A MARTÍNEZ, HOST:
The record-breaking cyclospora outbreak with over 4,100 confirmed cases comes more than a year after the Trump administration started slashing public health funding. NPR's Yuki Noguchi reports on how those cuts are affecting the fight against the diarrhea-causing parasite.
YUKI NOGUCHI, BYLINE: Environmental health expert Bob Custard has spent four decades working with local governments on clean water, rabies prevention and food safety. He also represents 160 others doing that kind of work as president of the West Virginia Association of Sanitarians. Cyclospora cases are spiking in nearby Ohio and Kentucky. But Custard, a public health consultant, says funding cuts have left local food safety vulnerable and grossly understaffed. He says it's like living in an unsafe home.
BOB CUSTARD: This is like we have a house, and we've just decided to start taking smoke detectors out.
NOGUCHI: Custard worked with a West Virginia county that, two years ago, employed four full-time sanitarians.
CUSTARD: The last time I talked to them, they were down to two. It's a growing county with growing needs, so they're pretty stressed.
NOGUCHI: That same county also lost its only epidemiologist, whose job included food poisoning investigations. When Custard looks at the state's food safety staff organization chart, from the very top to the very bottom, about half of all positions are vacant. Staffing is so bad. In fact, this March, West Virginia lawmakers lowered the state's job requirements for sanitarians from four years of college to a two-year associate's degree.
CUSTARD: Which is unfortunate because these people have a tremendous amount of responsibility, and because of the variety of programs they work in, they really need a really strong science foundation.
NOGUCHI: So Custard says it's no surprise that cyclones of infections keep spawning and swirling around the country or that three months after it began, regulators are still struggling to understand and contain cyclospora spread.
CUSTARD: At every level, the system has been weakened. If you're not getting the reporting from the local level, it doesn't roll up to the state level and then roll up to the national level.
NOGUCHI: Many experts in public health say the record caseload shows the strain on a food safety system suffering from cumulative divestments, going back many years. Sarah Sorscher directs regulatory affairs for the Center for Science in the Public Interest. She says a lack of information has left the public confused about what's safe to eat.
SARAH SORSCHER: Delays, lack of clarity, just time to solving problems are all symptoms of this broader issue that state and local public health departments are in crisis.
NOGUCHI: Most states' food safety and outbreak programs are funded by grants from the Food and Drug Administration and Centers for Disease Control and Prevention. Last year, the Trump administration slashed the CDC's grants alone by 40%, about $5.8 billion as of May. But where states cut varies. Kentucky's Cabinet for Health and Family Services said its food safety staff is down 30- to 50% from grant cuts. An Ohio Department of Health spokesman said its cyclospora response is unaffected by staffing cuts.
Michigan, with the highest caseload, successfully fought its grant cuts in court. That allows disease surveillance, investigation, reporting and public service messaging to continue for now, according to a spokeswoman at the Michigan Department of Health and Human Services. Meanwhile, Sorscher says, people are still getting sick by the thousands.
SORSCHER: That period of time it's taken them to solve the outbreak is a real cost to public health.
NOGUCHI: It's not just funding losses. Historically, states also received other support from the CDC, FDA and USAID, the now-defunct Agency for International Development, for things like scientific expertise, lab testing and pathogen monitoring overseas. Many of those functions have been curtailed or eliminated. Bob Custard says all that adds up.
CUSTARD: We keep taking smoke detectors out of the house, hoping that there won't be a fire, and yet we keep seeing fires from time to time.
NOGUCHI: Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.
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