Cyclospora outbreak tests CDC, RFK Jr. response

Robert F. took over. Kennedy Jr. took over the US Department of Health and Human Services last year, promising to reform the American food system and restore confidence in the agencies that oversee it.

The Secretary of Health and Human Services now faces one of his biggest tests yet, as the country tries to contain an outbreak — or the potential for several outbreaks — of foodborne illness. Two months and thousands of cases of cyclosporiasis later, the country’s already fragile system appears to be faltering.

Experts have long said the United States is ill-prepared to curb foodborne disease outbreaks. But after the Trump administration cut key officials — from federal employees investigating the source of diseases to those who share information with the public — Kennedy appears to face a more difficult task of containing the parasite and building confidence in the administration’s response.

“It’s difficult to accurately quantify, but it’s clear that cuts in federal funding over the last year or so have reduced our ability to respond to outbreaks like these,” said Craig Hedberg, co-director of the Minnesota Integrated Food Safety Center of Excellence.

Kennedy earlier this week defended the handling of a cyclosporiasis outbreak that has sickened at least 7,000 people in Michigan alone. (The official count from the Centers for Disease Control and Prevention, which lags behind state tallies, is approximately 4,200 cases.) Kennedy said the ongoing cyclosporiasis outbreak was “under control,” dismissing criticism that agency cutbacks had hampered the investigation as “incorrect.”

The U.S. Food and Drug Administration and Centers for Disease Control and Prevention have narrowed their focus on shredded iceberg lettuce from Taylor Farms, a supplier of the produce to a range of restaurants and grocery stores. The US Food and Drug Administration said over the weekend that the company’s lettuce had tested positive for Cyclospora, a parasite that causes severe diarrhea. The agency later backtracked, saying it was a false positive.

Donald Schaffner, chair of the department of food science at Rutgers University, said he had never seen such a reversal before and called it a “very big mistake.” However, a former top food official at the FDA said the agency was right to publicize the positive test because if it had turned out to be a true positive, delaying the announcement could have caused more people to fall ill. Regardless of the test result, agencies still see lettuce as the likely cause.

The flip-flop and the confusion it caused over whether regulators still suspected Taylor Farms lettuce was linked to the outbreak highlighted the difficulty Kennedy faces in trying to regain the public’s trust.

HHS spokeswoman Emily Hilliard said in a statement to CNBC that the FDA has been transparent with Taylor Farms throughout the investigation and that the corrected lab result does not change the agency’s findings.

Former federal health officials and independent food safety experts say they see Cyclospora’s response as a prime example of a system that has long been underfunded and overwhelmed, leaving the United States vulnerable to this type of outbreak. They fear that budget cuts, policy delays and staff turnover will worsen an already critical situation.

In response, Hilliard said regulators “mounted a robust, science-based response to this outbreak, working closely with health departments in all 50 states, quickly identifying known sources, and ensuring Americans had the information they needed to protect themselves.”

“The FDA and CDC continue to work together to use all available public health tools to identify additional sources of the outbreak and take rapid public health action,” she added.

Cyclospora is a parasite that is more difficult to track than some other pathogens. Parasites do not grow outside the human body, making it difficult to test and link cases to each other. Schaffner said Cyclospora tests are vulnerable to false positives because the process of administering them can sometimes make it look like there is a parasite in the sample when there isn’t.

Some experts said the Trump administration’s funding cuts make this difficult task even more difficult.

Dr. Daniel Jernigan, former director of the Centers for Disease Control and Prevention’s National Center for Emerging Infectious and Zoonotic Diseases, noted that CDC’s Division of Parasitic Diseases and Malaria lost $40 million in USAID funds after the Trump administration dismantled the organization. The agency expects to recoup some of the money, although it will represent a quarter of the money it was receiving from USAID, according to Jernigan.

Jernigan It is estimated that the group has lost about a quarter of its employees due to budget cuts. Some of these employees have worked on other parasitic diseases such as malaria, but they are usually tapped to help respond to emergencies like this one, he said. As a result of these cuts, the Centers for Disease Control and Prevention is trying to move parasitic disease groups to the Division of Foodborne, Waterborne and Environmental Diseases, which Jernigan says is a good thing to improve the investigation and control of foodborne diseases.

“At the beginning of this response, the cuts were due to USAID [funding] “It’s made the department less able to respond quickly, and it’s not rocket science. Just fewer people, you don’t have the reserve,” Jernigan said.

Hilliard of the Department of Health and Human Services said the money was intended for international activities and was not used to support the CDC’s domestic foodborne illness response. She added that Trump’s proposed budget for fiscal year 2027 proposes an increase of $33 million for food safety activities.

Jernigan suggests that increasing this budget would help improve the agency’s ability to respond to such outbreaks. CDC funding for food safety has not seen a significant increase since 2014, according to an analysis by the George Washington University Institute for Food Safety and Security.

This fiscal year, the CDC’s budget for food safety is $74 million, $2 million more than last year, according to the agency’s operating plan. This food safety amount represents approximately 10% of funds allocated to CDC’s emerging infectious disease and zoonotic disease control efforts.

The CDC’s FoodNet, or Active Foodborne Illness Surveillance Network, has stopped mandatory reporting for six of the eight pathogens it previously monitored, including Cyclospora, because there wasn’t enough money for the work, something experts say is a result of chronic underfunding of food safety. This program tracks foodborne disease outbreaks over time rather than identifying new outbreaks.

Kennedy said earlier this week that the cuts to FoodNet were for “redundant oversight.”

At the FDA, the agency’s budget for food has long been a small portion of the centers that oversee drug and device regulation. This year, the Food Center’s $1.17 billion budget represents about 17% of the agency’s total program-level spending of about $7 billion.

Food funding has lagged in other areas in part because it comes disproportionately from congressional appropriations, while money for other centers, including those that oversee prescription drugs and tobacco products, comes largely from fees the industry pays for reviewing applications.

The so-called Government Efficiency Administration, which oversaw widespread federal layoffs last year, spared Food and Drug Administration employees working on foodborne illness outbreaks from across-the-board cuts, according to a former senior FDA official. The FDA’s main press office was destroyed, stripping the agency of expertise in outbreak communications.

Some argue that the FDA’s messaging about false positives sowed confusion around the investigation and how consumers should respond.

The FDA’s recall communications have needed to be updated for some time, said Ellen Shoemaker, director of outreach for Safe Plates at North Carolina State University. She said the agency needs to provide clear communications to consumers, telling them in clear language concrete steps they can take. She added The agency needs to classify the severity of the recall more quickly.

In this case, the FDA said the illnesses began on May 17, but did not issue public notice until July 16, a timeline that suggests the response was slower than expected, she said. Frank Yanas, former deputy commissioner for food policy and response at the Food and Drug Administration. One measure he and other food safety experts say could have helped speed up the response is the Food and Drug Administration’s food traceability rule, which was supposed to take effect this year but was delayed by two and a half years. This policy is designed to help the FDA quickly identify the source of a food to respond to foodborne illness outbreaks.

Kennedy has repeatedly promised to rebuild trust in the Centers for Disease Control and Prevention in the wake of the COVID-19 pandemic and restore its focus on infectious diseases, and the Cyclospora response gives him an opportunity to showcase any improvements in the agency’s crisis response. So far, experts said they haven’t seen the response improve much.

State and local health departments are also feeling the effects of the Trump administration cuts. A May analysis from the Congressional Research Service found that the administration terminated $5.78 billion in CDC grants to states.

States are using block grants to fund epidemiologists and other specialists involved in investigating outbreaks, said Sarah Sorcher, director of regulatory affairs at the Center for Science in the Public Interest.

In Kentucky, the group primarily responsible for conducting case interviews for foodborne illnesses has seen a 30% to 50% reduction in staffing due to a reduction in federal grant money, according to a state Department of Public Health spokesperson. The state expects further staffing cuts next year due to additional cuts in federal grants next year.

However, one state hit hard by the outbreak said it had received federal aid. The Ohio Department of Health has requested federal assistance to investigate Cyclospora, and will host several CDC Epidemic Intelligence Service officers this week to assist, a health department spokesperson told CNBC. The government agency has requested assistance from the Centers for Disease Control and Prevention in its previous responses, including a measles outbreak in 2022 and the 2023 derailment of the East Palestine train.

Meanwhile, more people are falling ill. CDC has received reports of more than 4,000 laboratory-confirmed cases, and is aware of more than 7,400 additional cases, many in Michigan and Ohio, that have not yet been confirmed by laboratory testing.

On Wednesday, the US Food and Drug Administration reported a new outbreak among dozens of people linked to a yet-to-be-identified product, meaning health agencies have more evidence to investigate.