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The Trump administration is facing a key messaging test as it tries to stop potentially multiple outbreaks of cyclosporiasis, a parasitic illness.
Two months in and thousands of cases later, the outbreak has become a communications nightmare.
Experts say confusing messages and a lack of central leadership have left the public in the dark about what produce is safe and distrustful of the Trump administration’s public health response.
Any outbreak of foodborne illness requires careful public communication, experts said. There needs to be a balance in telling people which products to avoid without causing a panic and scaring people away from eating fresh vegetables.
But many Americans are continuing to wonder what they are supposed to do. They don’t know which lettuce is safe, and they don’t know if they can trust the Trump administration to be truthful about the outbreaks.
Asked on Friday whether it was safe for Americans to eat lettuce, President Trump said he hadn’t thought about it.
“You need someone to set and guide expectations, and I don’t think they have that right now at the federal level,” said Glen Nowak, director of the Center for Health and Risk Communication at the University of Georgia.
“You need expertise. You’re hampered by acting directors or not even knowing who the director is. That’s a huge handicap,” Nowak said.
“Where has CDC [Centers for Disease Control and Prevention] leadership been? There’s not one federal leader out there to explain what’s happening, or not happening,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Health officials are still investigating the potential source or sources of the illness but say they are making progress.
There are far more cases of cyclosporiasis this year than is normal, even if they aren’t all outbreaks. The country usually sees a few hundred to a thousand cases at most in a given year.
Nationwide, the CDC has confirmed or is investigating more than 11,500 cases of cyclosporiasis, though not every case is connected.
Cyclosporiasis, the disease caused by the cyclospora parasite, leads to diarrhea, with frequent bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps and pain. While it isn’t typically life-threatening, it can cause serious complications.
Health and Human Services Secretary Robert F. Kennedy Jr. declared the outbreak was “under control” earlier this week and said any criticism that the agency’s response is being hampered by funding cuts was “invalid.”
“We have done extensive forensics, epidemiological forensics, and we’ve identified the source of the outbreak,” Kennedy said Tuesday.
Officials from the Food and Drug Administration (FDA) have zeroed in on the same iceberg lettuce sourced from central Mexico as the likely culprit behind an outbreak that has now impacted nine states and infected nearly 2,000 people.
The lettuce came from Taylor Farms, the world’s largest producer of salads and fresh-cut vegetables. The company issued a recall of all lettuce from that Mexican facility.
But cyclospora is a notoriously difficult parasite to track, and cases are climbing. There are multiple outbreaks across the country, and they are not all linked to the same source.
The heightened attention on cyclosporiasis is also likely contributing to higher case rates, experts said. More cases being detected doesn’t necessarily translate to more cases being spread — investigators may be closing in on a link, and the long lag time means someone showing up as part of an outbreak now could have been infected several weeks ago.
“If I see somebody in my office with diarrhea, they’re probably pretty likely to have eaten some sort of fresh produce in the last two weeks. So, I’m going to check the special, expensive test for cyclosporiasis, whereas a year ago I probably wouldn’t,” said Dr. Tonya Crook, an infectious diseases physician at Penn State Health.
Scientists need highly specialized tests to detect it in food. The illness is caused by a parasite, so it can’t be cultured in a lab. In addition, people can get sick weeks after eating contaminated food, so by the time health officials are even aware of an outbreak, the food that needed testing will likely have been eaten or thrown away.
Scientists often rely on interviews with people who were sick to try to determine what they ate to trace an outbreak to its source. A positive test result is rare, and to date, no samples from the Taylor Farms facility in Mexico have tested positive for cyclospora.
But experts said officials haven’t done enough to communicate that uncertainty to the public.
It didn’t help when the FDA announced that a sample of iceberg lettuce outside the recall tested positive for cyclospora. Such a discovery would have major implications for the outbreak, but the agency reversed course the next day, saying the result was a false positive.
Taylor Farms then said the FDA “apologized to us” for the error. FDA officials contradicted that statement to reporters, but the confusion remained.
“That’s a huge communication misstep,” said Donald Schaffner, chair of food science at Rutgers University. “They rushed to judgement without doing the confirmation their own protocols require.”
The FDA hasn’t said how the false positive came about, and there was confusion among the public about whether the agency even still suspected products from Taylor Farms were responsible.
Food safety experts are quick to note that false laboratory test results are always a possibility, but they say this nuance is being lost amid the current state of communication coming from federal authorities.
“I think it’s important for people to understand that all laboratory methods have a false positive and a false negative rate,” Barbara Kowalcyk, director of the Institute for Food Safety and Nutrition Security at George Washington University, told The Hill.
“From my perspective, one of the things that’s contributing to kind of the whole issue that’s going on right now, which I think is broader than FDA, is a lot of the communication staff at FDA and CDC were let go as part of the DOGE cuts,” Kowalcyk added, referring to the now-defunct Department of Government Efficiency.
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