{"success":true,"data":{"id":"96f27fd9-2e68-4d2f-9975-5aaa255dbbce","title":"'Explosive diarrhoea' outbreak remains a mystery as officials struggle to find sources","summary":"Image source, PAUL J. RICHARDS/AFP via Getty Images By Madeline Halpert and Kayla Epstein Published 15 minutes ago Tracking the origin of an outbreak in the US that causes explosive diarrhoea has proved a challeng...","content":"# 'Explosive diarrhoea' outbreak remains a mystery as officials struggle to find sources\n\n![Image 1: Fresh raspberries are seen up close in green cartons](https://ichef.bbci.co.uk/ace/standard/3840/cpsprodpb/630f/live/5d821940-7f04-11f1-bf9d-c5939b8ebb1d.jpg)Image source, PAUL J. RICHARDS/AFP via Getty Images\n\nBy Madeline Halpert and Kayla Epstein\n\n*   Published 15 minutes ago \n\n**Tracking the origin of an outbreak in the US that causes explosive diarrhoea has proved a challenge for public health experts searching for answers about how it started - and how it's spreading.**\n\nCyclosporiasis, a parasitic infection that spreads through contaminated water or food, often during the summer, has now reached 31 states and infected over 3,000 people, according to state health departments. The main symptom of the rarely fatal illness is frequent, watery diarrhoea.\n\nSome experts told the BBC that the parasite is notoriously difficult to trace, a task possibly complicated in part by cuts to federal health agencies.\n\n\"This isn't like detecting a needle in a haystack. It's like detecting a microscopic portion of a needle in a haystack,\" said Steven Manderach, executive director of the Association of Food and Drug Officials.\n\nOne reason the parasite is so hard to track is that it takes one to two weeks for people to fall ill after infection, said Jodie Guest, senior vice chair of epidemiology at Emory University's Rollins School of Public Health.\n\nWith most food-related illnesses, people tend to experience symptoms within a couple of hours, making it easier to find the food that caused them, Guest said.\n\nTesting food for the cyclospora parasite is also far more complex than with other pathogens, said Manderach said , executive director of the Association of Food and Drug Officials.\n\nThe process requires washing large amounts of the potentially tainted food to remove the cyclospora organisms, reducing the runoff, and then testing it to see if the parasite was present.\n\n\"You'd have to have truckloads of lettuce to get to that point,\" said Manderach, who previously dealt with cyclosporiasis outbreaks as a food-safety official in Iowa.\n\n    \n\n    *   Published 46 minutes ago \n\nGiven the scale of the US outbreak, public health experts said there were likely multiple points of contamination in the food supply - another factor complicating investigations.\n\nMichigan is hardest hit, with over 2,600 cases, followed by New York state. Health officials have advised the public to thoroughly wash produce, avoid certain fruits like raspberries, and cook vegetables to kill off the pathogen - but they still have not identified its sources.\n\n## States scramble to test and track cyclosporiasis cases\n\nSome public health experts said finding the outbreak's origins also are complicated by cuts to agencies and programmes within the US Department of Health and Human Services (HHS).\n\nHealth Secretary Robert F Kennedy Jr made a number of budget and staff cuts as a part of billionaire Elon Musk's efforts to cut costs with his Department of Government Efficiency (Doge).\n\nThe federal government reduced the capacity of its Foodborne Diseases Active Surveillance Network (FoodNet), which tracks several pathogens, including cyclospora, salmonella and listeria. FoodNet scaled back monitoring for all but two pathogens last year.\n\n\"Funding has not kept pace\" with resources required for the programme, the CDC wrote in a memo to the state of Connecticut, according to NBC News.\n\nBefore FoodNet stopped monitoring cyclosporiasis, it gathered data about people who tested positive, and tested food sources from states and labs, then collated it at a national level, said Guest, who previously worked at FoodNet.\n\n\"When we see an outbreak or a cluster or something, we don't have the data we normally expect to go back to use to help us, and this is one of those consequences,\" she said. \"You're starting in the dark.\"\n\nThe CDC is still working with 3,000 health departments to gather data and it continues to collect data on cyclospora through surveillance sytems other than FoodNet, HHS told the BBC.\n\nThe department said health funding for foodborne diseases has \"remained stable\".\n\nIn Colorado, which has had 90 cases this year - about the same as past years - the state health department said it received less federal funding and has fewer staff to monitor cases.\n\n\"While our colleagues at the CDC are working hard to support state partners, we have had to adapt to federal changes,\" Hope Shuler, a spokesperson for the state's public health department, said.\n\nThe state has continued testing, monitoring and sending data to the CDC, she said.\n\nManderach said that federal agencies in charge of food safety are largely performing to the previous standard despite agency changes during the Trump administration.\n\n\"While yes, I do think there were challenges early on, most of those seem to have resolved,\" he said.\n\nOther, more serious health problems like the deadly Ebola outbreak in the Democratic Republic of Congo also have strained resources, said David Weber, professor of medicine, pediatrics and epidemiology at University of North Carolina at Chapel Hill.\n\nShortages put the onus on states to take more responsibility for foodborne illnesses, said Nancy Glick of the National Consumers League.\n\n\"States are doing that now, but they don't have the resources that the CDC had,\" she said.\n\n## Interviewing thousands about weeks of meals\n\nNow, epidemiologists are working to interview anyone who tested positive for cyclosporiasis about the food they consumed in the one to two weeks before falling ill, looking backwards to find the source.\n\nThe goal is to find the common link - a certain product or location where infection occurred - so they can put a stop to the outbreak.\n\nThe interviews are time-consuming and require lots of resources, which is difficult for some smaller local health departments, experts said.\n\n\"It is pretty straightforward, but it takes a lot of person power to do it,\" Weber said.\n\nMeanwhile, Americans are left to take a number of steps to protect themselves and avoid the uncomfortable illness.\n\n\"At the moment, the list of things that you need to be concerned about is unfortunately quite long, making it feel really hard to control,\" Guest said.\n\n## Related topics\n\n## More on this story\n\n    \n\n## The video playlist\n\nWatch our pick of standout clips from across the BBC\n\nPrevious Next, 4 of 19\n\n*   0:53 How you can help prevent wildfires. 00:00:53, play video How you can help prevent wildfires![Image 3: A firefighter surrounded by smoke](https://ichef.bbci.co.uk/ace/standard/400/cpsprodpb/b75e/live/d9e34050-7f7b-11f1-b976-0b9c15b0ccfc.jpg) \n*   1:26 Who earned what at the BBC between 2025 and 2026. 00:01:26, play video Who earned what at the BBC between 2025 and 2026![Image 4: Noor Nanji wearing a striped top outside the BBC](https://ichef.bbci.co.uk/ace/standard/400/cpsprodpb/cf19/live/790c2d70-7f92-11f1-bee8-53ce494e1abc.jpg) \n*   0:23 Pilot writes 'I'm bored' in sky during flight. 00:00:23, play video Pilot writes 'I'm bored' in sky during flight![Image 5: Bored spelt out in green letters on flight tracking app flightradar24 over a mape of North Wales\n](https://ichef.bbci.co.uk/ace/standard/400/cpsprodpb/5dc1/live/a12d6140-7f90-11f1-bee8-53ce494e1abc.jpg) \n*   1:13 Where can I get the MenB vaccine and who is eligible? 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