More than 900 people in Washtenaw County, Michigan, have been sickened with cyclosporiasis since mid-June. Linda Kim, a public health nurse, has called more than 100 of them. Almost everyone has said the same thing: It\u2019s excruciating, and one of the worst illnesses they\u2019ve experienced.<\/p>\n
But on a Wednesday in July, she called one man who said he wouldn\u2019t mind having it again, actually.<\/p>\n
\u201cYou\u2019re enjoying the weight loss?\u201d Kim said, laughing as she took notes in a small conference room at the Washtenaw County Health Department building, just outside Ann Arbor. \u201cWell, I\u2019m glad to hear that. At least you got something good out of it!\u201d<\/p>\n
Normally, Kim\u2019s supposed to be working downstairs in the clinic, where families wait in gray plastic chairs in the lobby for free or low-cost immunizations. But she hasn\u2019t been there in months.<\/p>\n
In March, Kim was transferred to a different department to help deal with a measles outbreak that sickened seven people in the county, five of them children. It was an all-hands-on-deck situation; everyone worked overtime. The state issued an advisory urging families in Washtenaw and surrounding counties to get babies 6 months or older vaccinated ahead of schedule, if possible.<\/p>\n
The contact-tracing calls for measles could be contentious, Kim said. People were suspicious, asking her how she knew they had tested positive, or why they should give her any information.<\/p>\n
\u201cPeople were like, \u2018Oh, you\u2019re just trying to restrict my life,\u2019 or \u2018You\u2019re just trying to get information out of me and get me in trouble,\u2019\u201d she said. \u201cIt\u2019s like, no, we\u2019re actually not doing that at all.\u201d<\/p>\n
As she tried to explain to them, tracing the spread of the highly contagious<\/a> virus and publicizing possible exposure sites was an effort to \u201ckeep it contained, so it doesn\u2019t become something huge.\u201d<\/p>\n Before reports of cyclosporiasis cases started pouring in this summer, Washtenaw County Health Department staff in Michigan were working to contain a measles outbreak with contact tracing and testing. The county\u2019s outbreak ended in May. (Kate Wells\/KFF Health News)<\/p>\n The county\u2019s measles outbreak ended in late May. Then in June, reports of cyclosporiasis cases started pouring in \u2014 more than 11,000<\/a> so far in Michigan, including two deaths. Both people who died had \u201csignificant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,\u201d the state health department said on its website Aug. 3. Health officials aren\u2019t providing more details, department spokesperson Lynn Sutfin said in an email, but are stressing that cyclosporiasis generally isn\u2019t life-threatening and that deaths from it are uncommon in the U.S.<\/p>\n Kim said the cyclosporiasis surveillance has been very different from her experience with the measles outbreak. Now, people seem eager to divulge even the most graphic details, such as \u201cpooping their beds, and, like, putting down towels and it\u2019s not enough.\u201d<\/p>\n Since she\u2019s a nurse, such confessions don\u2019t faze her, she said. Still, staffers have hundreds of these calls to make, so they try to keep each conversation under an hour.<\/p>\n But foodborne illness investigations are complex. Especially for this parasite, cyclospora. Symptoms can take as long as two weeks to appear after people have eaten contaminated food. And no one remembers what they ate two weeks ago, public health staffers said.<\/p>\n The interview process can be extremely detailed. Kim and her colleagues ask people to pull up their restaurant receipts, scroll through purchases on their grocery store apps, even try to recall details such as the exact brand of bagged salad mix they bought, or the type of taco they got at Taco Bell.<\/p>\n \u201cIs that the crunchy one or the soft one?\u201d Kim asked on a recent call, typing on a laptop decorated with cat and vaccine-themed stickers.<\/p>\n Kim has been working with the health department for two years, a period defined by federal funding cuts.<\/p>\n Laina Stebbins, a spokesperson for the Michigan Department of Health and Human Services, said the Trump administration\u2019s sweeping cuts to public health grants eliminated a contract between the state health department and 44 of the state\u2019s 45 local departments that funded 123 full-time employees.<\/p>\n Those cuts also affected the state\u2019s disease surveillance labs, \u201creducing funding for equipment maintenance contracts, data modernization, and the ability to innovate laboratory processes during emerging disease response,\u201d Stebbins said.<\/p>\n Some of that funding was restored after Michigan won a temporary restraining order<\/a> against the Trump administration. But Washtenaw\u2019s health department still had to scale back some disease surveillance and outbreak response work. Currently, employees who leave or retire aren\u2019t replaced, except for those on the nursing team, which is hiring but still understaffed.<\/p>\n The county\u2019s Health Equity Council<\/a>, which aims to reduce health disparities, including in mental health, was shuttered suddenly in early 2025. Nearly a year later, it resumed its work, with funding at least through this September.<\/p>\n Staff at the Washtenaw County Health Department in Ypsilanti, Michigan, have been working to trace the sources of the recent cyclospora outbreaks by conducting detailed, often lengthy interviews with hundreds of people. (Kate Wells\/KFF Health News)<\/p>\n An employee from the Centers for Disease Control and Prevention had been stationed at the department. During the funding chaos, the worker was fired, then rehired, then furloughed.<\/p>\n The federal response to cyclosporiasis has felt frustratingly slow, according to Christina Zilke, a nursing supervisor at the Washtenaw health department.<\/p>\n \u201cIt took them forever to say that this was lettuce, and fast-food restaurants were taking it off the shelves before the CDC ever said what it was,\u201d she said.<\/p>\n During a July 14 press call, the deputy director of the CDC\u2019s Division of Foodborne, Waterborne, and Environmental Diseases, Gwen Biggerstaff, said it\u2019s not unusual for it to take a long time to identify<\/a> a specific source for cyclosporiasis \u2014 if it\u2019s identified at all. That\u2019s partly due to the lag time between exposure and the appearance of symptoms, and the complexity of tracing this particular parasite.<\/p>\n Meanwhile, Zilke\u2019s been stocking the coffee station and bringing in pizza, trying to keep up staff morale. It\u2019s not a reward, she said. \u201cIt\u2019s more like: \u2018Here\u2019s some food for survival. Here\u2019s a break so you don\u2019t quit.\u2019\u201d<\/p>\n Kim, for her part, remains enthusiastic about the job but said it\u2019s been a surreal introduction to a public health career \u2014 first measles, now cyclospora.<\/p>\n \u201cIf nationally they don\u2019t know what\u2019s going on, how are we locally expected to know what\u2019s going on?\u201d she said. \u201cAnd also just frustrating to be, like, \u2018Wow, I don\u2019t think even our government knows how important public health is.\u2019\u201d<\/p>\n But there\u2019s no time to dwell. She has to move on to the next call, as soon as she can wrap up this one. She gives each person her work number, so people can call or text with any follow-up questions.<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":" More than 900 people in Washtenaw County, Michigan, have been sickened with cyclosporiasis since mid-June. Linda Kim, a public health nurse, has called more than 100 of them. Almost everyone has said the same thing: It\u2019s excruciating, and one of the worst illnesses they\u2019ve experienced. But on a Wednesday in July, she called one man…<\/p>\n","protected":false},"author":0,"featured_media":14897,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-14896","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/14896"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14896"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/14896\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/14897"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14896"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14896"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14896"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}