About Kristen Schweighoefer
Kristen Schweighoefer is the environmental health director for the Washtenaw County Health Department.
Resources
Washtenaw County Health Department (WCHD)
Transcription
Rebekah Warren: This is 89.1 WEMU. Summer is a time when many of us enjoy fresh fruits, vegetables, farmers' markets, and backyard barbecues. But this year, Michigan is experiencing something public health experts have never seen before: an unprecedented outbreak of cyclosporiasis, a foodborne illness linked to the cyclospora parasite. This is Issues of the Environment. I'm Rebekah Warren. Joining us to talk about this outbreak is Kristin Schweighoefer, Director of the Washtenaw County Health Department's Environmental Health Division. Kristin, thank you for joining us!
Kristin Schweighoefer: Thank you for having me!
Rebekah Warren: Kristin, most years, Michigan only sees a few dozen cases of cyclosporiasis. This summer, we've seen thousands! Can you help put the scope of this outbreak into perspective for us and our listeners?
Kristin Schweighoefer: Absolutely! So, while we normally see a few cases of cyclosporiasis locally here in Washtenaw County, we have topped hundreds of cases already just in the last month alone. And those numbers are continuing to climb. So, it has been all hands on deck for us at the Health Department.
Rebekah Warren: How significant is Washtenaw County's role in the outbreak overall?
Kristin Schweighoefer: So, Washtenaw County had early cases and many cases. The last data I saw showed that we had the second highest case count in Michigan. And so, given I think we're right behind Wayne County, and they have quite a bit larger population than we do. So, it's been a very significant number of cases in the overall state outbreak.
Rebekah Warren: Well, I'll be honest, Kristin. I'm sure many of our listeners, including myself, had never heard of cyclospora before this summer. Can you tell us a little bit about what exactly it is and what happens when someone becomes infected?
Kristin Schweighoefer: Sure. Well cyclospora is a parasite, as you mentioned. And so, people become infected by consuming food or water that contains the parasite. It's usually not life-threatening. That being said, the symptoms do tend to be pretty miserable. Common symptoms include loss of appetite, weight, cramping, bloating, nausea and, obviously, a lot of gastrointestinal distress, diarrhea, frequent and sometimes explosive bowel movements, which has created quite a few memes on the internet, which have been enjoyable by those of us who've been investigating the more lighthearted side of this.
Rebekah Warren:Well, you've given us some symptoms to think about and look out for. How would you say that this is different from a typical stomach bug that would just resolve in a day or two?
Kristin Schweighoefer: Sure. So, while this is spread similarly by eating contaminated food or water, one of the unique things about cyclospora is that it takes about a week to get sick after becoming infected, and that can range from two days to two weeks or more. And we're seeing again that longer timeframe. Most times, when people eat something that's contaminated, they get sick maybe 24 hours later or two to five days later. This long incubation period, or the time from the exposure to when you get sick, means that there's been a lot of other foods you've consumed. And so, we're really struggling trying to find all of those different foods with that level of specificity to determine the cause of the outbreak.
Rebekah Warren: Well, I have to imagine that that really complicates your investigation if these symptoms can not appear for days or weeks after someone's been exposed. I imagine it'd be kind of hard for folks to remember exactly what they ate when, when it was two weeks ago.
Kristin Schweighoefer: Well, and it's even longer than that. So, there's an exposure. And then, it takes one to two weeks to get sick. And then, you become ill. It might take a few days for you to go to the doctor. It might a few for that test to come back, and then, that test gets reported to the Health Department. Now, we're calling people as soon as we can within, hopefully, the same day that we get those results, if not the next day. But now, we're talking about two, three or maybe even four weeks have passed since you consumed that implicated food. And thinking about the level of specificity with ingredients, we don't want to just know if you had a taco. We want to know did you have cilantro, pico de gallo, lettuce, corn, beans, salsa? What was on that taco? Where was it from? Did you make home-prepared foods? What brand of food did you purchase from? What grocery store and when? So, really getting a lot of level of detail can be very difficult when you're dealing with that timeframe.
Rebekah Warren: You're listening to Issues of the Environment on 89.1 WEMU. I'm Rebekah Warren, and we're talking with Kristin Schweighoefer from the Washtenaw County Health Department about Michigan's unprecedented cyclosporiasis outbreak and what residents should know to stay healthy. Kristin, can you walk us through what happens when someone in Washtenaw County tests positive? You just talked a little bit about how you get the data, but what happens, and how does the Health Department start tracking where that infection may have come from? What kind of questions get asked? And just walk us through how that process works.
Kristin Schweighoefer: Sure. So, in Michigan, there's a number of what we call "reportable diseases," and that means that if a person is diagnosed with one of these reportable illnesses, the labs automatically report them to the Health Department. We have a database that that goes into, and then, our public health team of nurses goes through. And every morning, we open that database up and see what's come in overnight, and we triage those cases to determine who gets priority called and how we're to investigate them. We call the people with the illness, and we ask a number of standard questions for a gastrointestinal illness like cyclosporiasis. We're going to ask about what grocery stores you shopped at, what meals you consumed, if you had any travel, did you have any other exposures, did you have an event that you went to, such as a wedding or graduation party? Were there foods consumed there? And really just trying to get all of that information. And then, we go through and ask, "What common foods do you eat? Do you commonly eat fresh lettuce? If so, is it iceberg? Is it romaine? Is it a different salad blend?" So really, trying to get as much detail as we can. And these calls can take 45 minutes to an hour to really get that level of detail.
Rebekah Warren: Well, Kristin, it's a good thing for folks to think about. And as your investigators continue their work, what practical advice should people follow when buying and preparing fresh produce at this current time?
Kristin Schweighoefer: Right. So, at this time, we do have an implicated food, and that is the iceberg lettuce coming out of Taylor Farms in Mexico. And so, a number of recalls have been put out by that company, so grocery stores and restaurants are aware if they received the product and they are pulling it from their shelves. And then, the Health Department and the state will be doing recall effectiveness checks. So, the implicated foods that have been recalled should be off store shelves. That being said, it's always a good idea to make sure that you're following good food safety recommendations when making and storing foods. Things like washing your hands with soap and clean water, even regardless of what outbreak or not, that's always one of our number one recommendations. And then, thinking about if you do have fresh produce, peeling the outside layers because that's where some of the contamination can lie, making sure that you're washing produce. And if you have greater concern, avoiding fresh produce during times of an outbreak and making sure things are thoroughly cooked can help reduce risk as well.
Rebekah Warren: Outbreaks like this can remind us how interconnected our food system really is. Is there anything that you've learned during this investigation that you think our listeners should know that would help them better understand how our food safety and public health work together?
Kristin Schweighoefer: I think this outbreak really illustrates how complex our food systems are and how many different products maybe can get branded under one name or source that are distributed pretty widely in our food system, right? So, I think that's something to think about is we try to think of supporting our farmers' markets and small businesses. But we do have these large companies that if there is a problem, we find out about it quickly because it's a product that's consumed by many, many folks, and those smaller companies may have a harder time, in terms of finding an outbreak because there's less people that might eat that implicated product.
Rebekah Warren: Kristin, one message that I feel like has become clear is that this illness is treatable, but you need the correct diagnosis, and you need to get treatment. What recommendations do you have for someone who is starting to feel some of these persistent gastrointestinal symptoms?
Kristin Schweighoefer: Sure. So, if people are sick, they should definitely seek medical care. If it's been a couple of days, or if you have different immune conditions where you might be more susceptible to becoming more ill, the illness can resolve on its own. We've not seen a lot of that, I think, with this particular strain, so we're seeing a lot people seek medical treatment and get care. And then, once they receive antibiotics, they tend to feel better very quickly within a day or so, or at least that's the anecdotal stories I've heard. So, again, if you're not feeling well, certainly check with your medical provider to see if you're someone who would benefit from treatment and making sure that it doesn't turn into anything else. And then, I'll also just plug that while cyclosporiasis is getting all the attention, we still have all of our other summer gastrointestinal illnesses out and about. So, things like E. Coli, salmonella, Campylobacter are also all possibilities, and that's part of why when we're investigating this illness, we're making sure that we're not seeing people with different illnesses and trying to make sure there's no other outbreaks or clusters of illnesses that we can detect.
Rebekah Warren: Kristin, thank you for sharing your expertise and for helping us better understand this evolving public health situation. This outbreak is a reminder that protecting public health often starts long before food reaches our table. It also highlights the important work happening behind the scenes as local, state, and federal partners collaborate to identify problems, trace their origins, and provide clear guidance to communities. While investigators continue searching for the source, residents can reduce their risk by carefully preparing fresh produce, staying informed through trusted public health sources, and contacting their health care providers if systems persist. For more information on today's conversation, visit our website at WEMU.org. Issues of the Environment is produced in partnership with the Office of the Washtenaw County Water Resources Commissioner, and you hear it here every Wednesday. I'm Rebekah Warren, and this is your community NPR station, 89.1 WEMU, Ypsilanti.
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