Public health has been in the headlines a lot this summer.
A nationwide cyclospora outbreak has spread to Massachusetts, water quality issues have shut down local beaches, and the state has seen a dramatic surge in cases of Alpha-gal syndrome — an allergy to red meat and other mammal products that can develop after a bite from the Lone Star Tick.
Commissioner for the Massachusetts Department of Public Health Dr. Robbie Goldstein joined GBH’s Morning Edition to discuss the various risks people are facing this summer, and how to keep yourself safe from them. What follows is a lightly edited transcript.
Tori Bedford: So let’s talk about cyclospora. I’m terrified of this. It’s parasites spread through contaminated fresh produce. It can cause extreme gastrointestinal distress. The CDC says that there are now at least 1,947 cases detected, 98 hospitalizations linked to the cyclospora parasite across multiple states. How are we doing here in Massachusetts?
Robbie Goldstein: Well, here in Massachusetts, we’re tracking this really closely, as we do every summer. I should just note, cyclospora is a parasite that we see each summer season because it’s really easy for this parasite to get into fresh produce — in particular lettuce, parsley, cilantro, even things like raspberries and strawberries, or things that are a little bit harder to clean.
This summer in Massachusetts, we’ve only reported around 18 cases of Cyclospora in the state, not linked to the large outbreak that we’re seeing in the Midwest of the country. We know as the temperature gets warmer through August and the beginning of September, cyclospora can still persist, and then it usually goes away into the fall.
Bedford: How can we protect ourselves from this? We’ve been told washing [fruits and veggies] does help, washing doesn’t help. What can you do?
Goldstein: So first, washing [produce] does help. It doesn’t completely eliminate the risk of cyclospora. Like I said, this gets into the crevices of the produce. I think also pay attention to where your food is coming from.
There are national recalls that are happening with some iceberg lettuce products, and we’re going to learn more over the coming weeks about particular farms that produce parsley and cilantro that may be linked to other outbreaks in other states. But you want to pay attention. What’s being recalled? Where did you go shopping? What’s on your shelves and what might you want to take off your shelves and maybe throw away and not use?
Bedford: We heard a story on NPR recently about how [for] state and local health departments, the lack of funding cuts to those departments have slowed or muddled the response to Cyclospora outbreaks. If an outbreak does become a bigger issue here, is Massachusetts prepared?
Goldstein: I certainly think we’re prepared here in Massachusetts. We have a fantastic Food Protection Division in the Department of Public Health that is keeping an eye on this very closely. We work incredibly well with the Massachusetts Department of Agricultural Resources who helps to take a look at all of the farms here in Massachusetts, the produce that they’re producing, and what they’re doing in the farmers market. So we’re ready. We’ll respond appropriately.
But I do think if we look nationally, a lot of the funding that came out of CDC and FDA to support food illness investigations went away. A lot of those staff at the federal level are no longer working at FDA and CDC. And that’s made it more challenging not only to understand where is this outbreak coming from, but also for the federal government to communicate about the outbreak so that people can understand what’s happening.
Bedford: Late last month, a wastewater break dumped 10 million gallons of raw sewage into the Merrimack River. Then earlier this week, a pipe leak led to wastewater in the streets of Worcester as well, along with storm system sewage. What’s going on? Where do things stand with that now?
Goldstein: Well, as you noted, up in the Merrimack River, there was a large break in a water main that happened right in the city of Haverhill, and a large amount of sewage went into the river. Quickly, the state government turned to action. We worked at the Department of Public Health with our colleagues in the Department of Environmental Protection, not only to stop the leak, which was really important to stop the flow of sewage into the water, but to address the downstream consequences of that and what happens when that flows through the river and gets to our beaches. So we worked really quickly to test the beach water, to take a look at what was actually flowing through the river and how quickly it was moving out to sea, and then safely reopen the beaches just as the heat was hitting.
Bedford: How can people look out for themselves before they plan to go hang out near or around a body of water?
Goldstein: Well, first, I would say folks should go to the Department of Public Health website. We have a beach water quality dashboard, which I think is pretty fantastic. It takes a look at the entire state, and pretty quickly you can see red or green — which beaches are open for swimming and which are closed. And then, also be thoughtful about the forecast and what’s happening with the weather. We know that when there are heavy rains, those rains wash a lot of bacteria down into streams and into the beaches, and that can result in increased bacteria. And so just maybe think about what’s happened over the past 48 hours that might be increasing bacteria in the water and might make it a little bit less safe for you to swim.
Bedford: OK, let’s talk about alpha-gal syndrome. So it’s a life-threatening allergy to red meat and dairy. It’s caused by lone star tick bites. It surged on Martha’s Vineyard and has made its way to Cape Cod. Some of our listeners have questioned whether or not the state responded urgently enough to the tick outbreak.
So one listener wrote us an email. They said the situation should not have ever gotten this far and should be treated with far greater urgency and aggressive action than we’re currently seeing, that we are stuck in an information gathering phase when the state should have started a massive whitetail deer culling program years ago to slow this down. And this listener writes, “Alpha-gal is not cute. It’s not funny. A dangerous disease. And it hasn’t been treated with the seriousness that other public health hazards receive.” How can you respond to that person?
Goldstein: Well, I would note I agree with this listener that alpha-gal is not cute and it’s not funny. It is a very serious disease. It’s a disease that can be life-threatening. But it is also a disease that can certainly be life-changing for those who have it. So it’s something to take incredibly seriously.
You know, this is an emerging pathogen, an emerging tick here in Massachusetts. We’ve been watching this come up the East Coast. It actually started in the Southeast and it’s moved its way into Martha’s Vineyard, the Cape, and now to other parts of Massachusetts. And I think we are acting with urgency to understand why is this tick here, what tools do we have to prevent these tick bites — which might mean getting rid of the ticks and as you noted, getting rid of the deer as well. But then also, how do we respond once people have Alpha-gal syndrome?
So we’re working really hard with our partners in local public health, in particular our partners on Martha’s Vineyard, who have been fantastic to work with. They have a lot of expertise. We’re learning from them. And then we’re trying to take what we learn and bring it out to the rest of Massachusetts.
Bedford: The Lone Star tick was first documented on Cape Cod in 2015. And then there were two positive cases of Alpha-gal on Martha’s Vineyard in 2020. Five years later, there were more than 700 confirmed. So I understand it is emerging, but for this person who says it’s too late — what took so long to get to this point where now to take these steps?
Goldstein: Well, I think, like I’ve mentioned before, we work really collaboratively with our folks in state government. I think there’s a lot of actions that the folks in MassWildlife have had to take in order to cull the deer population. Some of this is what’s happening here in Massachusetts. We have fewer and fewer people who are learning how to hunt. And that means there are few people who are out there hunting the deer and culling the population. Some of the changes that you referenced were put out this year, specifically to try to encourage people to come here and hunt and in particular, to go to Martha’s Vineyard.
