Cyclosporiasis Outbreak Hits Genesee County: Health Officials Still Searching for Source

Eleven Genesee County residents had confirmed cyclosporiasis infections as of July 7, and health officials still had not identified the source by July 20 — even as Michigan reported 6,148 cases and 102 hospitalizations statewide by July 16. Illnesses began as early as mid-May, with statewide onset dates running from May 13 through July 13. Lettuce or salad greens remain possible links, but officials have not named a product, grower or supplier. For Flint-area families deciding whether to serve fresh greens — including households relying on food assistance, corner stores and ready-to-eat produce — the warning is concrete but incomplete: Cook greens when possible, officials say, without saying which foods may be unsafe. In a county where nearly 100,000 residents were exposed to lead during the Flint water crisis after state agencies withheld information about lead contamination and Legionnaires' disease, the standard for transparency and urgency when a food or water supply is threatened must be higher.

The county health department's latest public update was posted on Facebook on July 8, when Michigan had passed 570 cases statewide by July 4. By July 16, the statewide total had surged to 6,148 cases and 102 hospitalizations.

State officials are pointing toward produce while stopping short of telling residents what, specifically, to avoid. Dr. Natasha Bagdasarian, chief medical executive for the Michigan Department of Health and Human Services, said, "The leading hypothesis is a link to contaminated produce, though no specific grower, supplier, or type of produce has been confirmed." Dr. Natasha Bagdasarian, chief medical executive for the Michigan Department of Health and Human Services, added: "Early information has shown lettuce as a common product that regularly comes up during the investigation." Dr. Natasha Bagdasarian, chief medical executive for the Michigan Department of Health and Human Services, said, "Although we do not have a definite product identified as the source of the outbreak, we want to let Michiganders know what we have learned so far so they can take steps to protect their families."

Previous cyclosporiasis outbreaks have been linked to bagged salad mixes, cilantro, basil, raspberries, snow peas and green onions. In a multistate cluster across Indiana, Kentucky, Michigan, Ohio and West Virginia, 1,644 people infected with Cyclospora reported exposure to Taco Bell. Taylor Farms de Mexico initiated a July 17 recall of iceberg lettuce sourced from central Mexico and certain Walmart Marketside iceberg salad and shredded-lettuce products.

Cyclosporiasis is a diarrheal illness caused by the protozoan parasite Cyclospora cayetanensis, which infects the small intestine after a person consumes contaminated food or water. Its hallmark is watery, often explosive diarrhea averaging four to 10 bowel movements a day; abdominal cramping, bloating, nausea, vomiting, fatigue and loss of appetite can also occur. Symptoms usually begin two to 14 days after exposure, with an average incubation period of about seven days, and without treatment an infection typically lasts 10 to 12 weeks. The standard treatment is the antibiotic trimethoprim-sulfamethoxazole — also known as Bactrim, Septra or Cotrim — generally prescribed as one double-strength tablet twice a day for seven to 10 days.

The state's clearest advice is also one of the hardest for many households to follow: Cook greens. The Michigan Department of Health and Human Services says washing alone may not remove the parasite from salad greens and recommends cooking produce when possible, including pre-washed greens. Washing cannot reliably remove Cyclospora because its thick, sticky outer shell can cling to leaf crevices and resist common chemical disinfectants, including bleach, vinegar and soap. Cooking produce to an internal temperature of at least 158 degrees Fahrenheit, or 70 degrees Celsius, is the only sure way to kill the parasite. Under normal conditions, general FDA food-safety guidance says greens labeled pre-washed, triple-washed or ready-to-eat do not need to be washed again.

That leaves residents with a difficult choice — one that falls hardest on families in Flint and Genesee County who rely on food assistance programs or corner stores in neighborhoods serving produce deserts. Without named products, suppliers or growers, they must either avoid fresh greens entirely or cook them, a choice that may not be practical for households dependent on ready-to-eat produce from food banks or stores with limited fresh selections.

Flint does not need a lecture on why specifics matter. The water crisis ran from 2014 to 2016, when state agencies knowingly withheld information about lead contamination and Legionnaires' disease while emergency managers replaced local democratic oversight. The CDC determined that nearly 100,000 residents were exposed to lead between April 2014 and October 2015, while children's blood-lead levels doubled or tripled in some cases. In 2016, the Flint Water Advisory Task Force found the Michigan Department of Environmental Quality, the Michigan Department of Health and Human Services, the governor's office and emergency managers fundamentally accountable, concluding that residents were needlessly and tragically exposed. The Michigan Department of Health and Human Services, which that review found fundamentally accountable a decade ago, is now leading the cyclosporiasis investigation.

Officials have not provided a timeline for identifying the source or issuing definitive guidance on products to avoid. The county health department's Communicable Disease program can be reached at (810) 257-1017 to report cases or ask questions. Residents who develop watery diarrhea, abdominal cramping or other symptoms after consuming fresh produce should contact a health care provider and report the illness to the Genesee County Health Department.

In a community that learned during the water crisis to demand transparency rather than trust reassurances, residents have every right to ask what specific steps health officials are taking to identify the source, when they will receive clearer guidance, and why answers are taking so long.