State health officials in Michigan and Ohio are reporting thousands of cases of cyclosporiasis, a – a parasitic infection that causes “watery diarrhea”, loss of appetite and weight loss.

The outbreak of more than 2,800 cases comes a year after the Trump administration cut funding to state and local health departments and reduced the remit of a program dedicated to coordinating information on foodborne illness, including of cyclospora.

“It’s like putting a puzzle together,” said Barbara Kowalcyk, an associate professor at the George Washington University’s Milken Institute of Public Health, and the director of the university’s Institute for Food Safety and Nutrition Security. “You start taking pieces out of your puzzle – it’s harder to see the whole picture, and that’s what we’ve done. We’ve taken pieces out of the whole puzzle.”

In contrast, the Centers for Disease Control and Prevention (CDC) reported 843 confirmed cases and 1,500 suspected cases of cyclosporiasis across 31 states on Friday. Eighty-six people have been hospitalized, and none have died. The CDC expects the federal case count to rise, in part, because of delays typical in disease investigation.

Michigan appears to be especially hard-hit, with health officials reporting 2,640 cases. Over the border, state officials in Ohio are reporting 177 cases. The health departments did not identify a source of the outbreak.

The Michigan health department is urging restaurants and commercial kitchens in the south-east to thoroughly wash leafy greens, snow peas, some herbs and raspberries or, ideally, to cook them.

Cyclospora has a two-week incubation period, and the CDC assumes a six-week reporting lag between illness onset and receiving a case report. Investigating a disease with a long incubation period is tricky – to find potential links between cases, such as eating at the same restaurant or shopping the same store, epidemiologists interview everyone with a lab-confirmed case. Those interviews often take place two to four weeks after infection, making it difficult for people to recall what they ate.

Even with those challenges, Michigan’s chief medical executive, Dr Natasha Bagdasarian, told the Associated Press: “There is clearly a linked outbreak happening right now.”

However, in an era of funding cuts, Kowalcyk said typical delays have likely been exacerbated.

“Have the funding cuts to public health impacted the current activities related to the cyclospora outbreak? I think they have,” said Kowalcyk. “If you’re understaffed you might be interviewing [patients] after six to eight weeks,” she said.

In part, delays have been exacerbated by the Trump administration’s funding cuts, Kowalcyk said, citing both grant cuts to state and local health departments and changes to federal surveillance systems that make it harder to get “the whole picture”.

The Trump administration cut in March 2025 $11.4bn in grants to state and local health departments. Although those grants were earmarked for pandemic activities, Kowalcyk said they also built out local health department capacity. Michigan public health labs alone lost $5.5m, according to Bridge Michigan, a local news outlet.

“In state and local health departments, you might have people who are funded by three to four different funding sources,” said Kowalcyk. “If you take one away, you have to have people go part-time or you have to reduce your staff. There’s not a lot of choice, which means your capacity to scale up during an outbreak is limited.”

In July 2025, the Trump administration also reduced the scope of a program called FoodNet, which actively monitored for foodborne outbreaks. FoodNet’s remit was winnowed from eight foodborne pathogens, including cyclospora, to shiga toxin-producing E coli and salmonella alone.

FoodNet helped coordinate information across states, and developed the oft-cited statistic that 48 million people living in the US are sickened with foodborne illnesses every year, 128,000 are hospitalized and 3,000 die.

“Despite what the current HHS administration believes, ignoring a problem doesn’t make it go away,” Gail Hansen, a public health and veterinary consultant, told the University of Minnesota’s Center for Infectious Disease Research and Policy in August 2025. “States do not have the ability to coordinate information and data across states, and this cut will bring us back to a time before FoodNet.”

The administration has broadly defended the change in FoodNet’s scope as reducing duplicative efforts, and said foodborne pathogen investigations are not affected by the change.

“Narrowing FoodNet’s reporting requirements is, in part, because the surveillance landscape has changed since the collaboration began in 1995,” said a CDC website update in April. “Today, other surveillance systems monitor for infection with FoodNet pathogens.”

In response to questions from the Guardian, HHS senior press secretary Emily Hilliard said: “Under the leadership of Secretary Kennedy, FDA is currently investigating Cyclospora outbreaks using established epidemiologic, laboratory, and traceback tools in close coordination with CDC and state and local partners. Protecting the nation’s food supply is a core FDA responsibility, and the agency has the expertise, personnel, and resources necessary to detect, investigate, and respond to foodborne illness outbreaks and take regulatory action when warranted.

To be clear, cyclospora tracking never stopped. CDC is actively working with 3,000 health departments to gather data.”