 | Dhruv Khullar
A staff writer and a practicing physician | Last year, a friend of mine attended a picnic and later developed a case of—apologies if you’re reading this over dinner—explosive diarrhea. His symptoms worsened, improved, then worsened again; he lost ten pounds in about a month and was eventually found to have a parasite known as cyclospora. Because the parasite takes time to mature, people often don’t develop symptoms—which can also include nausea, bloating, and abdominal cramping—until a week or two after they’ve been infected; some become so dehydrated that they require intravenous fluids.  Photograph by Eszter Imrene Virt / Getty Fortunately, in my friend’s case, a doctor quickly prescribed an antibiotic called Bactrim, which resolved his symptoms. At the time, the illness seemed like an anomaly: cyclospora is a relatively rare cause of diarrheal illness. But in recent weeks the parasite has caused thousands of infections across the U.S. and, by the C.D.C.’s latest count, sent more than a hundred people to the hospital. In a typical year, Michigan logs around fifty cyclospora infections; in the past month, the state has recorded more than three thousand. The outbreak is already one of the largest on record, and—given the lag between infections and symptoms, symptoms and testing, testing and reporting—these numbers are almost certainly undercounts. What can we do to keep safe? Cyclospora isn’t transmitted directly from person to person. Instead, infections usually result from eating contaminated produce: raspberries, cilantro, basil, snow peas, lettuces. The C.D.C. recommends “not consuming food or water that may be contaminated with feces (poop)”—sound advice whether or not there’s an active cyclospora outbreak. Assuming you’re not sure, though, officials also advise thoroughly washing raw produce and, when possible, cooking vegetables before you eat them. Authorities haven’t yet determined the source of the outbreak, partly because, unlike, say, E. coli, cyclospora is hard to grow in a lab. Its genome is also more complex to sequence, complicating the process of linking scattered infections to a single origin. But these unavoidable problems of biology are compounded by totally avoidable problems of public policy. The Trump Administration has made unprecedented cuts to the nation’s public-health infrastructure, including to a program called FoodNet, which coördinates surveillance of food-borne illnesses across federal and state health departments. In the before times, FoodNet collected data on eight serious microbes; now it monitors just two. Cyclospora didn’t make the cut. In the wake of the COVID-19 pandemic, the country seems to have little appetite for contemplating, much less confronting, infectious threats. But as outbreaks of measles, Ebola, hantavirus, and now cyclospora make clear, we don’t get a say in whether pathogens emerge—only in whether we are willing to prepare. | 
