Enshittification: The Cyclospora Crisis

Enshittification “粪化”：环孢子虫危机

This year’s spread of Cyclospora — better known as the ‘explosive diarrhea parasite’ — is a symptom of federal budget cuts and a scary vision of how America deals with a health crisis in the future. 今年环孢子虫（Cyclospora）的传播——也就是人们熟知的“喷射性腹泻寄生虫”——是联邦预算削减的症状，也为美国未来如何应对健康危机提供了一个令人担忧的预演。

Bryan, a food broker from Michigan, wasn’t sure if he’d be able to make it to urgent care in time. He started feeling off on Thursday, and by Saturday, he was having to use the bathroom every 15 to 30 minutes. 来自密歇根州的食品经纪人布莱恩（Bryan）不确定自己是否能及时赶到急诊室。他从周四开始感到不适，到了周六，他不得不每15到30分钟就跑一次厕所。

“It’s no joke about the explosive diarrhea,” Bryan, who asked that his last name be withheld for obvious reasons, told me. I met him via Reddit, where I recently spent hours lurking in threads about cyclosporiasis, the explosive diarrhea illness infecting people across the country, and Cyclospora cayetanensis, the microscopic parasite that causes it, which spreads through human fecal contamination. “关于喷射性腹泻的说法一点也不夸张，”布莱恩告诉我。出于显而易见的原因，他要求隐去姓氏。我是在Reddit上认识他的，最近我花了几小时潜伏在关于环孢子虫病（cyclosporiasis）的讨论帖中。这种导致全国各地民众腹泻的疾病，是由一种名为卡耶坦环孢子虫（Cyclospora cayetanensis）的微小寄生虫引起的，它通过人类粪便污染传播。

Symptoms — including nausea, loss of appetite, cramping and bloating, and the much-discussed watery, explosive diarrhea — can begin anywhere from two days to two weeks after exposure, and experts say they can wax and wane. The explosive diarrhea may stop for a day or two, only to come back in full force. In extreme cases, patients can end up hospitalized after experiencing severe dehydration. So far, the government reports 141 hospitalizations and no deaths. 症状包括恶心、食欲不振、腹部绞痛和腹胀，以及备受讨论的水样喷射性腹泻。这些症状可能在接触寄生虫后的两天到两周内出现，专家表示症状可能会反复发作。喷射性腹泻可能会停止一两天，然后又猛烈复发。在极端情况下，患者可能会因严重脱水而住院。目前，政府报告了141例住院病例，暂无死亡报告。

As a connoisseur of elaborate salads, I was dismayed by the news that a poop-causing parasite may have found its way into America’s summer produce. I wanted answers — and, it appeared, so did thousands of other people on Reddit, who have taken to crowdsourcing information (and misinformation) in the absence of concrete guidance from the federal government. 作为一名精致沙拉的爱好者，得知一种会导致排泄问题的寄生虫可能已经进入美国的夏季农产品中，我感到非常沮丧。我想要答案——看起来，Reddit上的成千上万网友也一样，在联邦政府缺乏具体指导的情况下，他们开始通过众包方式收集信息（以及错误信息）。

Health agencies are being cautious about doling out immediate advice, but the gap in information has left suffering, toilet-bound Americans — and those who fear joining their ranks — to their own devices, and even made people a little conspiratorial. Online, people are speculating whether the government is trying to protect farmers or food distributors. The reality is more mundane but no more satisfying: Federal agencies won’t make hasty recommendations until they have more data, and Cyclospora infections are notoriously difficult to pin down. 卫生机构在发布即时建议时非常谨慎，但信息缺口让那些饱受折磨、离不开厕所的美国人——以及那些担心自己也会中招的人——只能自谋出路，甚至引发了一些阴谋论。在网上，人们猜测政府是否在试图保护农民或食品经销商。现实情况更为平淡，但也同样令人不满：联邦机构在获得更多数据之前不会草率提出建议，而环孢子虫感染以难以追踪而闻名。

Though Bryan wasn’t able to get a test to confirm it, he believes he has cyclosporiasis, making him one of more than 5,000 people across the country infected by the parasite. That figure is almost certainly an undercount, since many cases aren’t reported — and cuts to a federal program that tracks foodborne illness may be hindering investigation efforts. The “explosive diarrhea parasite” is a bigger problem than anyone has been able to grasp, though it’s not clear just how big. The Centers for Disease Control and Prevention has confirmed 1,645 cases since May 1st and is aware of at least 5,100 additional cases that require further analysis. 尽管布莱恩没能通过检测确认，但他相信自己患上了环孢子虫病，这使他成为全国5000多名感染者之一。这个数字几乎肯定被低估了，因为许多病例并未上报——而联邦食品源性疾病追踪项目的预算削减可能阻碍了调查工作。“喷射性腹泻寄生虫”带来的问题比任何人预想的都要严重，尽管目前还不清楚严重到什么程度。自5月1日以来，美国疾病控制与预防中心（CDC）已确认了1645例病例，并获悉至少有5100例额外病例需要进一步分析。

At urgent care, Bryan received “a full battery of tests” except for one — the one that would detect Cyclospora, which isn’t detectable by standard diarrhea tests. “The nurse practitioner said, ‘We can do one of two things: We can wait until Monday, or I can prescribe you Bactrim immediately,’” he explained. “She told me the labs were so backed up in Michigan that they can’t even keep up with the amount of people.” 在急诊室，布莱恩接受了“全套检查”，唯独缺了一项——检测环孢子虫的检查，因为标准的腹泻测试无法检测出这种寄生虫。“执业护士说，‘我们可以做两件事：要么等到周一，要么我现在就给你开复方新诺明（Bactrim），’”他解释道。“她告诉我，密歇根州的实验室积压太严重，根本应付不过来这么多病人。”

Michigan has more confirmed cyclosporiasis cases than any other state: 2,640 as of Monday, according to state health officials, who said lettuce and other salad greens are a “potential source for this outbreak, although other food items cannot be completely ruled out.” State health officials haven’t traced the outbreak to a specific type of produce, or to any growers or suppliers. But The Washington Post reports that federal and state officials are investigating Taco Bell after the fast food chain voluntarily recalled lettuce, cilantro, onion, pico de gallo, and guacamole at some of its locations. 根据州卫生官员的数据，密歇根州的环孢子虫病确诊病例数居全美之首：截至周一为2640例。官员表示，生菜和其他沙拉蔬菜是“此次疫情的潜在来源，尽管不能完全排除其他食品。”州卫生官员尚未将疫情追溯到特定类型的农产品，或任何种植者或供应商。但《华盛顿邮报》报道称，在塔可钟（Taco Bell）连锁店自愿召回部分门店的生菜、香菜、洋葱、莎莎酱和鳄梨酱后，联邦和州官员正在对其进行调查。

Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, explained that a lack of information doesn’t mean a lack of government action. “Anytime we have large outbreaks like this, it’s important to remember that they take time to solve, and it’s not uncommon that it can take multiple days, especially if there’s more than one product that’s involved,” Hamilton said. “There are a lot of folks who are working on this investigation, and it’s a good demonstration around why we do need epidemiologists and disease detectives to have some support and protect our food supply in the US.” 州和地区流行病学家委员会执行主任珍妮特·汉密尔顿（Janet Hamilton）解释说，信息缺乏并不意味着政府没有采取行动。“每当我们遇到这样的大规模疫情时，必须记住解决它们需要时间，这并不罕见，可能需要几天时间，特别是当涉及不止一种产品时，”汉密尔顿说。“有很多人正在进行这项调查，这很好地证明了为什么我们需要流行病学家和疾病侦探获得支持，以保护美国的食品供应。”

Even under the best of circumstances, the parasite is a tricky one to track. “Cyclospora outbreaks are among the most challenging foodborne outbreaks to investigate,” Rodney E. Rohde, program chair of the Medical Laboratory Science Program at Texas State University, told The Verge. The parasite’s long incubation period — usually about a week — and the short shelf life of most fresh produce make it hard to determine what foods made someone sick. Even when a culprit is identified, testing foods for Cyclospora is difficult. 即使在最好的情况下，这种寄生虫也很难追踪。“环孢子虫疫情是最具挑战性的食源性疫情调查之一，”德克萨斯州立大学医学实验室科学项目主席罗德尼·E·罗德（Rodney E. Rohde）告诉《The Verge》。该寄生虫较长的潜伏期（通常约为一周）以及大多数新鲜农产品的保质期较短，使得确定哪些食物导致了疾病变得困难。即使确定了罪魁祸首，对食品进行环孢子虫检测也很困难。

“Another challenge is that pathogens are often present in very low numbers and may be unevenly distributed throughout a food lot,” Rohde said, so a lab may analyze a 25-gram sample of thousands of pounds of product without getting a conclusive result. And even when a tainted batch is confirmed, Rohde explained, “tracing remains difficult because fresh produce often passes through multiple growers, packers, distributors, and…” “另一个挑战是，病原体通常含量极低，且在整批食品中分布不均，”罗德说，因此实验室可能分析了数千磅产品中的25克样本，却得不出结论。即使确认了受污染的批次，罗德解释说，“追踪仍然很困难，因为新鲜农产品通常经过多个种植者、包装商、分销商和……”