SACHA PFEIFFER, HOST:
Michigan has been hit hard by the cyclosporiasis outbreak. The state has had more than 10,000 cases since the end of June. In one county, public health nurses are investigating a flood of new cases, and they're getting a different reception from the public than they were a couple months ago when they were dealing with a measles outbreak. Kate Wells, with our partner KFF Health News, reports.
KATE WELLS: Most people Linda Kim calls lately tell her, this cyclosporiasis is the worst thing I have ever experienced. But today...
LINDA KIM: Hi, my name is Linda. I'm a nurse over at Washtenaw County Health Department. I was just calling...
WELLS: ...She has managed to find one person who's like, you know what? Not so bad.
KIM: You're enjoying the weight loss? (Laughter) Well, I'm glad to hear that at least you got something good out of it. I know...
WELLS: Kim is actually supposed to be working at the county's clinic, giving kids vaccines and doing STI testing. But she hasn't been there in months. First, the county got hit with a measles outbreak this spring. Then the cyclosporiasis cases started pouring in, more than 800 of them. Doing contact tracing for measles was very different.
KIM: People would be like, how do you even know about this? They're like, I don't want to give you information or why should I tell you things?
WELLS: If anything, the problem now is people are telling nurses too much information.
KIM: They're like, this is what my poop looks like. So it's, like, funny to see the difference between the two at least.
WELLS: They have hundreds of calls to make, so they try to keep calls to under an hour. But food-borne illness investigations are really complicated, especially this parasite, Cyclospora, which sometimes doesn't cause symptoms until two weeks after people eat contaminated food. And no one remembers what they ate two weeks ago. So Kim and her colleagues tell people, let's pull up your receipts. Can we look at your grocery store app? What brand of salad mix did you buy? And which type of taco did you eat at Taco Bell?
KIM: Is that the crunchy one or the soft one?
WELLS: Kim has only been working with the health department for two years, and the whole time federal funding has been chaotic. A mental health program was shut down then reopened. There was a CDC employee stationed here who was fired, rehired and then furloughed. The county health department has had to move money from one project to the next, and they are always understaffed. Kim's boss is Christina Zilke. She's a nursing supervisor for the county health department. And she says the federal response to this outbreak has felt slow.
CHRISTINA ZILKE: It took them forever to, you know, say that this was lettuce. And fast food restaurants were taking it off their shelves before the CDC ever said what it was. So that in itself is rare and weird.
WELLS: A CDC deputy director, Gwen Biggerstaff, recently said that it is actually not unusual for it to take a long time to identify the source for cyclosporiasis, if it's identified at all. Meanwhile, Zilke has been bringing in coffee and pizza, trying to keep up morale for the staff, including Kim. Her thinking...
ZILKE: Here's some food for survival. Here's a break so that you don't quit.
WELLS: Kim, the nurse on the receiving end of that pizza, says it has all been a surreal introduction to a public health career. First, measles, now this.
KIM: It's like, woah, if nationally, they don't even know what's going on, like, how are we locally expected to know what's going on? And also just frustrating to be like, wow, like, I don't think even our government knows just how important public health is and funding public health.
WELLS: But there's no time to worry about that. She's got to wrap up this call so she can move on to the next.
KIM: Well, I hope you have a nice day. Thanks. Bye.
WELLS: In Ann Arbor, Michigan, I'm Kate Wells.
PFEIFFER: Kate is with our partner KFF Health News. Transcript provided by NPR, Copyright NPR.
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