Many people have experienced diarrhoea.
So when it hit Nick Palmiter at the beginning of July, he didn’t think much of it.
“I’ll be alright,” he said to himself.
But symptoms persisted. And as days turned into weeks, the stomach cramps became unbearable.
The 29-year-old described the sensation as a constant pressure and bubbling, “almost like you have a balloon in your stomach”.
At the urging of a coworker, he finally visited an urgent care facility and, upon arrival, was told that he immediately needed to go to an emergency room.
It was at the hospital that Palmiter learned he had cyclosporiasis, the intestinal illness that continues to spread across the US, infecting thousands of people in 41 states – the largest recorded outbreak in US history.
Michigan has seen the most cases nationwide (over 7,000). And in Monroe County, a rural patch of land on the state’s eastern boundary, where Palmiter lives, documented cases are among the highest.
“It makes you feel absolutely sick,” Palmiter said about his experience. “Like you have nothing left to give.”
The county has a population of roughly 154,000. According to state figures, 286 people there have been infected by cyclosporiasis – which comes from ingesting the cyclospora parasite, and includes symptoms like “explosive diarrhoea”.
The outsized impact in this small community has caused a major rippling effect.
“Anxiety” and “scared” were the words Palmiter used to describe the mood locally.
His mother, Michelle Palmiter, said similarly.
“I’m seeing a lot of people that are freaking out about it,” she said.
That includes her niece who has cleared the entire fridge of any produce, tossing it all into the rubbish, including what Michelle saw as a perfectly good watermelon.
“Instead of doing a good scrub and then cutting it up, she’s just throwing it out,” Michelle said.
Chat boards on social media for Monroe County residents show that others are going to similar lengths, reflected in comments like the one left by a mother who said she has “a whole toddler living off chicken nuggets and Goldfish [crackers] ever since this started”.
Michelle is still eating fruits and vegetables, but only ones she cooks. “Definitely not going out to eat at all,” she said.
Part of what’s causing the “panic for people”, she says, is how the government has fumbled its response to the outbreak.
“We’re not trusting anything they’re putting out about it.”
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The infections were first detected on 13 May, according to the Food and Drug Administration (FDA). The number of cases has only risen since. So has the sense of mystery. Restaurants and major retailers across America – including Walmart, Jack in the Box and Taco Bell – have announced they’re pulling food from shelves. “Out of an abundance of caution,” has been the message. The primary target is iceberg lettuce, but, months later, the official source of cyclospora remains unknown.
Francisco Diez-Gonzalez, director of the Center for Food Safety at the University of Georgia College of Agricultural and Environmental Sciences, said the parasite can be “really hard to detect”.
Part of the difficulty has to do with gene sequencing, he explained. The other challenge is that symptoms from the parasite can take weeks to appear, making it hard for investigators to accurately trace back everything someone has eaten in order to pinpoint a common link.
FDA investigations have pointed to Taylor Farms as a possible source, and the company – a major US food supplier – has voluntarily recalled all of its iceberg lettuce from central Mexico. “In an abundance of caution,” they’ve said.
The investigation appeared to reach a breakthrough on Saturday, when the FDA announced that an iceberg lettuce sample from Taylor Farms tested positive for cyclospora. But the government retracted that position less than 24-hours later, saying on Sunday that it was a false-positive.
“We’re dealing with a pathogen that is really hard to work in the laboratory,” Diez-Gonzalez said.
“In this case, finding a few cysts of cyclospora in a lettuce sample is literally like looking for a needle in a haystack,” he continued. “It’s not easy.”
Finding a false-positive was not unordinary, Diez-Gonzalez said. However, hearing about it was. He explained that’s because test results aren’t typically made public without multiple rounds of testing to corroborate findings – “to make sure that the positive is indeed a positive”.
“Whether they had sufficient evidence to actually go public, that’s what is questionable,” he said.
The FDA did not return the BBC’s request for comment before deadline.
Extra precautions around testing are important, he continued, because inconsistencies risk “making the consumer really wary that we don’t have anybody to trust”.
On Tuesday, Health Secretary Robert F Kennedy Jr said cyclosporiasis was “under control”. That same day the Center for Disease Control and Prevention announced its highest tally of cyclosporiasis yet, citing 4,173 confirmed cases and 7,400 more under investigation.
“Many of the additional cases” were reported in Ohio and Michigan, the CDC said.
Getty ImagesIn Monroe County, Brian Clare counts himself among those infected. Though he’s never been officially diagnosed, he has eaten raspberries – on the list of foods to watch – the only produce he’s had in months. He said he also knows at least five other people locally with cyclosporiasis.
Clare has been dealing with symptoms for over three weeks. These include repeatedly waking up throughout the night to relieve himself and “stomach aches real bad”.
“This is the most painful thing I’ve ever been through in my life,” the 52-year-old said.
For Clare, a grain and beef farmer, coping with the illness has required bringing rolls of toilet paper with him atop his tractor. And if the moment calls, “pop a squat in the middle of the field”.
“When you think you gotta go, you got less than two minutes,” he said. “It’s going no matter what.”
There is an antibiotic available that is known to curb symptoms, which Clare heard has helped a friend. But he hasn’t sought medical attention himself yet.
“I’ve not got time to go to no freaking doctor,” he said. “Most farmers try to self-medicate anyway. We don’t have the best insurance in the world.”
Cyclosporiasis has taught Clare some hard lessons, like the importance of cleaning fruit and vegetables before consumption, which he “never” used to do. And, also, paying close attention to where he gets them from.
“I’m never buying raspberries in the store for the rest of my life, ever,” Clare said. “It’s been that miserable.”
