Foodborne illnesses are far more common in the United States than they should be. According to the Centers for Disease Control and Prevention, there are almost 50 million foodborne infections annually, leading to around 128,000 hospitalizations and 3,000 deaths. The most common by far, accounting for almost 60 percent of the total number of cases, is norovirus, which causes vomiting and diarrhea. The deadliest is Salmonella, which kills more than 400 people a year.
The vast majority of foodborne illnesses occur sporadically—that is, as isolated incidents rather than as part of a cluster of cases. The symptoms often pass quickly, with those affected not knowing what made them sick in the first place. As a result, the issue most often comes to public attention when outbreaks linked to the food supply grab headlines—as has occurred with this year’s wave of cyclosporiasis cases from several concurrent outbreaks, the largest of them apparently spread through iceberg lettuce contaminated with the protozoan Cyclospora—the parasite that causes the illness. (Culprits in the past have included leafy greens, parsley, and cilantro.)
The national food safety and oversight system is a sprawling enterprise, spanning many federal and regional agencies. The U.S. Department of Agriculture and the Food and Drug Administration share responsibility for food inspection. The CDC gets called in to investigate disease clusters triggered by contaminated products. These organizations have historically cooperated closely with state and local public health counterparts. Outbreaks of foodborne illness indicate that serious gaps exist somewhere in the regulatory and oversight pathways.
The wave of cyclosporiasis began more than 15 months into the second Trump administration. During this time, Secretary of Health and Human Services Robert F. Kennedy Jr. has been given license to undermine the agencies under his purview, including the CDC and the FDA. These critical entities have seen dramatic cuts in multiple domains, including in programs involved with food safety.
Significantly, the Trump administration has slashed the Foodborne Disease Active Surveillance Network, or FoodNet, a joint program of the CDC, FDA, and USDA. For almost three decades, the program required the 10 participating states to report cases of infections with eight pathogens. Last year, the program dropped the mandatory reporting of six of them, including cyclosporiasis. The program now requires only Salmonella and E. coli cases to be reported.
Some news reports have cited this regrettable change as a cause of the cyclosporiasis outbreaks. In fact, that does not appear to be the case. As experts in the field have noted, FoodNet was designed to capture longer-term trends in disease occurrence, not to track infections in real time. Moreover, the areas tracked by FoodNet include only 16 percent of the U.S. population.
However, that doesn’t mean that the cuts in the program are benign. “FoodNet cuts didn’t cause this outbreak, but they are a symptom of a deeper problem, and that is that our outbreak response programs are running out of money,” said Sarah Sorcher, director of regulatory affairs at the Center for Science in the Public Interest, at a press briefing on the issue in July.
I agree with her assessment. Beyond the diminishment of FoodNet, the Trump administration’s overall decision to reduce or eliminate key positions and functions at the FDA and the CDC has hampered food safety and oversight. State and local public health agencies also have a role to play but are themselves under enormous financial strain. They are not equipped to address the holes created by astonishingly bad choices at the federal level.
So what are consumers to do? Giving up fresh produce altogether is not an appealing option, especially considering its health benefits. Thoroughly washing leafy greens and vigorously brushing other produce, like melon, before cutting into it can reduce the risk of foodborne infections. Rinsing in vinegar may also help—although the evidence has been mixed for Cyclospora. In any case, these measures can’t fully eliminate the possibility of infection, especially in the case of cyclosporiasis because the parasite embeds itself in the flesh of leafy greens rather than resting on the surface. Heating (to 158°F) is the only sure way to kill the parasite.
In general, you should follow basic guidelines for preventing foodborne illness issued by the CDC or state health departments. It’s also a good idea to stay up to date on news about outbreaks and CDC investigations that might impact your geographic area. And if you live in a state with a Cyclospora outbreak, it’s certainly prudent to pay extra attention to public health guidance. Ultimately, however, the safest food supply depends not just on consumers doing their part but on a well-funded, well-functioning public health system that catches contaminated food before it ever reaches our tables.
