Why does America have a diarrhoea outbreak?

[00:00:00]Good morning and welcome to the daily odds. It is Thursday the 23rd of July.

[00:00:03]I'm Sam Koslowski.

[00:00:04]>> I'm Zara Sidler.

[00:00:06]>> Nearly 7,000 Americans have been struck down by a gut parasite [music] and some very explosive diarrhea linked to Taco Bell lettuce across 34 US states. On today's podcast, we're going to explain how the outbreak started, why scientists think it has spread so quickly, and whether US federal budget cuts are making it harder to stop.

[00:00:30]>> I for one am absolutely thrilled that I have been asked to join the podcast on the day that we talk about explosive diarrhea.

[00:00:37]>> Yeah.

[00:00:37]>> Um as someone in our comment section said when we posted this, thank God it's not just being described as diarrhea, but in fact explosive diarrhea.

[00:00:46]>> in every media report.

[00:00:47]>> Every single one. Um it's very descriptive, it's very evocative. Um it's certainly not usually what I feel like listening to or reading first thing in the morning, but >> But it also kind of makes you it makes you a bit curious because I feel like when these sorts of mass food stories come out, there's a little bit of it could be me.

[00:01:07]>> 100%. Well, I guess on that note, we should start by setting the scene that this is happening in the US. Um you're not at risk of explosive [laughter] I'm not going to get through this podcast of explosive diarrhea um here in Australia if you're eating lettuce because this this hasn't been detected here. Talk me through I guess top level what do people need to know about this story?

[00:01:29]>> So the scientific name is called Cyclospora cayetanensis.

[00:01:32]>> I prefer explosive diarrhea.

[00:01:33]>> It's kind of maybe that's why the media is using it as a bit of a crutch, but it's an intestinal illness caused by a microscopic parasite that your body ingests in some way. It's smaller than a human red blood cell, and the signature symptom, as you've mentioned a couple of times already, is profuse explosive watery diarrhea. There was one scientific paper Thank you. There was one scientific paper I was reading that explains that it's a type of diarrhea that's like an all get out. Like a mass evacuation. So >> [laughter] >> That's revolting.

[00:02:08]>> I this is this is actually important because if we're going to get through this.

[00:02:14]You also get appetite loss, unsurprising, stomach cramps.

[00:02:17]>> I have appetite loss listening to this.

[00:02:19]>> Yeah, [laughter] bloating, fatigue, and a low-grade fever. Now it shows up 1 week after you're exposed to the parasite. It can relapse and last for weeks without treatment, but it is treatable and most people do improve within a couple of days.

[00:02:34]>> Thrilled to hear it. Um how are people being exposed to this in the first place though? Like why has this become a story on the scale perhaps other than the fact that it's a little bit funny? It is actually quite serious. How has this story come to be?

[00:02:47]>> Well, the FDA, which is the Food and Drug Administration, kind of equivalent to some of the food safety bodies that we have here, maybe perhaps the TGA's remit is captured there as well.

[00:02:58]And the CDC, which is the disease control body we all got to know quite well during the pandemic. They've both been watching the outbreak that obviously starts getting reported from a local hospital level in some of the key states. And what they've found is that it's connected to shredded iceberg lettuce from Taylor Farms in Mexico that's been served at Taco Bell, one of the most popular fast food joints across the US.

[00:03:24]>> And that sentence ruined what I was going to say, which is that this is why I don't eat vegetables, but I do eat fast food famously [laughter] and I love tacos. So unfortunately, I am not insulated from this.

[00:03:38]>> Well, it's probably one of the least offensive vegetables out there, a sprinkling of iceberg lettuce on a taco.

[00:03:44]Now Taco Bell says that all affected lettuce has already been removed.

[00:03:48]What's really important though is that it's really hard to test for and it's really hard to track. So, no food sample has actually returned a confirmed positive for this parasite. And the way that they discovered that it was the iceberg lettuce was through kind of diary entry records of what patients had ingested in the lead up to them becoming sick.

[00:04:11]>> Interesting.

[00:04:12]>> Yeah, it can't even be tested.

[00:04:14]It's it's a very very interesting situation. There is a test that is essentially Do you remember the PCR tests?

[00:04:21]>> Yeah.

[00:04:21]>> So, it's essentially a PCR test for your stools. Um and >> Except the PCR test would be a less pleasant >> Well, it's um it's pretty intense because a standard stool test won't even pick it up. So, there's one test that clinicians can use now now that they've identified the cause to to track whether you have it or not. And uh a lot of cases therefore have gone undiagnosed. So, to give you a sense of how many cases there are um >> about 7,000 confirmed and suspected nationally. There's uh about 1,600 cases that have been lab confirmed. Now that there's kind of a standard though for that test working, they're expecting that number to rise quite quickly. 141 people have ended up in hospital. Zero people have died because it is able to be treated when you're in hospital and they can replenish your fluids as well as stop the spread of that parasite.

[00:05:18]>> Hey, it's Billy. I know I'm often talking to you on the podcast, but you might not know what I do outside of the podcast. [music] I lead the editorial team at TDA. And a big focus for me at the moment is what we do with AI. As a newsroom, we are operating in a world where misinformation is spreading faster than ever. [music] And AI is changing how people find and consume news, which is why our relationship with you matters more than anything. The strongest thing we have is a direct connection [music] with our audience. So, if you're listening to this, hit follow or subscribe wherever you're listening or watching. It's the best way that you can help our independent media company [music] grow. And thank you for being part of the Daily Oz community.

[00:06:02]>> Okay, so just before the break, you were talking about, I guess, the scope of this. Very important to lead with the fact that there have been zero deaths reported um as a result of this parasite, uh but there have been hospitalizations, and certainly uh the number of people that have been affected is now reaching uh late into the thousands. What has the FDA done or announced in response to this outbreak?

[00:06:26]>> Well, we're going to get into the political side of uh the kind of subtext of what's been playing out, but what you need to know about the FDA is that they came out on the 18th of July, uh >> [clears throat] >> so a couple of days ago, and they announced that they had done a test on the lettuce and found this parasite, and that they needed to warn everybody who had ingested the lettuce that they could become ill. They then retracted that 2 days later and said it was a false positive. And so, from that point, you really started to see, especially in news reports and local news reports, a lot of confusion over some clarity and guidance from the peak health body in the US. Now, that recall still stands.

[00:07:03]So, they're saying you can't eat the lettuce, you you need to make sure that you don't have any of the lettuce in your house, but we're actually not sure if it's got the parasite or not.

[00:07:12]>> Ah, I mean, rather be safe than sorry.

[00:07:14]>> And so, then it was actually up to the farm, Taylor Farms, to come out and say, "We've tested the lettuce, and we can confirm that there is a parasite in it, and we're very, very sorry, but you need to not eat the lettuce."

[00:07:24]>> And they're servicing Taco Bell, is that right?

[00:07:26]>> Exactly. So, they they're a huge industrial-size uh iceberg lettuce farm in Mexico. They also service Olive Garden and Red Lobster, which are two big two big American chains. Uh they have been linked to a a of this parasite before.

[00:07:42]>> Oh.

[00:07:42]>> So, they uh were linked to a cluster in 2013, 2018, and 2020.

[00:07:47]>> That's so many clusters.

[00:07:49]>> Yeah, and so it will look there's it's not just them. There have been um instances of this parasite being found in fruit and vegetables across the US over the last couple of decades, but cases are trending upwards.

[00:08:03]>> Mhm.

[00:08:04]>> Nobody's particularly sure how to because of those identification issues how to actually ascertain before you send out the letters to be eaten whether there is that parasite there. So, the conditions are not new, but the scale of this is.

[00:08:15]>> Yeah, super interesting. There you mentioned the political side of this.

[00:08:20]Obviously, we have to go into the politics of it all. Can't just talk about explosive diarrhea and leave it there.

[00:08:25]Um what has the political response to this been?

[00:08:28]>> Well, what's been interesting over the last few days has been watching how the conversation has shifted to the resourcing requirements of those two major federal agencies I mentioned, the FDA and the CDC, because they've had some huge cuts over the last couple of years connected to Doge.

[00:08:43]>> Okay.

[00:08:43]>> So, the uh government efficiency program famously run by Elon Musk during >> Formerly run by Elon Musk.

[00:08:49]>> Formerly run by Elon Musk. So, Doge took a lot of resources out of those two agencies. Uh there's been resignations since then because people still in the agencies have been feeling like it's been under-resourced. Uh and the people who have left the agencies have kind of come out in the last few days and said they're not surprised that an outbreak like this has happened. And it's gone a few days uncontrolled because of the lack of national visibility they can handle in such a big country. Uh and they've now I mean one team in the surveillance lab at the CDC that particularly looks at parasites like this has been cut from 11 to three.

[00:09:26]>> Okay.

[00:09:26]>> And so, that's been really interesting to watch. Then there's also a conversation about healthcare resources and healthcare staffing in those states that are severely affected. An influx of 7,000 people can overwhelm a health care system. Now, the CDC has come out and said the same systems and processes remain in place. There's no need to panic. Don't eat the lettuce.

[00:09:47]>> Don't eat the lettuce. Wise words there from the CDC. The man in charge of that health system in the US at the moment is RFK Jr.

[00:09:57]Who has certainly been very explicit and very forthcoming with his views on all things health-related. What has his response to this been?

[00:10:06]>> Yes, so this is somebody we've talked about on this podcast before, the leader of America's health care system. So, he's come out in the last few days and said that the outbreak is under control, that the source has been identified, which is that Taylor's farm. What's been interesting to watch from him is the questions he's been getting around the decision to cut funding from a program called FoodNet, which is a food testing program across the US. That has had massive redundancies in the last 12 months that would have potentially caught something like this. Here's a little grab of what he had to say.

[00:10:40]>> Those criticisms are invalid. We've had no cuts in our surveillance program. We did cut some in the FoodNet program, but they were for redundant surveillance, and all the states will tell you that.

[00:10:52]We're still doing forensics. We're still doing surveillance in all the states.

[00:10:56]>> Unsurprisingly, we've had some pushback from the Democrats who have essentially said that the cuts were foolish, short-sighted, self-indulgent, and that RFK Jr. has actively undermined food safety in America. I do have to say though that there is so much medical dispute in the last week around the exact link and whether preemptive testing and tighter regulation could have actually caught something like this. There's a lot of discussion about those previous examples where there was tighter food regulation, and that failed to catch it as well. So, a medical situation that's kind of puzzled everybody.

[00:11:32]>> I do would just want to end the podcast with where we started, which is that if you're listening to this in Australia, you don't have to throw away your lettuce. Rather, you shouldn't throw away your lettuce.

[00:11:41]>> No need to pull over. No need to pull over. Everything's going to be fine.

[00:11:44]>> that now.

[00:11:46]Talk to me about why Aussies shouldn't be worried.

[00:11:49]>> We've got a low risk to this particular parasite. It's not a nationally notifiable disease here in Australia. We don't particularly scan for it. And the reason why is because we have such tight biosecurity controls on what fruit and vegetable comes into Australia.

[00:12:04]>> Yeah, you got to go to the "will declare" not the "do not declare".

[00:12:09]>> Exactly. You got to pick the other lane.

[00:12:11]So, that specific Mexican iceberg lettuce isn't available in the country.

[00:12:15]The general consumer advice though still stands of you know, wash your fruit and veggies before you eat it. Make sure that you cut off any bits that look a bit dodgy and cooking all the greens that you get will always kill parasites anyway. So, it's always safer to cook your broccoli rather than eat it raw. Uh >> I guess my first step is eating broccoli.

[00:12:36]>> [laughter] >> That would be a good first step. You are immune from the disease.

[00:12:39]>> so immune.

[00:12:40]>> But no, this is for now a US-centric issue and sorry if that podcast was a bit but I thought it was worth talking about.

[00:12:47]>> Honestly, the fact that it had gone this far without you saying a dad joke and the fact that it was the last line, very impressive, Sam.

[00:12:53]>> Well, I wanted to give the parasite the dignity of its moment in the sun.

[00:12:56]>> There you go. All right, Sam. You have been redeemed in the ears of the listeners um >> I may have redeemed that episode.

[00:13:04]>> Yeah, should we play that again?

[00:13:06]Someone said "Viva la Sam's tidbit" and it really just like he had a like little skip in his step as a result of that.

[00:13:14]>> kind of wanting to never do one again because that was a beautiful place to be.

[00:13:17]>> how can you ever improve on this tidbit?

[00:13:19]>> I'm not going to improve, but I'm going to give you one that is very interesting. A different tone to the Eastern Rosella.

[00:13:26]>> Okay, I'll stop singing.

[00:13:26]>> [music] >> So, the Commonwealth Games kicks off this week in Glasgow.

[00:13:34]>> Today.

[00:13:34]>> Today. It's uh gone I would say a little under the radar, but there are still some incredible athlete stories from the competing countries. And one that's particularly interesting is a long-distance swimmer from Scotland is the brother of Madeleine McCann, >> Yeah.

[00:13:50]>> who was the 4-year-old who went missing in Portugal in 2007 and hasn't been seen since. Shawn McCann.

[00:13:57]>> There are some Daily Mail articles that would suggest otherwise, but yes, that has been a little bit of web traffic.

[00:14:03]>> Big conspiracy theory magnet that story.

[00:14:06]It It just hasn't ever diminished in its power to just really attract audience.

[00:14:13]>> Almost time that there's an entire category of true crime documentaries dedicated to the case of missing Madeleine McCann.

[00:14:19]>> But she's never been found.

[00:14:20]>> She's never been found. Shawn McCann, her younger brother, was 2 years old when Madeleine went missing and he is competing for Scotland in the long-distance swimming at the games, uh which yeah, kick off today. So, a fascinating story there.

[00:14:34]>> I think what will be interesting is that um her parents were in the news a lot around this story.

[00:14:41]I personally haven't seen [music] anything about them in >> True. Interesting.

[00:14:46]>> Presumably they will go to support their son as he embarks on this professional athlete journey >> [music] >> and seeing them in such a different context will be so interesting.

[00:14:56]>> Yeah, it will be. And it's not uh it's not always the most kind of watched event, the long-distance swimming. And so I'd say there's a chance that it will be a lot more watched this year because of that one Scottish swimmer.

[00:15:09]>> Fascinating. Well, Sam, thank you [music] so much. And thank you for listening to this explosive episode of The Daily Oz. Uh we'll be back later today with the headlines, but until then, have a great day.