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

**SPEAKER_1** (0:00)
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**Michael Barbaro** (0:34)
From The New York Times, I'm Michael Barbaro. This is The Daily.

**SPEAKER_3** (0:38)
So look, I had that little diarrhea bug, explosive diarrhea bug there. Can't even lie, caught me off guard.
I was sicker than a dead dog on the side of the river, man. I ain't lying to you, but I know that.

**SPEAKER_1** (0:51)
I don't know where I got it from. I think it was lettuce.

**SPEAKER_4** (0:54)
I'm not 100% sure where I got it.

**SPEAKER_5** (0:57)
I would get nauseous here and there. I had such low appetite and I'm a girl that loves to eat.

**Michael Barbaro** (1:06)
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.

**SPEAKER_6** (1:27)
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.

**SPEAKER_7** (1:38)
I feel like every day, the FDA got a whole new recall. Like, they can barely keep up with what's getting recalled.

**Michael Barbaro** (1:47)
Today, two public health reporters who have covered the parasite, Christina Jewett and Caroline Hopkins Legaspi, on what we've learned about where it comes from, how it spreads so quickly, and why our food safety system seems so powerless to stop it.

**SPEAKER_7** (2:06)
Do you know something? If you know something, or you know 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.

**Michael Barbaro** (2:22)
Please.

**SPEAKER_7** (2:24)
Thank you.

**Michael Barbaro** (2:28)
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.

**Christina Jewett** (2:40)
Pistachio muffin, no iceberg, not on the side, not on the muffin.

**Michael Barbaro** (2:44)
No iceberg, okay.

**Caroline Hopkins Legaspi** (2:45)
Yep, no iceberg, lettuce in my yogurt and granola either.

**Michael Barbaro** (2:48)
Okay. And I, as usual, had eggs and sausage.
Okay. So Christina, Caroline, thank you for coming into the studio for what I admit will be a somewhat stomach churning at times conversation.

**Christina Jewett** (3:02)
Glad to be here.

**Caroline Hopkins Legaspi** (3:03)
Yeah, thank you for having me.

**Michael Barbaro** (3:05)
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?

**Christina Jewett** (3:24)
Yeah, this really is expanding. So in a typical year, you would see about 3000 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 at 22,000 cases.

**Michael Barbaro** (3:42)
Which is, from your math, seven times a normal year's worth of outbreak.

**Christina Jewett** (3:47)
Yeah, but you can see why this would pile up. For one, you do your typical washing procedure, 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? 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.

**Michael Barbaro** (4:21)
Fascinating.

**Caroline Hopkins Legaspi** (4:22)
And it can take weeks after you consume something contaminated with cyclospora to start feeling symptoms. Scientists call this a long incubation period. So you might not even start to have the diarrhea until a couple of 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.