometimes there are sort. of like. indicator species or a certain level of. fecal contamination maybe in the water. that should trigger deeper testing. I.

mean, you have a system in this country. of food safety under the umbrella of the. FDA and CDC, [clears throat]. but as much as we care about not having. poop-tainted lettuce, we really don't. heavily support these areas. >> As taxpayers. >> Right. >> Interesting. Basically, not that much. energy or money is being put into this. testing processing. >> That's right. >> Well,

I wonder if it's possible that. Cyclospora isn't seen as enough of a. risk to put that much energy or money. into. I mean, Christina, you said these. companies are told by the US government, know your risks and take care of them. Carolyn, is it possible that so far. Cyclospora isn't seen as one of those? >> Yeah, I mean, up until now it's just. really not been that big of a risk. >> Right. Which means that could change. We. just don't know yet. Okay. So, I want to. turn to the larger US public health.

system and how it's handled this. outbreak so far and how it's talked. about it. I'm curious if you guys would agree with. me on this, but it doesn't feel like US. health officials have talked and. communicated all that much about this. outbreak. I can't recall a major news. conference from anywhere in Washington. about it. And should I have expected. one? >> Yeah, I mean, I think we've heard Robert. F. Kennedy Jr., you know, at a event on. a different topic say basically we have. this under control.

>> Well, does that feel accurate? >> Does it feel accurate? I mean. >> Absolutely not. >> Yeah, and state public health officials. are saying absolutely not. >> Hmm. So, why would the Secretary of. Health claim something's under control. that's not and overall just not seem all. that communicative about it? >> Yeah, well, he is part of an. administration that's really heavily. focused on deregulation. So, to make this a centerpiece issue, you'd probably be looking at writing. some tougher. regulations. Yeah.

>> Which perhaps is not so appealing to. Robert F. Kennedy Jr. right now. >> And what ends up happening is a lot of. the burden for doing these. investigations, for doing this. complicated trace back, interviewing all. of these people, this is falling on. state and local public health. departments. And that's happening in a. time when they are really underfunded. and they do not have the staff or. capacity to do this type of work. I. mean, in 2016, state health departments. said they received just 40% of what they.

they asked for to monitor, detect, and. respond to foodborne illness. >> And that's what they asked the federal. government for? >> Right, that's what they asked for from. the CDC that funds most of their work. >> Fascinating. >> And what I found in my reporting is that. the Trump administration is working on a. plan to actually hand off about 90% of. all the food facility and farm. inspections that go on in the United. States. over from the FDA to the states. >> Wow. >> Yeah, so if the funding situation. remains unchanged, that could be a.

really interesting transition to watch. >> So, you're saying at the precise moment. that states are already saying they're. insufficiently funded to do this kind of. stuff, the Trump administration, I'm. presuming for cost-cutting purposes, is. planning to shift more and more of this. work to the states away from the federal. system. >> That's exactly right, even to states. that don't even really have a food. safety program. >> Hmm. I mean. tell me if I'm wrong. All of what you're.

describing seems to point to a food. system that has a lot of risk baked into. it. A system where we expect food from. all over the world. to show up at our grocery store. providing us with year-round lettuce, strawberries, blueberries, whatever. And isn't that just a system as we now. have it very lightly regulated by the. government where outbreaks. should be. expected. Or. should we see what's happened here as a.

failure of that system? >> I mean, I think they are expected. I. think it's to be expected. But when you. have a parasite like this. and you have the gross out factor on 11, I mean, I really do think that gets. people's attention and it creates a. moment where we can have these. conversations and we should at a high. level be having these conversations. >> About whether this system's working. >> Right. Whether it's funded, whether it's. supported, whether it's as important. really as it should be given its, you.

know, central place at the kitchen table. with all of us in our families. >> Mhm. >> Yeah. And. >> [clears throat]. >> we just heard on Monday that two people. have officially died from Cyclospora, which up until this point there hadn't. been any deaths. I mean, the state of. Michigan where these people died did say. that they had severe underlying health. conditions. Even so, I mean, this has. come to a point where people are really. paying attention. This is dangerous. >> Right. When do you think, given all the factors.

you both described at the beginning of. this conversation, this outbreak is. going to end? >> Food safety epidemiologists, everybody. I've talked to you said they're hesitant. to predict the future. But there have. been some early signals that at least in. Michigan, which is the epicenter of this. outbreak, the rate at which new cases. are increasing seems to be slowing a. bit. >> Mhm. >> But even after this contaminated food. source is no longer in our food system, we still might see the cases go up.

because it takes so long to get sick. >> In the meantime, very quickly, how are you both. navigating. lettuce right now? News you can use. >> I'm sticking with dark leafy greens, the. kales, the spinach. I haven't heard. anything about any links to those, so. I've been kind of a spinach gal for the. last month. >> Mhm. Christina? >> I'm with you there. I've also been on a. bit of a roasted vegetable kick, I'm not. going to lie. Nothing like killing everything in the. pot with a little bit of heat.

>> Right. This is a strange moment for salad. >> [music]. >> Well, Carolyn and Christina, thank you very. much. Appreciate it. >> Thank you. >> Thank you for having me. >> [music].

>> We'll be right back. >> [music]. >> Here's what else you need to know today. >> What a race. You know, in the words of. Muhammad Ali, we shook up the world. >> In a major victory for the progressive. wing of the Democratic Party, Abdul.

El-Sayed, who campaigned on Medicare for. all and ending US military aid to. Israel, was declared the winner of the. Democratic primary [music] for US Senate. in Michigan on Wednesday, narrowly. beating his more moderate opponent, >> [music]. >> Congresswoman Haley Stevens, who was. backed by party leaders and major. donors. >> Uh we took on a machine. You're not supposed to be able to beat. 70 million dollars of outside spending. >> [music]. >> And what we showed is that the power of.

our many is greater than the power of. their money. >> Elsayed now faces former [music]. Republican Congressman Mike Rogers, whom. he immediately challenged to five. televised [music] debates. In an early sign of Rogers' strategy in. the general election, a Republican group. backing him [music] released a. commercial on Wednesday calling Elsayed, quote, "The most radical [music]. candidate in America.".

>> [music]. >> Today's episode was produced by Alex. Stern, Eric Krupke, and Diana Wynn with. help from Olivia Natt. It was edited by Paige Cowett and Liz. [music] O'Brien. And contains music by Dan Powell, Marion. Lozano, and Diane Wong. Our theme music [music] is by Wonderly. This episode was engineered by Alyssa. Moxley.

Special thanks to Alice Callahan. >> [music]. [music]. >> That's it for The Daily. I'm Michael Barbaro. See you tomorrow.