Phyllis Entis has no cell phone. She has a dog named Shalom, a daily Wordle/Connections/Strands group chat, and a food-safety blog called eFoodAlert with just under 2,500 subscribers. And over the past week, while plodding through state Cyclospora data from her home office in Victoria, BC, she did something federal public health agencies haven’t: She pointed out evidence suggesting Taylor Farms lettuce has likely wreaked far more havoc than previously thought. 

This outbreak is already the largest cyclosporiasis event in U.S. history, with states reporting at least 18,000 cases so far this summer.

Entis’ big discovery: On July 28, New Hampshire’s health department reported 17 cases in people who ate Taylor Farms lettuce at a hospital cafeteria in Keene. In its announcement, the health department said anyone with symptoms who ate at the location through July 20 should seek care. That suggests people might’ve eaten contaminated product at the facility as recently as a week and a half ago.

This is significant for a few reasons. For starters, it’s the first time a Taylor Farms product served outside of a Taco Bell has been implicated in the ongoing Cyclospora outbreak. That suggests it’s not just lettuce distributed to Taco Bell that was the problem, but quite possibly, lettuce distributed to other businesses. 

(The company has recalled lettuce distributed to lots of different companies. However, that’s not as strong a signal as an official public health announcement that authorities think a source might be responsible for additional cases.) 

It’s also notable because of Taylor Farms’ apology-farming drama around the FDA’s erroneous smoking gun test. Plus, around the same time the hospital cafeteria served its last contaminated salad, RFK Jr. said the outbreak was under control. In your dreams, bro.

Finding contaminated Taylor Farms lettuce in a restaurant that isn’t Taco Bell might feel like a big duh to public health people who read this newsletter. However, it’s a lot less intuitive to people who think they’re being safe if they get their lunch at, I dunno, the FUCKING HOSPITAL CAFETERIA instead of springing for a coupla Spicy Chicken Doritos Locos Taco Gordita Crunchwraps¹ Supreme. 

The finding also makes it harder for Taylor Farms to dodge suspicion that its products may be responsible for many of the cases of unknown cause. Or it would, if it were announced by a federal public health agency. But that hasn’t yet happened.

(I heard about Entis’ blogbuster revelation thanks to food safety attorney Bill Marler’s blog, all of which makes me want to put on my Uggs and do some multitap texting on my Motorola RAZR. Bloggy blog blog. Whatever happened to them?)

That’s just one of Entis’ discoveries. She also found that after changing the outbreak’s start date from June 22 to May 13 a couple of weeks ago, CDC had abruptly flipped it back last week. There was no explanation either time.

The result was a major change to the story the outbreak curve told: Now, the outbreak kicked off all at once with a wave of cases, then receded before rising again in early July. The change also substantially shrunk CDC’s estimation of the outbreak’s size by 210 cases, all of them from Michigan’s count.

This doesn’t make sense, Entis told me; foodborne epidemics don’t start two days before they peak.

To be clear, data often shifts around in the throes of an outbreak. Often, it’s because lab data takes a while to trickle in, and old totals get backfilled as they do. It’s also common to change the definition of an outbreak case as things are evolving early. But those changes typically come with an explanation from a public health agency that helps us all feel less tin-foil-hatty about shifting numbers and patterns.These did not.

“Best case scenario is that somebody goofed,” Entis told me. Worst case scenario? She didn’t want to answer. I wouldn’t be surprised if some Americans conclude this is less oopsie and more response to industry pressure. 

Entis pointed out that Cyclospora, a weird little thick-walled, single-celled parasite, doesn’t multiply on crops or in water the way some bacteria do. That means it’s harder for a single contamination event — like one day of portapotty overflow onto the edge of a field — to produce an outbreak like this one. 

The only way lettuce could become as broadly contaminated as it has is through contaminated water, says Entis — either irrigation water, or water used to wash lettuce and process it for packaging in a plant. Furthermore, this was likely an ongoing issue for a while. She also notes this was unlikely to have happened as a one-time event: “It's not just one day's worth of, ‘Oops, got a contaminated spurt of water in the wash water that's used on the produce.’ It had to have happened over time,” she says.

Marler has at least one theory about how that might’ve happened, which you can read about on his blog, right before you put on your Ed Hardy shirt and your Livestrong wristband (it’s ok, you didn’t know, none of us knew).

Ask Entis who's to blame for the messy response and she doesn't reach for conspiracy. "Budget cuts," she told me flatly — and not new ones. She’s been watching important government food safety programs get shut down since she started her career in the 1970s. In her telling, the current gutting of CDC and FDA isn't an aberration so much as the sharpest turn yet on a road federal food safety has been driving down for fifty years. FDA’s inspection capacity hasn't kept pace with the industry it regulates, and the "farm team" of junior CDC disease detectives who'd normally be trained up to handle a surge like this one is much smaller than it used to be. 

Still, it’s not outrage (and it’s definitely not money, she says) that motivates her to keep doing what she does: It’s the “aha moment.”

“I've always been a puzzle person," Entis told me. It's the same aptitude that led her to write seven self-published mystery novels during a blogging burnout a few years back instead of just quitting. Lately, her predilection has led her to a different purpose: solving the riddle a devastated public health system can no longer solve for itself.

In my first Cyclospora post, I asked who you blamed for the rise in cases. The largest number chose RFK Jr. Donald Trump was next, followed by Elon Musk, then Big Balls. My favorite response:

“I blame anyone with a nickname past the age of 12.”

You guys are funny! This person wins a free annual subscription for themselves or a friend.

Know any other citizen scientists who are filling the gaps in our public health system? Email me at [email protected], fill out this form, or find me on Signal at kerenlandman.07.

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