Over 900 people in Washtenaw County, Michigan, have fallen ill with cyclosporiasis since mid‑June. Public health nurse Linda Kim has called more than 100 of those individuals. The illness has been described as excruciating and among the worst many have experienced.
During a July call, one man admitted he would not mind contracting the disease again because of the weight loss it caused. Kim responded with humor, noting the unexpected “benefit.” The exchange illustrates the range of reactions patients have.
Earlier in the year Kim was reassigned to assist with a measles outbreak that affected seven county residents, including five children. The outbreak required intensive contact‑tracing and overtime for all staff. Public health officials urged early vaccination for infants six months and older.
Measles tracing proved difficult as some residents questioned why officials needed their personal information. Kim explained that identifying exposure sites helps contain the virus and prevent larger spread. The county’s measles outbreak was declared over in late May.
In June, a surge of cyclosporiasis cases emerged statewide, with more than 11,000 reported and two deaths linked to underlying health conditions. State health officials emphasized that the infection is rarely fatal in the United States. The Washtenaw County health department began a new round of surveillance and outreach.
Unlike the measles response, patients with cyclosporiasis have been forthcoming, describing symptoms such as severe diarrhea and loss of bowel control. Kim notes that these graphic details, while uncomfortable, aid investigators. Each call is kept under an hour despite the high volume.
Tracing a food‑borne parasite is challenging because symptoms may appear up to two weeks after exposure, making recall difficult. Interviewers ask patients to retrieve restaurant receipts, review grocery‑app purchases, and identify specific food brands or menu items. The process can involve detailed questions about salad mixes, taco types, and other items.
Funding reductions in recent years have strained the county’s public health workforce. Cuts eliminated a contract that previously supported dozens of full‑time employees and limited laboratory resources. Although some funding has been restored, vacancies remain unfilled except for nursing positions, which continue to be understaffed.
The county’s Health Equity Council, created to address disparities, was temporarily closed and later reinstated with funding secured through September. Staff turnover has included a federal disease‑control specialist who was hired, dismissed, and later furloughed amid budget turmoil.
The federal response to the cyclosporiasis outbreak has been slower than local officials hoped. Identification of lettuce as a likely source and removal of contaminated products from fast‑food outlets occurred before an official statement from the national agency. Officials acknowledge that pinpointing sources for this parasite often takes considerable time.
To sustain morale, supervisors have provided coffee, pizza, and brief breaks for the contact‑tracing team. These gestures are intended to prevent burnout rather than serve as rewards. Kim remains committed to her role, describing the experience as a surreal introduction to public‑health work.
She emphasizes the difficulty of responding when national guidance lags behind local realities. “If the nation does not know what’s happening, how can we be expected to?” she said.
