Will My Lettuce Give Me Diarrhea?

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0:34What's your

0:35Nicholas Florko: deal? What's his deal? He went to Metro and got$450 in value on the new Samsung Galaxy A37 5G for free and no activation fees. Free phone? Oh, sign me up. Get that more for your money feeling only on Metro by T-Mobile. Bring your number and activate$40 period plan. $450 based on device discount waived activation fee. Not available if with Metro or T-Mobile in the past 180 days.

1:05Nick Florco doesn't want to brag or anything, but it was more than a year ago that he wrote an article that has come to seem prescient. Its title was, Now is Not the Time to Eat Bagged Lettuce.

1:22Nick wrote this way before the multi-state outbreak of Cyclospora, a parasite that is associated with explosive diarrhea. But now that this outbreak is here, Nick's ready. So tell me what your fridge looks like right now. I have a wedding coming up in a week and a half. So you're living on cans. Yes, I cooked a salad last week. The worst part about this illness is that it can take up to two weeks to show up. So I mean, I could have already gotten sick and it's just going to hit me right before my wedding. We'll see.

2:00Nick was originally warning against bagged lettuce because he knows leafy greens are the most common cause of foodborne illness. And he could see the way the Trump administration was weakening the U.S. food safety system. He worried about it. To be clear, it's not like we know what's causing this cyclospora outbreak. Not yet. But it is clear that lettuce is suspect, especially because you probably assume the bagged stuff is clean already. For the record, Cyclospora has also been known to hang out in raspberries and cilantro. A key thing is it is tough, maybe even impossible, to wash off. And like Nick said, you can ingest this parasite and not feel the impact for weeks.

2:47Can I tell you a story about me? Yeah, of course. I love kale, but bagged kale. I love bagged kale. It's on my list every week. The little bag says it is triple washed. I trust the bag. I pour it from the bag into a bowl. And at least once a week, I eat that salad. Is that a good idea right now? No, it is not a good idea. I feel like the kale is hardier. Maybe it's somehow rejecting the spores. What do you think? I don't know. all those little crevices. That's the thing. All those curly crevices. Yeah. People say to stay away from berries because of the crevices. So I don't know. Kale could be the same.

3:29What I've read about this pathogen is that in the extreme cases, it can be really bad. Like there was a case in Nepal where someone had symptoms for over 100 days. Yeah, it can be rough. I mean, the good thing is we do have antibiotics that treat it. But But if left untreated, yeah, it can be rough. And one of the, I think, scariest parts about it, at least from like a quality of life perspective, is it seems to go in waves. So like you get really sick, you think you're fine, you go about your day again, you get sick again, and it just keeps going. And you just keep riding that wave until you get it treated.

4:05No one is going to die from cyclospora. Am I getting that right? I always hesitate to say no one because maybe someone's super frail and their diarrhea is so bad that they, you know, lose too many fluids. They don't go to the doctor. Maybe they die that way. But generally, yes, you're right. It's just a pain.

4:27I feel like it's in this sweet spot where it's like a really bad outcome is possible if you get infected. but you're probably going to be okay, which allows people to both be scared and think this is kind of funny. Exactly. Yeah. And I also feel like that's kind of what is going through the public health officials' minds when they're thinking about advice here. Because when we see something that's potentially deadly, usually we see public health officials being like, we think it might be this, do not eat this right now. And that is not what they're saying. They're not saying to avoid anything really.

5:06I mean, there was a press call yesterday and they were essentially saying, wash your vegetables, try to be safe, but... Even though the washing won't get rid of it. Exactly. That is my own... It drives me crazy hearing them say that over and over again, but I guess it's the best advice you can give in the moment. Today on the show, can you eat that lettuce? Everything you need to know about Cyclospora a summer. I'm Mary Harris. You're listening to What Next. Stick around.

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9:20I want to just go back to the beginning. What is this explosive diarrhea bug? What is cyclospora? It's a parasite. So it's a parasite that is spread, unfortunately, only by human feces. And it kind of gets worse. It's human feces that has to be left out in the environment to mature. And then essentially it matures, gets infectious. If it touches food, that food gets contaminated. You eat the food, you get explosive diarrhea. How is a pile of poop that's sitting out for two weeks and then getting on the food? Can you just like like draw me a picture here? Yeah. I mean, so the one thing that I will say is it's a microscopic parasite.

10:05So it's not necessarily a pile of poop. Yeah. You can imagine like a water source gets contaminated in some way. That water then is used to irrigate a field. It's not as if it's brown water. It's a small amount of poop. and that poop gets onto the food. I mean, that's really likely how this happens. I mean, I don't want to say that we won't see like an egregious violation of standards. That's always possible. But much more likely is no one knew this was happening. It was not something you could see and it got us all sick. I mean, I've read that sometimes it's like there are workers at a farm who don't have access to a bathroom.

10:46So they're doing that somewhere near a water source or near the actual crops themselves. A water supply being contaminated, I don't know where that would come from, though. I mean, it can be like sewage overflows, for example. I mean, also, we don't know that much about this parasite. It was only recently that it was found to be domestic, like in outbreaks from domestic sources, right? Exactly, yeah. So that I mean, and that's the part of this that as a science nerd, I'm the most interested and most concerned with is we used to think that this was only endemic to tropical regions. And then we started to see cases that are homegrown here.

11:27And we still don't know why that is. I mean, the thing is, we don't have a long history with this parasite. Like you said, like we only discovered it really in the 1990s, as I understand it. Like that was when the first outbreaks we were noticing happened. And so science is really still catching up here. And there's a lot of reasons why it's harder to track than other foodborne outbreaks. So we're just kind of behind the eight ball in terms of the information we have about it. The only good thing is it is like less deadly than other pathogens. So that helps a little bit. Can we talk about why it's so hard to track?

11:59Because my understanding is that this is because of the lifespan of the organism, right? Like it takes a while to develop into something infectious. Once it's inside you, it takes a while to show symptoms. Is that what it is? That is part of it. The other part of it is kind of weeds, we easy into the science. But basically, there are genetic tests that can be done for most pathogens where you essentially can create a genetic fingerprint of that pathogen, either from food that was collected or from stool, for example. and public health officials will track all those cases together and say, okay, those are all exactly the same genetic fingerprint.

12:39They are definitely related. Let's go talk to those people and find out exactly what they ate. And you find the common source there. You can't do that with this pathogen. Why? As I understand it, you just, you can't grow it in the same way in the lab. And there's just not enough of it really in the stool to make it easy to study. So a little dab will do you. Yeah. Yeah, exactly. Okay. Yeah, none of that sounds great. Where are we seeing the most cases at this point? Like, is there a locust, a hotspot? It's Michigan. It's 100 % Michigan. It's just Michigan. Well, it's Michigan, Ohio. Which is sort of connected.

13:18Exactly. Yeah, they're all close to each other. I'm honestly, I mean, I'm not privy to the insider information. I'm not sure why they don't think New York is connected. But I mean, you could under, like, those are also close together. So they could be connected. I have read that this may indicate there's better screening in those places, not so much that there's more cases. Like, it could be still something else we don't understand. I mean, I think screening is definitely a part of it. But Michigan is just seeing so many cases that it's hard to think that it's just screening. I know that you've said it's hard to track this bug.

13:51But what are the theories about where the outbreak is coming from? Like, OK, if I'm a person reading around in the world, I've read about the Michigan Taco Bells that are like, sorry, no lettuce, no cilantro. The one active theory, I think, is that it's salad greens. And maybe that's salad greens from Taco Bell. Washington Post had a report yesterday that the federal government is looking into Taco Bell. We should say like it's not like Taco Bell is like growing its own salad. It's getting it from a distributor. So it's like Taco Bell may just be the canary in the coal mine. I mean, McDonald's had an issue with this a few years ago, much, much smaller, but same thing.

14:29I mean, they don't grow their own produce. They're getting it from a major supplier. And I mean, I would say because there's so many cases and they seem to be spread out in multiple states, it's likely a large supplier of produce. I mean, somebody who could have the scale to supply a Taco Bell, for example. Someone who could put the produce in a bag. my guess is they've interviewed a lot a lot of people and they all ate lettuce and so that's what they're going off of at this point but it's so funny though it's like they all ate lettuce but given the weeks between the lettuce eating and the onset like everyone ate lettuce in the last month do you know what i mean like that's just not exactly there's too much noise there for it to really be a signal.

15:16And that's what's so mind bending here. Like we should just be explicit. Like you could eat the thing that infects you and then two weeks later get symptoms. And so it's like you're trying to recall what was I eating two weeks ago or was it three weeks ago or whatever? Yeah, I can't remember what I ate yesterday. Yeah. It's really, really difficult. It's difficult even in the best of situations. I mean, if it's Taco Bell, I mean, it's bad for Taco Bell and frankly I love Taco Bell so bad for me too but you know people remember when they eat at a chain more than they like might remember if they like had some like a piece of lettuce on their burger one day and so if a bunch of people ate Taco Bell it's a clear signal that they can go track down so when it is a big chain it honestly does make it a little bit easier to track got it You know, I have heard some critiques that are looking at the Trump administration and the fact that they have scaled back funding to programs like FoodNet, the Foodborne Diseases Active Surveillance Network.

16:23It would monitor and track cyclospora, among other pathogens like listeria. Now they're only looking for salmonella and E. coli. Do you think that's a reasonable critique here? It's certainly a reasonable critique. I mean, the thing about FoodNet specifically, though, is as I understand it, and I've heard this from folks that aren't in the government as well, is that FoodNet is used to develop sort of intelligence about these bugs, but it's not used as sort of like an active surveillance system in an outbreak. So it's not as if we just don't have tracking anymore. So that's a good thing. Like those systems still exist.

17:00But at the same time, we've been talking about how this is a bug that didn't used to show up on our shores that we don't know that much about. Scaling back any sort of surveillance or intelligence system related to that bug is not going to be good. And so there's definitely a legitimate critique there to say maybe that was a bad choice. And then there's also just a legitimate critique over the fact that like CDC and FDA have both gone through major turmoil over the last year or so. And so there's just a question of what do things look like at those agencies? And frankly, when we lost a bunch of key leaders at those agencies, those are folks that have dealt with these sorts of things over and over and over again.

17:43When we lose that collective intelligence, does that put us at a disadvantage? Yeah. And I mean, I guess if you're looking at something like FoodNet, it may not have been set up to track an outbreak in real time, but it was at least like a channel for information to flow towards. Exactly. Now you have all of these individual state agencies which may be dealing with funding challenges of their own, collecting their own data, holding it, and then, you know, maybe trying to find a way to get it to the CDC. It just sounds herky-jerky. Yeah, the piece of this that I think has been most striking, and I do think it's getting a little bit better, it has been the CDC's lag in information.

18:21The states are reporting information so much quicker than the CDC. Last week when I wrote my first story on this, I think CDC was reporting like 200 cases. And Michigan was saying that they had thousands at that point. And so it was just sort of a question of like, what is going on? And CDC did hold a press conference yesterday. They said they're doing more frequent updates. Now the numbers are much, much higher. So maybe they're getting better. But it's just a question of like what was going on for the last few weeks? Why was the data coming out so slowly? Yeah. I mean, I remember during COVID, there was this whole issue of testing versus not testing.

18:59Like Donald Trump's whole idea was like if you keep testing, the numbers are going to keep going up. So maybe you don't want to do that. But is that going to be an issue here? Like, what is the CDC actually advising people to do? And how do you think that's going to change how we see this outbreak? Hopefully it won't be an issue here. I mean, the CDC did put out an alert to doctors that was essentially like, hey, if you weren't aware, there's a giant outbreak and this is the test you should be running for this, which in this case, I think is pretty helpful because, again, this is not a normal thing that doctors typically test for.

19:35So having that information from the CDC of saying you should be running this test should help. I haven't seen anything that is explicitly said, you know, essentially don't test for this, but things can always change. I don't I don't count any possibility out at this moment. I mean, the CDC also said yesterday there were thousands of tests just waiting to be tested. Right. So it's like there's also a backlog situation here. Yeah, no. And I mean, that again goes to funding for public health infrastructure. I mean, public health labs, all these groups are always struggling to work with minimal resources.

20:13And when there's a huge influx of tests that need to be run, it becomes an issue. And unfortunately, you would have think we would have solved this sort of thing with COVID, but we haven't. We actually specifically unsolved it. Yeah.

20:32When we come back, a lightning round of do's and don'ts so you can avoid getting sick.

20:49Being a serious business owner takes hard work, patience, and a drive to keep moving forward. So it's important to find a serious business card that goes the extra mile. With the VentureX business card from Capital One, you earn unlimited double miles on every purchase. And with big purchasing power, you can spend more and earn more. This is your sign to take your business to the next level. The Capital One VentureX Business Card. What's in your wallet? Terms apply. See CapitalOne.com for details. State fair food is getting smaller and pricier. We'll have room for fried cookies. Okay, you never overspend on food.

21:24What's your deal?

21:25Nicholas Florko: What's his deal? He went to Metro and got$450 in value on the new Samsung Galaxy A37 5G for free. And no activation fees. Free phone? Oh, sign me up. Get that more for your money feeling. Only on Metro by T-Mobile. Bring your number and activate$40 period plan. $450 based on device discount waived activation fee. Not available if with Metro or T-Mobile in the past 180 days.

21:50So what do we know about a potential treatment here? If someone is experiencing symptoms, I guess what we're saying is you definitely should go to the doctor. You definitely should get a test. You've mentioned there might be a treatment, though, too. What is that? Yeah, there's antibiotics for this treatment. Just simple antibiotics over the like not over the counter, but it's a specific antibiotic that I don't think most people would have had before. But it's I think it's like readily available as I understand it. So I don't think people should be experiencing big issues there. Honestly, the one issue that I heard that I've been meaning to run down, which is concerning and I'm not sure if the issue's been solved is I've heard that folks are experiencing like out of pocket costs for the tests.

22:35I heard that from one state and that seemed like an emerging issue. I mean, if you're going to the doctor and then you're said, you know, you've diarrhea and you're they say this is going to cost 100 or 200 bucks, you might not do it. But I haven't fully run that down that issue yet, but I did hear it from a good source. So it seems like that is a potential issue for some folks. I mean, it sounds like the better thing is to avoid this bug, if at all possible. I wonder if we can go through some like a lightning round of questions. Sure. I think a lot of my listeners will have heard like, don't eat the bagged lettuce.

23:05Don't eat the processed stuff. Here's a question. Is it safer to get food from my local CSA or farmer's market than getting it from the grocery store? I would say so. Why? Simply because there is a much smaller distribution network there. And since it seems like this is coming from a major supplier, at least the big cluster of cases in Michigan, those farms that are supplying that lettuce are different than the farms that are supplying your local CSA. And again, this is a virus that is spread through contamination of produce on the field. So you find a field that isn't contaminated, you're not going to get sick.

23:42Yeah, I've read that there's actually never been a documented cyclospora outbreak linked to a local farm, which I was like, hmm, interesting information to have. I mean, there's always a first time for everything. But I mean, to be fair to large farms, they produce a lot of product. And so that increases the chance that somebody will get sick. So but yeah, no, I mean, local seems like a good option at this moment. What about freezing my food? Is that going to stop this bug? I have not seen anything reliable that says freezing it will solve your issue. Cooking it does. It does. How cooked are we talking?

24:17How much? Am I blanching? Can I blanch? Can I grill? What do you think? You can definitely grill. So as I understand it, food has to reach a temperature of 158 degrees to kill the bug. I've read that means like sauteing raw spinach for 1.5 minutes, which seems fine. I can do that. I can. That's not too that's not too like hot plate at college kind of feeling. You know what I mean? Like that's that sounds delicate. It gets harder when you're thinking about. I mean, luckily, it seems like we're zeroing in on lettuce. But before that, we were talking about herbs like cilantro. I don't know anybody who sautés their cilantro.

24:55So that would be a little bit harder. Yeah. And you're going to want that guacamole. What about microwaving? I feel like you get the cold spots with microwaving. That's what I'd be worried about. Yeah. Yeah, exactly. Okay. We've said whole heads of lettuce versus like bagged lettuce. Am I like peeling the outside off? They do say to peel the outside layers off. It can't hurt. And you would expect that there would probably be more parasite in the outer layers. So it seems like a good idea. But I mean, overall, cooking is still the safest thing to do. Yeah. If I'm going to pitch food because I'm so worried about it, can I feed it to a pet?

25:36That is a great question. It should be fine because this only impacts humans. So you should be good. That's an interesting fact. Only impacts humans. I think there are other strains of the pathogen that can impact other animals, as I understand it. But this one specifically is humans only, which is why it's only spread by human feces as opposed to like E. coli, for example, which typically comes from like cow manure. I do feel like we should list off previous culprits of cyclospora just so people know like what's in the mix here that's you're gonna correct me if I'm wrong but I'm seeing raspberries with all those like good little nooks and crannies where the it can get in there herbs basil cilantro onions snap peas and snow peas and of course the lettuce the leafy greens with all those yeah leaves it's almost always raw produce yeah yeah it's the unfortunate part about all foodborne illnesses is they all they often hit the foods that people should eat one want to eat in the summer and this is a summer outbreak right like this happens in the summer yeah and i part of that i don't think it's been fully established but i think part of it is that it the like again And the parasite needs to mature in a warm environment.

26:56And so that's the environment you get in the summer. Yeah. And plus, people probably eat more fresh produce in the summer. So that is likely at play, too. We've talked about how no one's going to die from this outbreak. And you've compared it to other outbreaks. Like in 2024, there was a listeria outbreak, which did kill 10 people. That was about meat, right? Processed meat. Yeah. Cold cuts. Yeah. In that listeria outbreak, there was a form of closure, right? We knew where it came from. And the company that produced the tainted meat actually faced real consequences. But everything from our conversation makes me think that things might go differently this time with this outbreak.

27:42that we may not know the exact source ever? Will consequences look different? Like, are we going to be able to learn from this outbreak? I'm not super hopeful that we will. I mean, I think 2020, where we had another cyclospora outbreak tied to bagged salad, as I understand it, is pretty illustrative here. I mean, essentially, they were able to nail down that it was lettuce. They were able to nail down likely where the lettuce came from, and they were able to find Cyglospora in a nearby water canal. But they were never able to prove that infected water was used to water the produce. So there was never that causal link.

28:30So we might get that close. And was the farm ever punished, or would that be seen as unfair because it's like that was just their local water supply? Right. Yeah, I don't think the farm was punished. So that is likely the sort of situation that we could have here where it's just sort of like, it's really unfortunate this happened, but that's how these things happen. And that's super unsatisfying for consumers who have to spend their summer worried if they can eat a salad. But yeah, it's a tough situation for sure. Well, the thing I hate about that is that it plays into this RFK Jr. approach to public health, which is like, well, people just get sick sometimes.

29:12Let's just suck it up. And it's like, yeah, people do just get sick sometimes, but we can actually stop it. We can take initiative to prevent people getting sick in the future. You know? Right. Yeah. No, 100 percent. And I mean, the thing about covering this for a long time is there has been so many delays in the FDA's implementation of all these different rules related to produce safety. And it's super frustrating because there are best practices for a lot of pathogens that there's still a long lag and it's taken way too long to get those actually implemented. Cyclospore is a little bit different because it's newer.

29:56But I mean, the same issue applies. I mean, we shouldn't be having foodborne outbreaks from our produce. And there are things that folks say should help, but it's just taken so long. We don't have to live like this. That's what you're telling us. Exactly. And yet here we are. Yeah. How does this end? I think it peters out eventually. I mean, that's the reality of it. Like eventually the produce has to go bad and we all stop getting sick. And the season ends in September, right? It's like, OK, good night to Cyclospora until next season. See you then. It's like summer camp. It's either that or there is some egregious thing happening.

30:39And so many people get sick that it's very clear that it's one farm and they find the farm that way. But I think that that's less likely to be to be honest. I think it is more that the produce eventually goes bad. Everybody recovers. Hopefully people get antibiotics. And we all remember this summer as the cyclospora summer.

31:04Nick, thank you for coming on the show, answering all of my cyclosporer questions. I'm grateful for you. Yeah, thanks for having me. Nicholas Florco is a staff writer over at The Atlantic. And that's our show. What Next is produced by Rob Gunther, Evan Campbell, Madeline Thames-Ducharm, and Patrick Fort. Paige Osborne is the senior supervising producer of What Next and What Next TVD. Mia Lobel is the executive producer of podcasts here at Slate. Ben Richmond is the senior director of podcast operations. And I'm Mary Harris. Go track me down a blue sky. I'm at Mary Harris. Thanks for listening.

31:40Talk to you soon.

31:54being a serious business owner takes hard work patience and a drive to keep moving forward so it's important to find a serious business card that goes the extra mile with the venture x business card from capital one you earn unlimited double miles on every purchase And with big purchasing power, you can spend more and earn more. This is your sign to take your business to the next level. The Capital One VentureX Business Card. What's in your wallet? Terms apply. See CapitalOne.com for details. State fair food is getting smaller and pricier. We'll have room for fried cookies. Okay, you never overspend on food.

32:29What's your deal?

32:30Nicholas Florko: What's his deal? He went to Metro and got$450 in value on the new Samsung Galaxy A37 5G for free. And no activation fees. Free phone? Oh, sign me up. Get that more for your money feeling only on Metro by T-Mobile. Bring your number and activate$40 period plan. $450 based on device discount waived activation fee. Not available if with Metro or T-Mobile in the past 180 days.