Cyclospora and salmonella outbreaks raise concerns about U.S. food safety

Geoff Bennett:

Public health concerns are growing, as cyclosporiasis cases surge, and now a salmonella outbreak across 17 states has many Americans raising concerns about U.S. food safety.

William Brangham tells us more.

William Brangham:

Geoff, these back-to-back cases where people are getting sick from food have put many people on edge and raised questions about the nation's food supply.

With nearly 4,200 confirmed cyclospora cases nationwide across nine states, and more than 7,400 additional unconfirmed cases, plus a salmonella outbreak linked to eggs that has sickened almost 100 people so far, consumers are wondering if enough is being done to keep unsafe food out of our stores.

For more on these concerns, we are joined again by Caitlin Rivers. She's an epidemiologist at Johns Hopkins University.

Caitlin, so nice to have you back on the program.

Let's start off with this troubling pattern. We have got this very, very big cyclospora outbreak happening, really concentrated in Michigan, but we're also seeing the salmonella outbreak. Is this just a particularly bad year or is something else going on here?

Dr. Caitlin Rivers, Epidemiologist, Johns Hopkins Center for Health Security: I think both are true here. There is no question that this is a very large outbreak of cyclosporiasis. To my knowledge, it's the largest on record. And so that is absolutely consequential.

The addition of the salmonella outbreak in eggs is unsettling, but actually not uncommon. There are one to two large outbreaks of something, some sort of foodborne illness each month. And so currently it's salmonella and shelled eggs, but the existence of a second sizable outbreak is not in itself notable.

William Brangham:

Is there a connection between these two? I mean, I know cyclospora, we have seen that linked to contaminated water being sprayed onto lettuce and in some cases berries, but we're still searching for the root cause of that, or the root causes, salmonella, as you mentioned, linked to eggs.

Is there any linkage between these two things, or are they just separate outbreaks?

Dr. Caitlin Rivers:

They're just separate outbreaks. They're caused by different pathogens, different food items. Different states are affected.

What they have in common is that our food system is very interconnected. There are very large food producers that distribute to many, many states, reach often millions of consumers. And so when we see outbreaks like this, it's because we largely share a food supply with our neighbors.

William Brangham:

There have also been a series of cuts made by the Trump administration to some specific surveillance monitoring programs, as well as much, much broader cuts that have trickled down to the public health world writ large.

Is it fair to say that those cuts are somewhat complicit in this or not?

Dr. Caitlin Rivers:

It's hard to draw a straight line because we don't necessarily see the inner workings of the people who used to work there, but are now RIFed, or, that is to say, laid off, or the direct cut line to budget cuts.

But I can say with confidence that, when you lose a quarter or a third of your public health work force, when you are under strain for coming up on six-plus years coming out of the pandemic, the consequences of that do matter. They do manifest.

And we like to say in public health that, when we do our jobs right, nothing happens, and we're seeing now the opposite of that, where things are happening. And I think we need to recognize that there are -- there are things we can do, which is to say, investments and support, that can help to reverse that trend.

William Brangham:

Cyclospora in particular is hammering Michigan. Do you have any sense as to why it is so bad in that state?

Dr. Caitlin Rivers:

I think there are two probable reasons. One is that they received the contaminated product, right? They had the shredded lettuce, the iceberg lettuce from Taylor Farms.

But I also think Michigan has done a very good job alerting the public to the existence of this outbreak and educating providers on the need to identify and test cases. And so although you may see higher numbers and think, oh, dear, that's worse, in some ways, it's better because it means that public health officials have more information to be able to identify the source and take the necessary actions to keep people safe.

William Brangham:

Alongside those two outbreaks, we have also seen another virus reemerge, and that is measles. And we have got this record number of cases this year. I believe it's 2,300, which is, I think, the worst in 35 years, I believe it is.

This was a virus that we had once basically eradicated in the U.S. Why are we seeing a return of that virus?

Dr. Caitlin Rivers:

It's true. This is already a record year for measles. We have surpassed last year's total already in July, and this is the biggest year since the virus was declared eliminated in 2001.

We have a safe and very effective vaccine against measles. And so the reason that we're seeing these increased cases is because that vaccine coverage is falling. The good news here is that the trend is reversible. If we are able to increase vaccine coverage, then we will be able to return to a state where we can say measles no longer circulates.

But, unfortunately, today that's not the case.

William Brangham:

And some of what you're talking about is, I think, driven by some messaging that we have been hearing coming out of HHS and the health secretary, Mr. Kennedy.

Do you think, though, that state and local public health departments are able to step in when you're talking about salmonella and cyclosporiasis system and measles and the messaging involved in that? Are they up to that task?

Dr. Caitlin Rivers:

Oh, absolutely.

State and local public health officials are actually the front lines. Many people don't know that public health in the United States is federated, which means it's the state and local officials who have the power and the ability to act, whereas federal officials, at least on the CDC side, it's different for FDA, but they act in a more advisory, technical capacity.

And so I have absolute confidence in our ability, our state and local officials' ability to combat these threats, but they do need resourcing and support. They can't do it in the absence of money and people. And so that really comes back to the need to continue to invest in public health and give our systems what they need to thrive.

William Brangham:

Caitlin Rivers of Johns Hopkins University, always great to hear from you. Thank you so much.

Dr. Caitlin Rivers:

Thank you.