← That Can't Be True with Chelsea Clinton
That Can't Be True with Chelsea Clinton
Is Your Fruit Safe? The Cyclospora Parasite Outbreak, Explained with Dr. Katelyn Jetelina
00:36:03
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- [00:02]
Dr. Caitlin Jettalina
Lemonada.
- [00:11]
Chelsea Clinton
Welcome to that Can't Be True, a show that sorts fact from fiction, especially on issues impacting our health. I'm Chelsea Clinton and today we're doing a special episode on Cyclospora. What it is, what we need to do to keep ourselves and our families safe, and just what we all should know. And I can't think of a better person to have this conversation with than Dr. Caitlin Jettalina, an epidemiologist, scientific communicator, and the founder of your local epidemiologist, where she translates fast moving and sometimes slow moving public health science for an ever growing global audience. I'm just always so grateful to her for all that she's doing. I always learn a lot when I read her newsletter, when I watch her Instagram, or certainly in the conversations I've been lucky enough to have with her. Hi, Caitlin. Where are you? We formally get started. You said you were in a hotel.
- [01:06]
Dr. Caitlin Jettalina
Where, where do I. I'm in Kentucky. I am in Kentucky. There is a very big public health conference here. All local and state public health departments are here. So I'm giving a plenary and there's lots to talk about in public health these days. So it's a busy week.
- [01:27]
Chelsea Clinton
Sure are. I thought we would just jump right into the news of the day if that's. If that's okay.
- [01:33]
Dr. Caitlin Jettalina
Sounds great.
- [01:34]
Chelsea Clinton
And go to a TikTok clip reacting to the news that Taco Bell was pulling some of its fresh produce as a precaution. Just given all that many of us are experiencing these days. So here's the that can't be true tape.
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TikTok User (Clip)
When Taco Bell is behaving more like the CDC than the CDC is, that's when you know that is really bad. Literally. The country is in the midst of a nationwide outbreak of explosive diarrhea caused by a parasite that the CDC stopped tracking in July of 2025 before Doge cut it. A CDC program called FoodNet used to track eight foodborne pathogens across the country. One of which was Cyclospora, which has now sickened over 2000 people in 28 states with explosive diarrhea that is so bad that one person affected described it as something she wouldn't wish on her worst enemy, saying that she had been to the bathroom flying 40 times each day for the last six days and nothing had been solid.
- [02:30]
Chelsea Clinton
So Caitlin reaction.
- [02:32]
Dr. Caitlin Jettalina
She's great.
- [02:33]
Chelsea Clinton
Yeah, that is great. And there's a lot of truth in that. But maybe you can tell us kind of maybe what's true and what's hype both about the outbreak and also, was the CDC tracking this a year ago and now no longer is?
- [02:51]
Dr. Caitlin Jettalina
Yeah. So this is a massive outbreak. Daily cases change. I think we're up to more than 5,000 cases right now on Wednesday. Right.
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Chelsea Clinton
It's more than doubled, right, since she posted that clip.
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Dr. Caitlin Jettalina
It's. Yeah, more than doubled. It's increasing very quickly. You know, we have cyclospora cases every single year, but annually we see about 3,000 to 4,000 cases. And so 5,000 plus cases and one outbreak is absolutely abnormal. This is the largest outbreak we've really ever seen in US History of cyclospora. And so. So that is completely true. I think the real question right now is why and is Doge is federal oversight, Is all of these things really contributing to it? Now? That video mentioned FoodNet. FoodNet was cut. That was a CDC surveillance program. I think it was cut, I don't know, last September or October of 20. But with FoodNet, it was never designed to actually track outbreaks and response. It was more of surveillance on the background to look at trends over time and for researchers to have access to that data. What is happening, though, and I think really a big problem is lack of centralized coordination from the federal government. We have incredibly siloed health systems. No one really knows what the right hand is talking to the left left hand. We have insufficient capacity at the state and local health departments. And like these interviews, I mean, the only way to figure out what the source of this is is epidemiological interviews. And that is a lonely epidemiologist like myself interviewing someone for probably around two hours to understand what they've ate the past two weeks. It's very laborious, takes a lot of resources. And when those resources are cut or public health is chronically underfunded, they get overwhelmed incredibly quickly.
- [04:58]
Chelsea Clinton
So, Caitlin, you know, do you have any sense of how many of the patients affected have been interviewed? And what do you think, you know, in this moment really would be required? Do we need 3,000 Dr. Jettalinas?
- [05:16]
Dr. Caitlin Jettalina
Yeah, you know, 3,000 Caitlin Jettalinas is a terrifying picture in my brain. But that is what we need. Like, we need a workforce. Right. And that takes resources. Parasitic teeth teams have been chronically underfunded. That's even before we lost 1/4 of HHS scientists. Right. So we just need more people. We need the historical knowledge that a lot of these experts bring. We need the resources, and we need, unfortunately, time. But what I think I need and what I think patients need incredibly quickly Is a lot of transparency at the federal government of what the heck is happening. Is very unusual for the FDA to not come out yet explaining what is the signal. In fact, Michigan came out before the fda, which is very. Is very rare. I would say they're putting their neck out there for the patients. We need better communication. It's absolutely insane to me that the federal government hasn't been communicating with a sense of urgency that people and filling in information gaps that people have and is leading people like her on TikTok and me and others to fill the gaps. And we need a whole lot of accountability. Why did this happen and how are we going to prevent it in the future?
- [06:42]
Chelsea Clinton
So let's take a step back. I was so struck when you said this is the largest outbreak of cyclospora that we've ever had. So maybe you can tell us exactly kind of what this is. You mentioned it's a parasite.
- [06:57]
Dr. Caitlin Jettalina
Yeah. So the culprit is this microscopic parasite called Cyclospora and it spreads through food and water contaminated with human feces. So it only really lives in humans, it doesn't live in other animals. And so this parasite, once you ingest it, it lives in the human gut and then it's shed through the stool. Human to human transmission doesn't happen.
- [07:24]
Chelsea Clinton
It is.
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Dr. Caitlin Jettalina
This outbreak is ballooning quickly because the US hasn't publicly pinpointed a contaminated food. How does contamination for this outbreak? It's unclear, but broadly there are two possibilities. One is contamination at the farm level. So poor field sanitation, such as like workers without adequate bathroom access or contaminated irrigation water. The second way is contamination during processing, typically via contaminated water at the packaging or washing stage. And we don't know which one started. So officially from the fda, we don't know what the exact source is, but like I said earlier, Michigan came out on Monday to say there's a very clear signal with lettuce and bagged salads. And so what should people do? What I'm doing is you avoid lettuce right now. Right. Bagged salads that you get at grocery stores or those box salads that you get at grocery stores. This lettuce can also be in restaurants. And so that's why we've seen Taco Bell, for example, last week pull a lot of their supply. But we don't know who the distributor is yet. And we don't know what other restaurants are infected in the. And we don't know if there's other produce infected. And so being very careful with other produce that has created or started Cyclospora outbreaks in the past like cilantro or raspberries or things with very rough edges where the parasite can lodge in there. And it's hard to get out with washing.
- [09:09]
Chelsea Clinton
And I think that's a really important point, right. For those of us who diligently like wash our fruits and vegetables, wash our hands while we're dealing with food, after we're dealing with food, we can't wash the parasites off.
- [09:24]
Dr. Caitlin Jettalina
That's right. Washing helps really little because these parasites, microscopic parasites, like I said, hide in those grooves and those crevices. They can also hide from home remedies. They're very, these parasites that have a shell around them. And so it's not even like chlorine or lemon juice can really get into it. The really only thing that kills it is cooking the food. And you need to cook the food to an internal temperature of 158, which is like about, I don't know, a minute and a half when you're sauteing raw spinach, for example.
- [09:59]
Chelsea Clinton
And I think that's exactly the type of very sensible and straightforward guidance that historically we have gotten from the government. And then why we're so thankful, Caitlin, to folks like you and including you for saying things like that that people actually can use in their, in their daily lives.
- [10:22]
Dr. Caitlin Jettalina
And I hope that it's empowering. Right. There are steps we can all take to reduce our risk while these systems catch up. Or maybe even without these systems these days, I don't know. You know, it feels like I'm a mom. It feels like very much we're kind of left on our own to figure everything out. And that's just not how I've ever viewed government. But that is the reality that we're in right now. And there are things individuals can do. It's just a matter of reaching people and educating them so they can make evidence based decisions themselves. So, Caitlin, I do want to go
- [11:08]
Chelsea Clinton
back to really talk about the role of government because I certainly believe part of what has helped our country always strive to be great and to be healthier is that historically we've really invested in not only basic science research and applied science research, but then ensuring that the government is continually conscientiously learning from what we've learned and putting into practice systems to help keep us healthy and safe and public health, and then also help us get healthier, as we all would hope to be, kind of through medicine. And so much of that seems to have been fractured over the last year and a Half. So just what should we know about where the world was? I guess January of 2025 and kind of what was working well, as we think about the future and also what we've never quite gotten right, but that we could if we really marshaled like time, energy and resources.
- [12:14]
Dr. Caitlin Jettalina
Yeah. So before 2025, I was actually working with Mandy Cohen and then before that Rochelle Walensky at cdc. And you know, Rochelle Wolinsky called me and asked me to come help with scientific communication. And you know, I waltzed right around in. I'm like, oh, I'm going to fix everything. This is going to be so easy. But it's hard. These systems are so, so hard to change, but they're not impossible. And I would say that back in 2025, 2019, whatever year you want to pick the status quo wasn't great. You know, these institutions were built for a different time. They haven't kept up with Americans needs or the needs of today. And they've left people behind. And when you leave people behind, they don't see themselves in it. They lose trust. And I think that's kind of where we're at right now. And so, you know, going forward, there will be a time we're already there that there's going to be rubble all around the floor. And we are going to need to reimagine these systems so they can be in better service of the American people, because that's ultimately what we need. I cannot stand RFK for a lot of reasons, but there are things that he's correct on and there's some common ground. And one of them is we need to be doing better with nutrition and with corporate interests and holding people accountable. And I think that's a lot of where the FDA can go. Another big bucket I think we very much need to improve on is data. Right. Data is our eyes. And data is so fragmented in the United States. It's incredibly decentralized. And honestly like very much in like stuck in the 80s. Like I think we're getting there better. I mean during COVID we would be submitting, we would have sheets that PDFs that we were faxing in 2020. Like we need to just get a whole lot more efficient with data so we can see these outbreaks faster. And then I know I just keep repeating this but like communication and engagement is absolutely key in a lot of this too. I mean we could have the most brilliant scientists, but if we're not listening to the needs on the ground, if we're not then responding to their needs and helping them in a timely, understandable translata, an actionable way. We're always going to miss the mark in government and especially in public health and communications has always kind of felt like this afterthought on response and outbreaks and public health and even with food. But it has to be a core capacity, it has to be integrated in every single thing that we do.
- [14:59]
Chelsea Clinton
I wonder if we can just return back to this outbreak for a moment of kind of what should parents know? What should people know? Like, how do you know when you're so sick that you really should call the doctor? When should you go to the emergency room?
- [15:15]
Dr. Caitlin Jettalina
Yeah, I mean, I think what we bring up is risk, right? Risk is on a spectrum. It's not dichotomous, it's not black and white. And there are certainly higher risk people with cyclospora, pregnant women as well as older adults as well as immunocompromised. And this is rarely deadly, but what it can cause is severe dehydration. And that is what we really are concerned with, with these high risk patients. And so if you're in one of those three categories, don't toughen it out at home, call your clinical care team. The reason why is because you can get tested for this and if you test positive, there are treatment options. So like if you're immunocompromised or older adult, for example, you can an antibiotic that helps a lot, clear this parasite. And so, yeah, don't toughen it out. There are, if you have symptoms, there are other types of bugs out there that can cause diarrhea. One kind of tail sign of Cyclospora is that it lasts for more than a week and then it comes and goes for weeks. It's kind of nasty. And so if you have it for a very long time, it's also time to call your clinical K team. There was this one outbreak in Nepal, one patient had it for 107 days. Like it's just not a fun thing. Yes, yes, it can last for weeks. It's just not, I know it's not a fun thing. And that's why I think prevention is the key here. And there are things that we can do and then, you know, if you are high risk, I would be a lot more diligent than the less risky, the less at risk. Which means, you know, definitely not eating raspberries until we get a certain source, definitely cooking your spinach and, you know, really taking those extra steps. So you, you don't have it for 107 days.
- [17:21]
Chelsea Clinton
What. What symptoms should people look for outside of diarrhea? Do sometimes people get, you know, stomach pains before they have diarrhea? Does it, you know, manifest in any other kind of symptomology that people should be mindful of?
- [17:37]
Dr. Caitlin Jettalina
Yeah, I mean, it's very watery diarrhea. You have the cramping, you have the bloating, you have the gas, you have the fatigue. Vomiting and fever are less common than other bugs. So really it's your back end, not your front end. I don't know if I should say that on a podcast, but it's okay, Caitlin. Okay. And then, like I said, one of the biggest signs is how long it lasts, weeks if untreated, and it can relapse is one of the biggest signs that you have this compared to another virus, which is called norovirus, which hits hard and fast, but doesn't drag on.
- [18:18]
Chelsea Clinton
Yeah, we're very familiar with norovirus in our house, given kind of the age of our children. If someone thinks they may have been exposed to cyclospora, is there anything they can do?
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Dr. Caitlin Jettalina
I mean, the one thing is you can call your clinical care team. Mostly if you are healthy. It honestly just means drinking fluids and staying at home. Unfortunately, next to a toilet, that's kind of what it looks like. One thing, though, I do want to call out is that it's really important that if you are sick and a health department calls you for an investigation, which means like an interview, please participate because it will help others avoid the misery you're experiencing, because your data will help find that signal. It'll also increase the likelihood of accountability down the road. And so if you're. I know people are miserable, but if the health department calls, please answer, because that will help too you.
- [19:21]
Chelsea Clinton
Caitlin, One of the things that I certainly have heard a lot of my friends talking about is only using frozen fruit to either make smoothies for kids or as a snack for kids. Is frozen fruit safe or is there also concern around frozen fruit?
- [19:39]
Dr. Caitlin Jettalina
Yeah, so freezing isn't really reliable because in order to kill this, your home freezer is just not to going cold enough to kill the parasite. Like, you need a deep freeze for a long time for that parasite to be frozen. Now I have fruit in my freezer. Maybe I shouldn't admit this. That was like there before May. And you know, this outbreak started in May or June, so I am very confident in using that frozen fruit. But just the fact that it was. It's in the freezer. Doesn't necessarily make it automatically safe because of that temperature. Really the only thing that kills it is heat. I will say that where you live really matters. And Chelsea, I think you're in New York and New York is having a big outbreak. I live in California, which doesn't seem to have a signal. And so this is where risk really comes into play that like, if I was a mom in New York, I wouldn't really be touching the raspberries for my kids. But because I'm in California, it doesn't look like we have any cases connected to this outbreak. I will be feeding them raspberries. Right. And I think that this is where risk is on that spectrum and that scale as well as risk tolerance as well as like, how do we just get food in our kids bellies Right. If their only thing they're eating is raspberries? I get that too as a mom. So all of it is we're all just doing the best we can until we get more clear signals of where this really is coming from.
- [21:16]
Chelsea Clinton
I have two more questions in this vein before we go on to our next segment. One is I've also heard, admittedly, yes, in New York, but from friends elsewhere, of how people really feel. Like if we're buying from a local farmer's market, hopefully that's safer because it's not the industrialized kind of large scale farming that otherwise might show up in Whole Foods or a Safeway or an Kroger or an Albertsons or kind of whatever your local grocery store is wherever you live in the country.
- [21:51]
Lemonada Media Announcer
Is that
- [21:54]
Chelsea Clinton
kind of a salient, you know, evidence based kind of hypothesis or no?
- [22:01]
Dr. Caitlin Jettalina
Yeah, local produce is. Risk is much lower than big distributors. In fact, there's never been a documented Cyclosporus spora outbreak linked to a local farm.
- [22:14]
Chelsea Clinton
So that's really a powerful. That's super powerful, Caitlin, what you just said.
- [22:19]
Dr. Caitlin Jettalina
Yes. So I would be a lot more comfortable. The risk is lower. That said, Cyclospora lives in soil and contaminated water. So if a local farm, like a local farm could be affected if it shares a water source next to a large commercial farm, because we don't know like where the real culprit is. I think it's in the distribution. I don't actually think it's at the farm level. We don't know yet. But the risk is lower with local farms. Absolutely.
- [22:51]
Chelsea Clinton
And do you have a sense of where this could have originated?
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Dr. Caitlin Jettalina
Yeah. So what we see with Cyclospora outbreaks is that sure, it can enter the food supply at the Farm level. But outbreaks get amplified. They really blow up and scale at that packing, processing, distribution facility. So if I were a betting woman, I would bet on distribution. The other reason is because this is a massive outbreak with this massive scale. It just has to be some distribution network. I know they're complex, but like, at that we're not. It's not going to be from a local farm. Right. It's going to be something that really gets amplified.
- [23:37]
Chelsea Clinton
Too many people in too many places.
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Dr. Caitlin Jettalina
Yeah, right. And so many signals that like it has to be either a huge distributor, a very huge, you know, fast food restaurant. I know Taco Bell came out. But like, I think we'll be getting a lot more answers quick. I hope we get more answers quickly. But that, that's where I would put most of my resources is finding that upstream source and trying to stop it from there.
- [24:07]
Chelsea Clinton
Yeah, I want to talk about public health wins, which I know you highlight on your Instagram particularly because I do think it is important that we not only acknowledge but celebrate where we've made real advancements in helping to protect public health, but also individual health and well being. So I wonder if you can just share a few public health wins that you're particularly excited about that have recently really advanced.
- [24:56]
Dr. Caitlin Jettalina
I mean, I think right when you said that, the one thing that really popped into my mind is the opioid outbreak and how quickly that is declining incredibly fast. And that was because of public health. That was because of better treatment and access as well as education and harm reduction on the streets from street teams and because of accountability through our, I mean it was, it was a, all hands on deck sort of response. And we are starting to see numbers. It's not perfect everywhere, I will say that, but they are starting to nosedive. And given that that opioid outbreak impacted so traumatically so many families in this country, that is like the, that's a big, A big piece of hope and joy is seeing those, those numbers down. We're starting to see decrease in obesity. I think it's a really big question with GLP1s versus public health. But you know, I think any reason we're seeing a decline in obesity as well as, you know, heart disease and the number one killer in the United States. That is a huge public health win. And you know, other. There's other things like, you know, the hantavirus outbreak didn't get any bigger. That was all because of public health work on the ground and coordination. So I try to find hope and light wherever I can these days. And wherever I look, these public health workers are working double time, sometimes 2, 3, 4 jobs in the service of their community. And that's the whole reason I got into this field in this first place. It's so we're in it for the mission. None of us get a lot of money for it, but we are there to protect communities and we'll continue to do so even with less resources.
- [26:57]
Chelsea Clinton
That's great. Well, Caitlin, just. I'm so thankful for all of your time and just want to end as we often, or I guess always do, where we finish with a fact or fiction segment where I'll throw out some claims, some of which we've already talked about, but I want to just ensure we kind of underline emphatically. And you're going to tell us whether they're fact or fiction or if there's nuance.
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Dr. Caitlin Jettalina
Okay, let's go. I'm a nuanced person, so we'll see how I do.
- [27:29]
Chelsea Clinton
I mean, I think nuance is really important. I also think some of these will probably even kind of push you out of nuance. Cyclospora is mostly a foodborne illness. Fact or fiction?
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TikTok User (Clip)
Fact.
- [27:51]
Chelsea Clinton
Cyclospora can be hard to trace because it often comes from multiple sources. Fact or fiction?
- [27:58]
Dr. Caitlin Jettalina
This is true. That is fact.
- [28:02]
Chelsea Clinton
It's harder to track parasites than bacteria as it relates to foodborne illness. Fact or fiction?
- [28:13]
Dr. Caitlin Jettalina
It is fact, specifically with cyclospora because tests are not as available as other parasites.
- [28:25]
Chelsea Clinton
Cyclospora is generally seasonal, so we see it more in the summer than winter, spring or fall.
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Dr. Caitlin Jettalina
Definitely. Fact.
- [28:35]
Chelsea Clinton
This I have to ask because I've heard this now from at least three friends. If you use an at home ozone machine, it kills the cyclospora on your produce.
- [28:51]
Dr. Caitlin Jettalina
Fiction. I don't think we have the. We don't have any evidence that it does.
- [28:58]
Chelsea Clinton
Kaylin. I'm going to clip that part and send it to my friends because I worry they have a false sense of safety and I'm very concerned for them and their families. All right. A couple of other things that I know that you've really talked a lot about in your newsletter and on Instagram. Kids build immunity by getting sick and need to build immunity by getting sick. Fact or fiction?
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Dr. Caitlin Jettalina
Fiction.
- [29:26]
Chelsea Clinton
Vaccines are great.
- [29:28]
Dr. Caitlin Jettalina
Fact. Yay.
- [29:31]
Chelsea Clinton
The flu shot can give you the flu. Fact or fiction?
- [29:34]
Dr. Caitlin Jettalina
Fiction.
- [29:35]
Chelsea Clinton
That one doesn't seem to die. Caitlin, why is that? I hear that all the time.
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Dr. Caitlin Jettalina
It doesn't.
- [29:41]
Chelsea Clinton
Why? That one really has like very strong just resistance to all evidence. And experts like yourself telling us the truth. Why is that one so stubborn?
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Dr. Caitlin Jettalina
Yeah, I think it's correlation versus causation. Right. Because when you're getting the flu vaccine, a lot of flu is circulating. And so you get a. There are people that get the flu vaccine and then get the flu because they went to Walgreens and then got the flu while they're getting in line for the flu vaccine. Right. Like, there's just what people experience on the ground. I don't want to dismiss it. But also we see in the evidence that, I mean, it's just not. It's not a live vaccine. It's just not even biologically possible.
- [30:26]
Chelsea Clinton
And something I think we've talked about before, but just once again, want to bring up. Ivermectin is a miracle drug and can cure anything. Fact or fiction?
- [30:37]
Dr. Caitlin Jettalina
Fiction.
- [30:38]
Chelsea Clinton
Another one that just seems to really have longer legs than I would have anticipated. Yes, the ivermectin lobby is surprisingly strong. Caitlin, Dr. Jettalina, thank you just for all that you're doing for all of us. Thank you for your time today. I always learn so much from you. I'm gonna look forward to learning the answer about kind of the deep freezing in grocery stores or not as it relates to cyclospora. And I'm already looking forward to our next conversation. Thank you just for everything.
- [31:12]
Dr. Caitlin Jettalina
Thank you for having me. Appreciate being here.
- [31:20]
Chelsea Clinton
You can follow Dr. Caitlin Jettalina at Yourlocaleepidemiologist on Instagram and on her newsletter on Substack. Thanks for listening. Talk to you next week.
- [31:34]
Lemonada Media Announcer
That Can't Be True is a production of Limonada Media and the Clinton Foundation. The show is produced by Katherine Barnes, mix and sound design by Johnny Vince Evans. Kristin Lepore is senior director of new content and Jackie Danziger is VP of narrative and production. Maggie Kralshore is our managing director of partnerships. Executive producers are Jessica Cordova Kramer, Stephanie Whittles, Wax and me, Chelsea Clinton. Special thanks to Erica Goodmanson, Sarah Horowitz, Francesca Ernst Kahn, Caroline Lewis, Sage Falter, Barry Lurie Westerberg, Emily Young and the entire team at the Clinton Foundation. You can help others find our show by leaving us a rating and writing a review. And if you can think of someone who might benefit from today's episode, please go ahead and share it with them. There's more of that can't be true with Lemonada. Premium subscribers get exclusive access to bonus content when you subscribe on Apple Podcasts. You can also listen ad free on Amazon Music with your prime membership ship.