Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Cyclospora

Episode Date: July 21, 2026

The food has been going wild lately, and none more in the headlines this second than cyclospora parasite which is causing an outbreak of . . . intense gastrointestinal distress. Dr. Sydnee and Justin talk about the history of parasitic illnesses and what to know about the outbreak right now. For example, maybe just never eat lettuce ever again. Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/ Asian Pacific Environmental Network: https://apen4ej.org/our-work/ Help support this show and unlock bonus content! Become a member at https://maximumfun.org/joinsawbones

Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. Hey, welcome to Sawbones, a marital tour of Miss Guide Medicine. I'm your co-host, Justin McRoy.

And I'm Sidney McRoy. You didn't point at me when you said Justin Maceroy. No, I'm having it. We went to, you know what it is? You know what it is, don't you? Is it the flage effect? No, we went to Norlands. Oh.

We went to Norlands. And when you go to Norlands, the slow gets deep down in your bones. Sorry, that's us actually quoting. An SNL sketch about New Orleans, which we quote so many times that we ended up going to New Orleans for our 20th anniversary. I desperately try not to be the people from the SNL sketch. But we couldn't help it. It was a lovely time, but you're right. I've been thrown so far off my game said.

I'm just full of jumbalaya and Bayou Air, and it has slowed my podcasting instincts. I've been thickened with bignets to a point where I've become unwieldy as a professional broadcaster. Sad. In my prime, too. That's the sad part. I'm here to rescue you How?

With some exciting current medical news. The food is going wild lately with the things you can and cannot eat. Yeah, so we had a lot of people reach out and I was already, I have to be honest, I didn't thank you all because I was already working on the episode. As soon as I heard about the explosive diarrhea parasite cyclospora,

which I will say I learned about cyclospora in medical school, of course. And then I also, I don't know if I've mentioned this on the show before. I also did a track in my residency for global health. And as part of that, you're looking at me like, oh, tell me more. You know about this. You were there with me. Yeah. Part of the thing when you're a co-host is you try to look like an engaged listener because the person you're talking to only has sort of you to talk to. So even though many things you tell me are familiar to me as we have been married for quite some time. So this is a performance. This is acting. It's not a performance. It's a facet.

Anyway, as part of this track that I went on, I was able to travel overseas. I think I've talked about that practicing abroad, but I also took a course on tropical diseases and learned more than your average, I think, family doc about things like cyclospora, about parasites that don't necessarily affect people in the U.S. all the time. It was a really great class. It was through the military. I'm not in the military, but I was able to take it. I noticed that you build it as the explosive diarrhea parasite cyclospora. And it's very rare that we have one where they front load the bad part and then the name. It's like you never get like the amazing Spider-Man. It's just Spider-Man.

But this is one where they're like hyping you up like, here it is. You've heard about it. The explosive diarrhea parasite cyclospora. Well, okay. What I was going to say is, in. In none of the courses that I took, whether they were in regular medical school or in the specialized track, did anybody refer to it in my memory as the explosive diarrhea parasite? But now it is, I think, in the popular media, this is how we're talking about it. Which is interesting because it's just diarrhea, guys.

I mean, I guess any diarrhea can be explosive. I don't characterize, I don't ask patients like, but is the diarrhea explosive? It's a weird, it's a weird thing. Like, is it watery? Is it mucusy? Is it bloody? These are things I need to know. But, like, I don't normally say, but is it explosive?

I mean, yes, but that's classic, like, doctor privilege because, like, the most important thing I think as a suffer is how long you have to react. You know what I mean? Like, reaction time is massive. Like, that is definitely a symptom as a key component. Okay. We're going to talk about cyclospora or cyclosporiasis, which is when you have the, you have been infected with the parasite, and now you have the diarrhea. Now you have the parasite, now you have the diarrhea. I don't want you to stress.

It is, is it a big deal, of course. Like any illness, you know, that is the, any outbreak, anything that we could limit exposure to. Don't stress. No, don't stress. Is it a problem? We should take it seriously. Act intentionally. Freak out a little.

No, don't freak out. Don't freak out. And like as we're recording this, I was sitting down to record this episode and I was double checking like newest updates because this is an evolving story. So like there's literally news from nine hours ago that I had to include right now. So this will probably, we are recording this on Monday, July 20th. Yeah. So things might change after this. But this is what we know now.

Well, you used to be able to talk about history. this show. We didn't need these date lines. Well, I mean, when you defund major health organizations that are supposed to monitor these sorts of things and prevent foodborne illness outbreaks. Careful, Sid. We're going to lose another long-time Sawbones listener due to getting too political. Every few weeks, we still get one. Hey, I've listened for 14 years, and this show has gotten too political for me. It's like, brother, what show did you listen to? Sorry, go ahead. Well, I mean, I don't know if I should just say health care is political. It just is. Yeah. I didn't make it that way. I just want to take care of people, but my government made it that way.

So it is political. It's a human right there. Anyway, let's talk about cyclospora. Yeah. Let's not get too political justice. Yeah, Sidney. I'd hate to have to quit listening to Sovereones. So we have cyclospora in the, first of all, it's a parasite. I think parasites are interesting. Do you know, okay, most of the infections that you think of, like that you come in contact with in your life, especially in the U.S., would be a bacteria or a virus. And we talk about those a lot on the show and the differences and how we treat them

and all those kinds of things. Cyclospor is a parasite, which certainly we see in the U.S., but I would say less frequently. And parasites are interesting because they're actually more closely related to animals. than two bacteria. Isn't that wild to think about? It is wild. Yes, they are also eukaryotes, meaning their cells are more complex.

They have organelles, they have nuclei. So it's a more complex organism than a bacteria, which makes them more challenging in a number of ways. They're more challenging to diagnose because they have a life cycle and you have to catch them

at certain times. You have to know what to look for at different times in their life cycle, and they can be harder to treat for that reason. Not necessarily in this case, but in other cases sometimes they're harder to treat.

In so much as this is a spectrum, would you say that viruses, viruses are at the very end of that because they're like half dead. They're basically like half machine anyway, right? Half dead anyway. I think that's probably a fair thing to say. Viruses are kind of over here, the undead of the microbiological world, right, or the infectious disease world. It's like the dead. Killing the dead. They're their own thing and they're unique. Bacteria are obviously living organisms. We know that. We have. We are. We can define bacteria that way. And then parasites. We're moving closer to animals at that point and to humans, you know. Because then you start, like, you start thinking about worms and things, which they're really small. Parasitic worms are very small.

But, like, you identify them. When you look at them, it's like, oh, that looks like a worm. I know what a worm looks like. So you're starting to get towards the animal kingdom. Does that make sense? Yeah. Okay. And then the top of the chain, Cyrus, the virus, from Conair, of course, is the apex.

That's that you go all the way up to Cyrus the virus. So we knew about this genus cyclospora back in the probably a while ago before the 70s, but we didn't know it existed in humans until the 70s. There's a lot of different cyclospora parasites for different kinds of animals. Like there's some in reptiles, there's some in birds, and obviously there are some in humans. They're unique to what they infect, which is important. Like the cyclospora that we get is a. humans, like it's going to infect humans.

It's not existing in other animals. There are other cyclospora for those animals to get, and I guess also have explosive, their own explosive diarrhea. Yeah, but we get... Probably cuter. But we get this one. We first started to see human cases that we were able to, like, okay, there is a new something, there's a new organism, and it's causing diarrhea back in the late 70s in Papua New Guinea.

They found some sort of new organism that they knew was a parasite, but they didn't know what it was in three people with diarrhea. But at the time, we were still sort of building the parasite world. Like, you know, I mean, it's the whole like taxonomy of how we categorize different forms of life is really interesting and it evolves because every time we add something new to the catalog, we start to redefine what does that. Sure, because it's all in relation to. Yes, exactly, exactly. It's all made in relation to it. So the more information you put in there, it might change over time. And we see that because a new. Initially, we think it's something that we already sort of understand, and we call it an isospora, which, I mean, I think at the end of the day, probably to most of you listening, like, I don't really care what we used to call it. Why is it causing diarrhea? But it's an interesting evolution of like, well, it looks much like this. And then we saw another outbreak in the 80s. There were some travelers to Haiti and Mexico that had a diarrhea illness. And they started to describe something in them that looked more like cryptospritium and like, oh, maybe it's some kind of blue-green algae. We're not sure.

And it really wasn't until 1994 that we see, okay, this is a new organism. It is a cyclospora. We know it's in the genus that we recognize already. But it's its own thing. And it is the cyclospora chyatenensis. And that is the cyclospora that we are talking about right now. Cyclospora chyatenensis. Cayatenensis.

So that is the, it's from the university where they named it. Oh, okay. In Peru. Gotcha. Anyway, so, but I think if you talk about some of the other infections, I mean, if you think about, like, the history of bacterial infections and stuff that we talk about on the show, they've been around for so, I mean, you think about, like, the history of syphilis and how long we've known it was a thing.

And we didn't really define this as its own organism until 1994. That feels so new. Recent, yeah. Yeah. Now, part of it, again, is because it is a parasite, and parasites are, like, a said, because they're more complex, they can be more difficult to diagnose. So cyclospora specifically is a, it's a fecal oral parasite. You know, that's my favorite kind. Your favorite route. Which means that you get infected. By poop in your mouth. You get some poop in your mouth.

Well, yeah, I mean, you didn't. You don't bet a poop. In your mouth. I mean, it's not, you didn't know the poop was there probably. It's a little time. I bit of poop. It's so small. You can't see it and you eat it. It makes you sick. That's Sydney's favorite route. So the thing is there's a life cycle to cyclospora. I have a, where's my picture? There it is. And you've got, you have these little oocytes. They're just eight to ten micrometer.

So they're tiny, tiny little round things, okay? You guys drop the ball with oocytes, by the way. I've been meaning to tell you. That's no good. They start off unsporeulated. And so this is an important piece. of the life cycle. When you first poop them out,

these things that are in your feces, they cannot infect anyone. They have not matured to a point of infectious capability. They have to sit in the ground for a while and grow and change. Develop some character. Yes. And then they separate.

And you can see there's like a circle with a blob inside, and then there's a circle with two distinct blobs inside. It has divided into these two infectious. Is that mitosis or myiosis? It's mitosis? No. It's not it's neither. Sporulation.

Oh, gotcha. Yes. It's its own thing. So they have sporulated and now they are infectious. So what can happen is once you have that material on the ground and this is really important. The reason I'm trying to outline this is that it's not going from human to human. It can't. Going to human poop to dirt.

Right. What comes out of you if you are an infected human, which that's where it is. Like it only lives in humans. So there are humans carrying it around. It's endemic to certain parts of the world. A lot of our focus with this current outbreak has been in Central America and then also now in Mexico. It looks like maybe. I just don't want this to have a chilling effect on the eating of other people's fecal matter intentionally.

If that's something that you enjoy or want to pursue, don't worry about cyclospora. Don't do that. Don't do that. Okay. That's my advice. That's medical advice. I'm not trying to, no, no, I'm not, this is not a judgment. Just medical advice, don't do that.

Yeah. I mean, we said the same thing about drinking pee. Like, don't drink pee. My medical advice is don't drink pee. We take a pretty hard line around here sometimes. Yeah, they just don't. Anyway, so. Now we're getting political again.

Is that political? That's way too political. But again, I'm just trying to outline it's not a human to human thing. I think that in the wake of COVID, when you see. see outbreak of a new illness, being really clear about what is contagious and how things are past is really important, right? Yeah. Because otherwise we create this undue panic when it's like, oh my gosh, you had diarrhea.

Am I going to get diarrhea now because you had the parasite and do I have the parasite? You know, and no. And if you see a big patch of explosive diarrhea out there, I want you to avoid it, give it a wide birth for the normal reasons that you would avoid a huge pile of explosive diarrhea, not because you're worried about cyclospor just for the regular reasons, your shoes or whatever. Now, what will happen is that these, once these now sporulated parasites have matured, and they're out there in the water, in the soil, whatever, they can contaminate food. And this is what we're worried about, right? They can contaminate water and they can contaminate food, specifically crops that

might then be packaged and sent somewhere else in the world. And so you wouldn't necessarily be expecting cyclospora where this product might end up. And it's not endemic. And the thing is, when you have something in an area that is endemic, you have an illness that people catch over and over and over again, they tend to build up some sort of immunity to it, right? So you hope that future cases in the same human body will be less severe because your body is more accustomed to it. When you take that same organism and introduce it into a, like, a naive population that does. doesn't typically become exposed to it, you can get more severe illness in mass. So lots of people getting sicker all at the same time, which, again, still might not mean that it's fatal,

but it can put stress on a health care system, right? All of a sudden, if you have a small community where everybody eats a lettuce and gets sick, and then you've got, you know, 30 people with explosive diarrhea who all need it. Hey, who here ate a lettuce? Raise your hand if you ate a lettuce. God, all of you? all 30 of you ate a lettuce? What's wrong with you? Also, I will say you only, you really need a very tiny amount

of the parasite to become infected. That's one thing about this. That's why you got to be careful with lettuce, folks. You may think one slice on your burger is okay, but I've been banging this drum for a long time. You've got to be careful. It can be a very tiny amount. We kind of talk about that with different,

with viruses, we talked a lot about the R not. remember that? Like how many people would the average person be expected to infect? With parasites, what we're talking about is the infectious dose, how much of this parasite can you eat safely? Like none is the ant, but I mean, how much realistically it does not take very much for you to be infected. And the incubation period can be anywhere from one to 11 days, meaning that it can be hard to figure out what made you sick, because it could be almost two weeks ago. Yeah. Right. So now it's in your body. What is it going to do to you and what do we need to do about it? And what you need to know about the outbreak right now.

I'm going to tell you after the billing department. Oh, well, let's go. The medicines, the medicines that escalate macabre for the mouth. All right, said, catch me up. How are things going with cyclospora? Okay, so it's gotten into your body. Oh, no. So probably some contaminated water or food source.

You probably didn't know, right? I mean, hopefully you didn't know. And now it's been some number of days, and you're going to start to get the usual symptoms of what we would call a gastroenteritis, meaning that your stomach and intestinal tract are inflamed, infected, inflamed, irritated. Something is in there causing problems with the function of your intestines, and you're getting cramps, nausea, you've lost your appetite, you feel tired, you might get a low-grade fever, it's possible. And then, of course, the diarrhea, watery diarrhea, multiple bouts of watery diarrhea that can be, and when we say explosive, I think all they're trying

to highlight is that it can hit you out of nowhere. Like all of a sudden you get that intestinal parastolsus, meaning it's squeezing, it's doing the wave, squeezing stuff down, squeezing stuff down, all at once. Like, bam, I got to go, I got to go right away. Yeah. Generally, the infection, like how severe, it depends on the host. So if you are someone who doesn't have any chronic, underlying chronic illness, if you generally are in good health, if you're not very young and not very old, kind of in the middle of the age spectrum, you're not on other medications, you were, you know, well before this, you're probably not going to get very severe disease. If you are on either end of the age spectrum or if you are immunocompromised in some way or have some underlying chronic illness,

you could get much sicker. And, you know, that's true for a lot of things. And the main thing is your body's ability to withstand diarrhea. Diarrhea, I know we kind of, we're joking about it here, but diarrhea is a big deal across the globe. We take for granted a lot of us. Don't do that to me. Don't do that to me. Don't try to me the bad guy because I think diarrhea is funny. Don't you dare. Don't you dare. Okay. I think, I think everything can be funny in context, right? Listen, I work in medicine. There's a lot of dark humor in medicine. So there is a context in which lots of things can be funny. You're right. It's super serious because hydration becomes a huge problem

very quickly, especially in resource limited settings. You're exactly right. That's the reason that illnesses like cyclospora, these diarrheal illnesses are such a big deal is that in the U.S., I mean, I know right now that if I become infected with this parasite, I don't think I am, but we live in West Virginia and we are one of the states impacted. We have cases in the state, so that's possible. So if I got this illness, I know one, that, I could go to the hospital or heck, I could probably go to somewhere closer at one of the clinics where I work and get hooked up to an IV and get some fluids if I need them. I also could access an antibiotic if I was severely ill enough that I needed an antibiotic. I could access those things pretty easily, right? So my expectation is that I would be just fine. If I live in a part of the world where there's nowhere to easily access oral or IV fluids, maybe both are at a shortage. Clean water is a problem. Water period is a problem. And then on top of the world, of that, if I am sick enough that I need antibiotics, am I somewhere in the world where I can access those easily?

Yes. Are they affordable? Is there somewhere who can prescribe them? So once you start to add that into the equation, it can be a very big deal. And across the globe, diarrhea is a huge problem, especially for children. Young children all over the globe, become severely ill, and it is fatal in many parts of the world. Not necessarily cyclospora, but just diarrheal illnesses in general.

So I think that's why it's important. And in the U.S., we're freaking out because we don't like having diarrhea for the rest of the world. These illnesses can be a much bigger deal. And certainly in some parts of the U.S., that's true, too. For areas, like I said, where it's endemic, you usually are going to become accustomed to it as you have more bouts of it. And so you may have even asymptomatic infections, meaning people who have the parasite don't know it. with outbreaks like we're having in the U.S. right now, probably most of the people or all of the people who are getting cyclospora have never had it before. So they're going to have symptoms. It can last anywhere from a few days to a month. A lot of people, I think, in the headlines, have heard that piece of it like, oh, you're going to have diarrhea for months. Most people aren't going to have diarrhea for months. But you could. I mean, that's the thing with this parasite. You could have recurrent bouts. It could kind of even come and go. Like you start to get better. And then a week goes by and all of a sudden you got diarrhea again.

Hey, Love, I got to tell you, that's a real roller coaster of a paragraph emotionally. You really took us on a journey there. Like, it's not so bad, but then you could. I mean, you probably want to have diarrhea for a month, but you could have diarrhea for a month. I mean, what do you want me to feel? Should I be relieved? I think it highlights the importance of us studying and putting money, research dollars, into understanding illnesses

that don't necessarily affect Americans as frequently. You see this bias that has always existed where we are not that interested. I mean, there's a reason there's a whole body of illnesses that we call neglected tropical diseases because they're neglected, because they are not happening in resource-rich settings where a lot of money is going to be put into understanding them better.

And so when they do impact us in the U.S., we start asking the questions we always ask, how long, how much, what do I expect, what do I take? And we don't have clear answers. And people here get frustrated. And it's like, well, yeah, because we don't put money into researching this. We put money into researching all the stuff that people here get all the time. Yeah.

We can give you lots of answers about. Boner pills. Oh, I was going to say erectile dysfunction, but yes. Yes. I mean, that. And I'm not saying we shouldn't. This isn't me saying we shouldn't study that. That's a huge quality of life.

Experts. Yes. But that's a huge quality of life issue, and it should be studied, and we should know how to treat that. If it's a huge quality of life issue, you may have taken too much. But two things can be true. We can study erectile dysfunction, and we can study cyclospora. We have the ability. There's lots of money that could be put into these things.

It just depends on what our priorities are. So what's happening in case you're interested, like what's happening when the parasites in there? It's actually the thing I like about parasitic infections, I know this is a sentence is that it's a lot easier to understand from like a pathophysiology like what is the parasite doing in your body because they're they're kind of they're bigger they're more like little animals than bacteria they really are and so they're just kind of like burrowing in the walls of your intestines and messing it up they're causing inflammation they're causing fluid loss and all that fluid is coming out through your intestinal track and you get diarrhea it's really straightforward

When bigger parasites, like worms get in your body, they're just kind of crawling around, squirming around, and they're damaging everything. It makes a lot of sense. Like tremors. Kind of like that, yeah. Like from a, if you're trying, if you're like me, like when I learned about all of these different infectious organisms, I want to be able to like see it inside you and think about what it's doing. And then that's how I understand it because then it all flows from there. Once I understand what it's doing inside you, the symptoms that come from that are intuitive. And with parasites, it's really clear.

It's just like digging into the intestinal walls. It's causing havoc. Holes where there shouldn't be holes. Right. Anyway, most of the treatment is supportive. We've got to keep you hydrated. If you're able to stay hydrated orally, which most people would be able to, that's best. If you cannot, if you're so sick that you can't keep fluids in, then you need to be able to access IV fluids.

And certainly some people have been hospitalized for this. There is an antibiotic that is a phyllic. effective, I will say, and this is true for a lot of diarrheal illnesses, not everybody will necessarily need an antibiotic. There are many people who will get sick and get better and not require antibiotics. So don't rush and think every time you get diarrhea, you need an antibiotic. Most time you don't. For people who may be, again, on either end of the age spectrum or more susceptible to severe illness due to their underlying, you know, disease status, these individuals we can treat with something called trimetoprim, sulfamethyxazol, or you probably know it as Bactrum.

Most people have heard of the antibiotic backdrum, and it is ineffective treatment. There are, because that is a sulfa drug and sulfa allergies, are one of the more common drug allergies. There are some alternatives like Cypro, if you can't take backdrum. But it is treatable. And certainly, if you're having severe disease, we could do that. That being said, what is happening right now? I don't know. It's been in the headlines a lot of.

Yes, it's been in the headlines. I think the latest total I have, I mean, really, I've just checked the same. CDC website for an updated total. 1,644 cases of cyclospora that we know of, like diagnosed cases. 94 hospitalizations, nobody has passed away. So, and the last diagnosed case we have is July 13th, which means maybe we've, maybe we don't have any more new cases. Maybe we've caught them all.

We don't know. We don't know for sure. What happened? Why did all these people get it? Well, as I mentioned, some of our surveillance for cyclosporo, we actually ended that program last year. And so we are not going to pick up these things as quickly. And because there's this lag between when you are exposed and when you might have symptoms, it can be hard to do the, you know, disease investigation and pen down exactly where it came from, especially when we're not surveilling for cyclospor like we used to. So we know that the most common outbreaks, and there have been a number of outbreaks.

outbreaks in the U.S. in the past. You can look through the CDC has like on their website, like, here are all the past outbreaks we've had and what they were linked to. They've been linked to things like raspberries, cilantro, snow peas, mainly lettuce, especially bagged lettuce. That seems to be one of the, or in Basil. Basel's one another big one. But one of the biggest is those sort of like salad bags or lettuce bags that you get at the supermarket. Uh-huh. What is that? No, just. You're saying salad?

I've been pretty firm about salad for a long time. I'm just saying it sounds like the chickens are finally coming home to roost. Our vegan friends have been pretty quiet this past few weeks. And I'm just saying maybe salad ain't all it's cracked up to be, you know? I mean, okay, this conversation gets so sticky and it's so nuanced because... No, salad's never sticky. It's sticky. It'd probably be better to have syrup or something on it.

I felt really lucky that. that as they were saying, like, well, snow peas is a common culprit. I was outside, like, picking the snow peas that I grew thinking, like, well, I grew my own. I have my own basil. I have my own cilantro. I actually made Justin go out and buy a couple raspberry starts because we have blackberries, but I don't grow raspberries. I was already out. And I have to go to Lowe's every day legally speaking.

It's a privilege to be able to grow your own food, though. That's not a ready solution for everybody. That's not realistic. For those of you who can, great. But for most people, that's not. realistic. There is a recommendation that generally speaking, buying a whole head of lettuce is thought to be safer than buying like the bags of leaves. There's only one thing safer than that, leaving that lettuce right on the shelf where it belongs. Obviously, you want to wash your hands

before you handle food. You want to wash your fruits and vegetables. Really with cyclospora specifically washing everything, even like scrubbing them and stuff, while that is always a good idea to wash your fruits and vegetables after you buy them from the store before you eat them. Of course, please do that. That's not going to kill cyclospora. You have to heat food to 158 degrees to kill it. And I think most of us don't cook lettuce. So that's rough. That's a rough one. I know. So we do think they might have figured out where this is coming from. So what they did is they started asking people who are sick, who have confirmed cases, which by the way, it can be hard to diagnose cyclospora because you're looking at the stool, regular stool panels usually don't test for it. You have to look at the

stool under a microscope. I've done this before in my training for the specific form of the unsporeulated oocyte. I really love that word, by the way. As much as I hate oocyte, I love unsporeulated. That's a real cool. Say it again. Unsporulated. You have to know what it looks like, and it can be hard to find. You've got to look through a lot of poop to make sure it's not in there. Like how many slides until you can say, like, absolutely not. You got to look through a lot of poop. You got to look through a lot of poop. So it can be hard to diagnose. Now there is a PCR polymerase chain reaction test, meaning we're actually looking for like DNA.

That can, that's a faster, but it's more expensive. So there's a tradeoff there. It can be harder. Anyway, it can be hard to diagnose. We think, so initially there was a, there was an announcement from the FDA that after they investigated all these cases, they found that most of them were linked to eating at a taco bell. Like 90% had had lettuce from a taco bell.

So they thought, ah, it's this kind of bagged lettuce that these taco bells are getting and specifically supplied by Taylor Farms of Mexico. Hey, by the way, I hear you out there. I don't get my lettuce on my tacos. No, nice try. I do, but I hadn't in that time period, I guess. But let me say, now listen, the FDA announced, we think it's linked to these, we tested these bags of Taylor Farms lettuce that were supplied not just to Taco Bells, but also. to a number of grocery stores like Walmart's were selling these bags of lettuce as well. And we thought we detected cyclospora in two of the bags. So we think we found it.

This is the link. And so then Taylor Farms... It's not Taco Bell? Well, hold on. Taylor Farms did a voluntary recall on the 17th. On July 17th, this is really brand new. Of all of their Taylor Farms lettuce products, like Taco Bell stopped serving them. They recalled them from all the grocery stores.

And then they told everybody, like, check your bags. if you have bought lettuce of this brand in this time frame, throw it away. Don't eat it, okay? We think we're good. Got it. And then, yesterday, July 19th, the FDA provided an update saying that due to the complexity and detection of cyclospora,

FDA laboratory experts re-reviewed the sample results and have concluded that the finding does not represent true amplification and should be considered a false positive. So we don't know. Taylor Farms said that the FDA called them and apologized. The FDA has not clarified if they did. We don't do that, actually. But so here's the thing.

It was a false positive. We don't know. They're still, the voluntary recall is still going through. They're still saying, don't eat this lettuce because we did have this one finding. There was some evidence just based on report that maybe it was linked to this lettuce. But we have not confirmed it. As of this moment, we have no confirmed positive samples of science. cyclospora in any specific product. So as of this moment, we do not know if it was from this lettuce,

if it was something else. We do seem to have a common link with a lot of people having eaten at Taco Bell in this time frame. So is, but I mean, right now we're going to have a lot of confirmation bias because everybody who has diarrhea is going to go, well, but did I eat at Taco Bell? Because we've all heard this report about Taco Bell. This has this has RFK's fingerprints all over it. You can tell here. Yeah, yeah, yeah, yeah. Oh, yeah. Taylor Farms Day Mexico? Hmm, interesting. And the other person they're trying to blame for it is Taco Bo? Huh? I don't think so, guys. I don't think you're going to make those charges stick, my friends. I think that you

probably need to look elsewhere. I swear, Sidney, this is, this is, this is RFK trying to shut down. You put on your tinfoil hat here? You put on your tinfoil hat? I'm just saying it's very interesting that the Trump run FDA accuses Taylor Farms Day Mexico. I think. think they were trying to target, I don't know, I'm just raising a conspiracy theory for no reason. Hmm. Well, it would be convenient. You tell me, I don't know.

When you reduce funding for surveillance for cyclospora and then the following year you have a large cyclospora outbreak across multiple states where many people are ill and some are hospitalized, it would be convenient if you could then just blame the whole thing on Mexico, I guess. Yeah. Or Taco Bell. I will say that at this moment. Both of which are currently non-guilty, by the way. We have no proof. We have no proof. Reassert.

I rode with the bell last night. Your boy's here. I'm here. I'm not going to let you down. You will beat these charges. We do know that there have been cases just so in case you haven't been following this this closely. I said in West Virginia in Ohio and Michigan and Kentucky and Indiana, Michigan's been hit the hardest so far.

But if it was from this Taylor Farms lettuce, that product was distributed in multiple other states. I'm not going to list them all. There's lots of them. But you can go to the CDC or the FDA update. If you look at FDA update from July 19th, it'll give you this whole paragraph in exactly what states where the Taylor Farms lettuce could have been distributed. I was joking. It's worth checking if you did buy bagged salad, whatever company it's from, bagged salad has been a culprit in these outbreaks in the past. How are you parsing stuff? I was kidding, of course, about, RFK and Trump and everything, but like, how are you parsing stuff from the FDA currently? Because as we've established, there's obviously a lot of good scientists and a lot of good people in that organization. But like, what kind of filter are you running this kind of stuff through? Well, I think that for yourself personally, I should say.

When you've got something like, I mean, this is a multi-state outbreak of an illness. So you have multiple state health departments and probably county health departments and then the hospitals in these locations and the labs that are running these tests. accumulating this data, we're not going to get lies about the numbers of cases as far as we know. Do you know what I mean? Like the sheer data that's coming out, the conspiracy that would have to be involved across multiple states. And not, I mean, not all these states are like going to kowtow to the current administration. So that kind of stuff I can trust.

Like, you know, all the data that's coming out of these hospital systems, health care systems is probably all fine, right? We can assume that's true. As much as we can diagnose cyclospora, yes. I think what you need to look at is sort of the lens that is cast over this, not necessarily in these reports from the FDA or from the CDC, but when you hear people talking about it who are politically motivated. So if we see the press secretary reporting on this, whatever spin is put on it, I would question. I don't trust anything RFK says ever. I don't, I mean.

Yeah, I mean you can't. No, he has done so much damage to vaccination rates in this country, contributing to the subsequent illness and then unfortunately death of children. Yeah, RFK's lies. Those lies have contributed to the death of children. And so I do not trust RFK for any information. Whatever he says, I don't trust. But this kind of data, I mean, you can't undermine like all of

of these local health departments and local health care facilities who are working really hard to try and understand, accumulate the data, and then control an outbreak of something, although you can't really control the outbreak of all you can do is figure out where it came from and get it off the shelves. Ban lettuce. And advise people. Prematurely. I mean, if you're advising people like, don't buy bagged lettuce, buy a head of lettuce right now,

that's reasonable advice to give. How much do you frigging need lettuce? that you are willing to risk explosive diarrhea for what's wrong with you people? Just don't eat lettuce. It's... God! Maybe, are the heads of lettuce okay? Just don't eat lettuce!

I've been doing it forever. It's easy. It's a really complex issue, though, because... It's not don't eat lettuce. No, we live... Well, listen, whatever you think of it, we live in a globalized economy. And so we are going to have food products. coming in and out of different countries,

this is not just for the U.S., coming in and out of different countries that were grown and handled and processed very far away where the natural pathogenic flora is very different. And that population of people has built up immunity to things that are endemic in a way that maybe the receiving population hasn't, and vice versa, right? That goes both ways.

So how do we reconcile that? and then also continue to live in a global economy and then also survey for these things and make sure we're monitoring and then be as concerned about these illnesses in the countries we don't live in as we are here.

I mean, it's a very complex topic. And to just say, like, grow your own food, yeah, that'd be great. It's a privilege to do so. It's expensive. It's not our society anymore. No.

It's not built for it. It's expensive. and time consuming and it is, I'm very lucky that the little bit of stuff that I grow because I enjoy it for fun, I can do, but I could not feed our family. I couldn't do it. We're going to have to go buy groceries and we're going to eat at Taco Bell. And so we need to live in that reality and find a way to make that safe, right? For everybody. If everybody stuck to Utsprice Rods, like I have been suggesting, none of these problems would happen. Thank you so much listening to our podcast. It's called

Sawbones. We want to thank the taxpayers for use of their song, Medicines. It's the intro of our program and the outro, and has been since we started it, way back in 2013. So that's it. We really appreciate them. And they're playing out. They have a band

camp. You can go see them live sometimes. Go check out the rest of their music. It's really good. There's also different versions of that song. If you like that song, it's a kick. I would like to personally thank everybody that came out to the Taz's book launch. If you didn't pick up your copy of the Adventure Zone story and song, that's our last Adventure Zone book. And if you wouldn't mind grabbing a copy of that, I would really appreciate it.

It's really wonderful. It made me cry. Thank you. In a good way. That's going to do it for this week on Sawbones. Until next time, my name is Justin McRoy. I'm Sidney McRoy. And as always, don't drill a hole in your head. Maximum Fun, a Worker Owned Network of Artist Owned Shows, supported directly by you.