Washtenaw County in Michigan has experienced a significant cyclosporiasis outbreak affecting more than 900 residents since mid-June. Public health nurse Linda Kim has conducted interviews with more than 100 patients as part of the investigation effort. Patients have described the illness as excruciating, with severe gastrointestinal symptoms that have been debilitating for most who contracted it.
Investigating cyclosporiasis presents unique challenges compared to other foodborne illness outbreaks. Symptoms can take up to two weeks to manifest after consuming contaminated food, making it difficult for patients to recall what they ate during the incubation period. Public health staff must conduct extensive interviews, asking patients to retrieve restaurant receipts, review grocery store app purchase histories, and recall specific details about food items such as brand names and product varieties.
The outbreak follows a measles outbreak in the county that infected seven people, including five children, earlier in the year. Kim noted that cyclosporiasis patients have been more cooperative during interviews compared to measles contacts, who were sometimes suspicious of health department inquiries. The county’s measles outbreak concluded in late May, just before the cyclosporiasis cases began appearing in June.
Public health response efforts have been complicated by recent federal funding cuts. The Trump administration’s reductions to public health grants eliminated contracts funding 123 full-time employees across 44 of Michigan’s 45 local health departments. While some funding was temporarily restored through a court order, the Washtenaw County Health Department continues operating with staffing shortages and has suspended some surveillance activities. A CDC employee who had been stationed at the department experienced disruptions during the funding uncertainty.
Health department officials have expressed frustration with the federal response timeline, noting that retailers removed lettuce from shelves before the CDC publicly identified lettuce as the contamination source. According to CDC Deputy Director Gwen Biggerstaff, identifying specific sources for cyclosporiasis often takes considerable time due to symptom lag and the parasite’s complexity.
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