Jalapenos. Frozen berries. Beef. Alfalfa sprouts.

A summer of food recalls, including the record-shattering cyclosporiasis outbreak tied to iceberg lettuce that has sickened thousands, has raised many Americans’ fears of contracting a foodborne illness.

The recalls have focused attention on the Trump administration’s decision to cut funding and staff at several public health agencies, and prompted questions about whether those changes have made consumers more vulnerable.

In fact, this year’s tally of food recalls is roughly in line with the numbers in recent years. About 48 million people each year get sick from a foodborne illness. But experts worry that the scope, severity and scale of outbreaks and their associated food recalls are growing.

While the United States sees some cyclosporiasis cases every year, this year’s outbreak has crushed records: Since May, the federal Centers for Disease Control and Prevention has confirmed more than 17,000 cases, with another nearly 12,000 reported cases still under investigation. The outbreak has resulted in at least 922 hospitalizations and two deaths.

Federal officials have blamed this year’s multistate outbreak on processed iceberg lettuce from central Mexico. The lettuce was brought to the U.S. by Taylor Farms, a distributor that supplies foods to thousands of restaurants and grocery stores, including Target, Taco Bell, Whole Foods, Kroger, Walmart, Costco and Jack in the Box.

The CDC and the Food and Drug Administration are investigating at least six other clusters for which a source hasn’t yet been confirmed.

Cuts at the CDC and FDA haven’t necessarily increased consumers’ chances of food contamination or outbreaks, said Jennifer McEntire, a food microbiologist and the founder of a food safety consulting firm. However, McIntire said, “I do think the cuts may have influenced the way outbreaks unfold.”

“I think there are valid questions around the timing of the response, the time it took for agencies to recognize the outbreak and to start to investigate it, get boots on the ground in Mexico,” she said.

Darin Detwiler, a food safety expert and professor emeritus at Northeastern University, noted that the U.S. is seeing more recalls affecting multiple states, rather than a small area. He added that more recalls are being tied to a problem earlier in the food chain — such as contaminated irrigation water at a large lettuce farm rather than, say, improperly stored deli meat at a sandwich shop  — which can spread the pathogen to a far higher number of people and make it harder to track and contain.

“We’re seeing so many people impacted, so many states impacted, and the recalls are dragging on for a long time,” Detwiler. “There’s ambiguity or lack of transparency over who’s even behind a recall.”

The White House dismissed concerns about the federal government’s ability to handle outbreaks.

“The Trump Administration has never cut FDA food inspectors or other frontline personnel for domestic disease response,” White House spokesperson Allison Schuster told Stateline in an email. “President Trump’s top priority is the health and safety of the American people, and the federal government remains capable of robustly addressing any future outbreaks.”

Fewer staff, less funding

Last year, the Trump administration laid off thousands of employees at federal public health agencies including the CDC, which tracks and responds to disease outbreaks, and the FDA, which oversees and regulates food safety.

While some of the layoffs were reversed through lawsuits or by Congress, the nation’s health public agencies remain at diminished capacity. The CDC workforce has been reduced by 28% since December 2024, the month before Trump took office, according to a Stateline analysis of data from the U.S. Office of Personnel Management. Employee numbers at the FDA are down 23% during the same period.

Last year, U.S. inspections of foreign food facilities, such as the Mexican farming operation linked to the cyclospora outbreak, plummeted to historic lows following those staffing cuts. The FDA suspended a quality control program for food testing. And the parasite surveillance staff at the CDC, which responds to outbreaks, was downsized last year by the Department of Government Efficiency from 11 people to three.

Sandra Eskin, a food safety expert who worked in the office of food safety at the U.S. Department of Agriculture during the Biden administration, likened federal public health cuts to the game Jenga, where players construct a tower of wooden blocks and then remove the blocks one at a time while trying not to make the tower fall.

“I think that’s what we’re seeing,” said Eskin, who now leads a public health nonprofit called Stop Foodborne Illness, which advocates for stronger food safety policies. “Whether it’s cuts in staff, cuts in funding that trickle down to the states, or late responses to outbreaks — these are all pieces of wood in that game where you start pulling them out and then the whole thing collapses.”

The federal government also has delayed requiring companies to comply with new food safety rules, included in a law enacted more than a decade ago, that would help regulators track where food comes from and where it’s going during outbreaks.

Detwiler and other experts say the new rules could have helped speed the government’s sluggish response to the cyclospora outbreak investigation after Taylor Farms initially tried delaying the recall.

Last year, the Trump administration also drastically scaled back FoodNet, an early warning surveillance system that required tracking of infections caused by eight different foodborne pathogens. The federal-state collaboration is now only required to track two pathogens: salmonella and Shiga toxin-producing E.coli. The other six pathogens, including cyclospora, were made optional.

The CDC says the change was made because other surveillance systems monitor those pathogens. But McEntire and other food safety experts want them reinstated on FoodNet.

State impacts

Infectious outbreaks like cyclosporiasis are typically investigated by state and local health departments, which largely rely on federal dollars distributed through the FDA and CDC. Public health has been chronically underfunded for decades under several administrations, experts say.

But the Trump administration since last year has terminated $5.78 billion in CDC grants — funds that were appropriated by Congress but had not yet been spent.

Michigan, at the center of the cyclosporiasis outbreak with the highest number of cases and clusters, is one of 23 states (plus the District of Columbia) that successfully sued the Trump administration in June 2025 over federal funding cuts.

Changes to federal funding last year affected public health infrastructure across Michigan, a representative from the Michigan Department of Health and Human Services told Stateline. During the cyclosporiasis  outbreak, the state used its own resources to bolster local responses.

“While we are able to support this investigation on a local level, sustained investment in public health capacity is essential to ensuring Michigan can respond effectively to future regional and statewide public health threats,” said department spokesperson Lynn Sutfin.

Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org

WASHINGTON — Dr. Erica Schwartz will be the next director of the Centers for Disease Control and Prevention, after the U.S. Senate confirmed her nomination Wednesday.

The Senate confirmed, 51-44, President Donald Trump’s pick to lead the national public health agency within the Department of Health and Human Services, which has taken heat over the vaccine-skeptical agenda pursued by Secretary Robert F. Kennedy Jr.

That agenda marked a central theme of Schwartz’s tense confirmation hearing in July before the Senate Health, Education, Labor and Pensions Committee, where lawmakers on both sides of the aisle pressed her on how she would deal with any political interference from the Trump administration when it comes to vaccine policy. 

Schwartz ultimately scored the backing of the panel’s chair, Louisiana GOP Sen. Bill Cassidy, who had appeared dissatisfied with her responses at her confirmation hearing.

Sen. Tim Kaine of Virginia was the only Democrat who voted to confirm Schwartz’s bid.

Five senators did not vote, including GOP Sens. Mitch McConnell of Kentucky, Marsha Blackburn of Tennessee and Ron Johnson of Wisconsin, along with Democratic Sens. Ruben Gallego of Arizona and Amy Klobuchar of Minnesota. 

Schwartz worked as an occupational medicine physician in the U.S. Navy. She transferred to the U.S. Public Health Service Commissioned Corps, where she achieved the rank of rear admiral. 

Schwartz also served as the chief medical officer of the U.S Coast Guard and later as deputy surgeon general of the United States.

WASHINGTON — Health and Human Services Secretary Robert F. Kennedy Jr. pledged during his confirmation hearing to do everything in his “power to put the health of America back on track.”

Kennedy testified that when he worked as a lawyer he “learned that human health and environmental health are intertwined and inseparable.” He referred to the Make America Healthy Again agenda as “one of the most powerful and transcendent movements I’ve ever seen.”

“The nation is ready for change and recognizes that this is a unique inflection moment,” Kennedy said.

Less than two years into his tenure at the helm of the department responsible for the health of millions of Americans, a string of outbreaks has repeatedly made headlines. Public health experts interviewed by States Newsroom said the upswing is the result of several factors, but that Kennedy’s decision to cut back the country’s safety net while spreading misinformation about vaccines has aggravated the problem. 

“We track serious infectious diseases, and over the last year and a half, the number of diseases we’ve had to put on the list has quadrupled,” said Jennifer B. Nuzzo, director of the Pandemic Center and professor of epidemiology at Brown University.

Old diseases like measles have surged to the highest level in decades after vaccine misinformation left entire communities vulnerable to a virus once eradicated in the United States.

Americans learned about an unfamiliar strain of hantavirus after cruise ship passengers were moved to a quarantine facility in Nebraska and public health officials raced to contact trace those who left the ship before the illness was detected.

Cases of West Nile virus reached the highest level seen in more than two decades as mosquitoes spread that virus as well as several others. Monthly emergency room visits for tick bites spiked in April to their highest level since 2017. And the cyclospora parasite sickened thousands as public health officials struggled to determine the cause.

Disease spread among animals, which could easily become a human health problem if not properly contained, has also cropped up, some more unexpected than others. 

Bird flu continued to decimate poultry flocks and wreak havoc on dairy herds as well as some people, raising concerns about the possibility it would evolve into something more problematic. And New World screwworm reemerged in cattle after more than half a century without a case in this country. 

HHS and the Centers for Disease Control and Prevention did not agree to interview requests or to send a statement on the cause of the myriad of disease outbreaks. 

Outbreaks growing

Environmental changes like deforestation, people moving into new places that used to belong to wildlife and climate change have all contributed to more disease spread among people. But those factors have been exacerbated by cuts and other policy changes put in place during this administration, Nuzzo said. 

“We don’t have the protections against these outbreaks in place at the level that we used to, which allows them to continue,” she said. “We had bad measles before, but we managed to stop them before we got to the point where we’d lose measles elimination status. We’re going to lose measles elimination status this year.”

The CDC has tried to keep track of it all but the agency has experienced both staffing and funding cuts under Kennedy’s leadership. 

Complicating matters, the CDC had a Senate-confirmed director for just 29 days after Susan Monarez was fired for refusing to pre-approve vaccine recommendations or fire career officials for no reason. 

“Most of the activity for public health exists at the state and local level,” Nuzzo explained. “But the CDC is really important for not just providing funding to those state and local health officials, but also to nudge them. To say, ‘Yes, this is worth prioritizing. Or pay closer attention to this now, because what we see in one place might be happening in another place.’ 

“And the more we can collectively learn and act, the more likely it is to be able to stop it in its tracks.”

In addition to hollowing out certain domestic programs, the administration has cut how the U.S. government monitors and responds to disease outbreaks overseas, which are typically just one airplane flight away. That includes how U.S. officials have handled the outbreak of Ebola caused by the Bundibugyo virus in the Democratic Republic of the Congo. 

“The fact that we didn’t hear about this outbreak publicly until nearly 200 cases were identified means that normal checks and balances just weren’t happening,” Nuzzo said. “So that’s the kind of thing where when we contract our overseas presence and our overseas assistance, we lose a protection. 

“Now, do I think Bundibugyo is going to come here? It could. Is it going to spread? No. It’s not going to spread in the same way like a COVID would.”

States stuck with the burden

American Public Health Association CEO Dr. Georges C. Benjamin said public health officials faced severe burnout and “left in droves” following the global coronavirus pandemic.

That has left public health departments to track more disease circulating in their communities with less staff and funding. 

“If you’re in a local or state health department, the same people dealing with measles are the same people that are going to deal with cyclospora, are going to be the same people if you have a Legionella outbreak,” Benjamin said. 

Those challenges were compounded by efforts under the Trump administration to shift more of the responsibility for preventing and containing outbreaks to state governments “without adequate planning,” he said. 

“Half of both state and local health department budgets are from federal dollars. Some whole programs are almost 100% federally funded. Most immunization programs are pretty much federally funded,” Benjamin said. “So when the feds abruptly decide not to fund something, the money just goes out the door. And you just can’t fill that hole overnight.”

The situation doesn’t seem likely to change anytime soon, he said, possibly leading more people to suffer from vaccine-preventable illnesses as well as those that spread from animals to people or from person to person.

“If we don’t pay attention to this, we’re going to be spending more money on the healthcare side of the ledger for people who will be sicker at a higher cost, because we’re not paying attention to the prevention side of the house,” Benjamin said. “I mean, we have the knowledge and tools to mitigate a lot of this stuff. We really do. And the challenge I think we have here is that as a society we’re pretty good at dealing with emergency stuff, but very poor at prevention.”

More infectious diseases expected

Dr. Amesh A. Adalja, senior scholar at Johns Hopkins Center for Health Security, said there has been progress in recent years on some vaccine-preventable diseases even as there’s been backsliding in others. 

“Now we have RSV vaccines for the elderly, we have RSV vaccines for pregnant women and monoclonal antibodies for babies to protect them against RSV,” he said. 

The American Lung Association writes on its website that respiratory syncytial virus, or RSV, “is a common virus that you have undoubtedly been sick with before.” But that it “has the potential to make you really sick.”

Measles, however, isn’t becoming less common as doctors and other healthcare professionals struggle against an undercurrent of misinformation about vaccine safety, including from Kennedy, as they’re trying to treat all the other illnesses circulating. 

“In measles, it’s less about public health burnout, rather, it’s more about the anti-vaccine movement making inroads,” Adalja said. “For cyclospora, that’s always been a threat. We always get cases every year. But the fact that the malaria and parasite division in CDC has basically been gutted does play a role.” 

Overall, he said, the infectious disease trend in the United States has become worse since the coronavirus pandemic. And that’s not likely to change in the near future. 

“If you’re saying, ‘How resilient is the U.S. or should we expect more infectious disease problems in the United States?’ I would say yes,” Adalja said. “But it’s not clear which ones they would be. I definitely would think the vaccine-preventable diseases, the control of them is going to slip. And it’s not just going to be measles.”

Then there are the bugs

Director of the Center for Infectious Disease Research and Policy at the University of Minnesota Michael T. Osterholm said on his podcast the El Nino weather pattern that leads to warmer temperatures in some parts of the country and heavier rainfall in others can be a “perfect breeding ground for mosquitoes.”

“We talked about the El Nino in previous episodes in the context of hantavirus but it can actually play a large role in disease transmission for a number of viruses, West Nile included,” Osterholm said.

That could be one of the reasons the CDC reported in early July it observed “the earliest start to the West Nile virus (WNV) season in the United States with the highest number of human disease cases reported by this time of year since 2004.”

Osterholm said that is likely “a really major underestimation of the true number of infections.”

“Approximately 20% of West Nile infections in humans are symptomatic and less than 1% result in the severe neurologic symptoms for which testing would typically be sought by medical providers,” he said. “I say that not to undermine the public health importance of West Nile, but to highlight that this virus is likely much more widespread than our surveillance data might suggest.” 

Ticks are also leading to more illness among Americans, including Lyme disease and Alpha-gal syndrome.

That second condition, caused by the Lone Star tick, can cause people to become allergic to red meat that contains Alpha-gal sugar. This includes beef, pork, lamb, venison, goat and rabbit, he said. 

Michigan Department of Health and Human Services Public Information Officer Lynn Sutfin wrote in a statement that even though “infectious disease threats have been trending up in general, there are several practices and issues that are contributing to the increased awareness of outbreaks.” 

“Outbreak definitions, modernized reporting, investigative capacity, improved diagnostics, genetic sequencing and even declining vaccination rates are all having an impact on disease spread and information about their spread,” Sutfin wrote. “Globally, additional considerations like climate change, antibiotic overuse, modern travel, industrialization and deforestation also need to be considered.”

The number of cases of cyclosporiasis — a parasitic infection linked to contaminated water or food that causes severe intestinal issues — has more than doubled to over 4,173 cases across 41 states this week, up from the 1,645 confirmed cases in 34 states reported last week by the federal Centers for Disease Control and Prevention.

Cyclosporiasis causes symptoms that include watery or “explosive” diarrhea, nausea and stomach cramps. The surge in cases had made 2026 the worst year for the infection on record.

The CDC estimates that there are likely more than 7,400 additional cases that have not yet been confirmed. No deaths have been reported, but 308 people have been hospitalized, more than double the 141 hospitalizations reported last week.

State and federal officials suspect there are multiple sources of the outbreak, but they had reported that the cases in Indiana, Kentucky, Michigan, Ohio and West Virginia were connected to shredded iceberg lettuce grown in central Mexico and sold by Taylor Farms. On Monday, however, federal officials said tests making the connection were a false positive.

Michigan, the first state to report an outbreak, reported 7,171 cases and 102 hospitalizations as of July 16. Indiana, New York, North Carolina, Ohio, and Indiana also have seen high case counts, alongside New York City.

The Association of State and Territorial Health Officials, which represents public health agencies across the country, said labs have a hard time tracking case connections because cyclospora is a parasitic genome that is more complex than the bacterial pathogens that cause other foodborne illnesses. As a result, state and local heath investigators must resort to reviewing restaurant and grocery receipts, menus and supply chain records, according to the organization.

“Case interviews and traceback investigations are often time intensive, creating a burden on state and local public health infrastructure,” senior analyst Heather Tomlinson and environmental health director Courtney Anderson wrote.

North Carolina had confirmed more than 560 cyclosporiasis cases as of July 20. Dr. Carl Williams, state public health veterinarian for the North Carolina Department of Health and Human Services, told reporters on Tuesday that the state has relied heavily on its 86 local health departments to track cases.

Williams said twice weekly calls with the CDC also have been helpful.

“The CDC has been very responsive to us and the other states,” Williams said during the briefing. “But as you can imagine, I mean, it’s a lot to go through.”

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org.

The tiniest menace of summer doesn’t care if you’re hiking through the woods, walking the dog or pulling weeds in your backyard.

It just wants a ride and a meal.

As ticks spread into new parts of the country and emergency room visits for tick bites climb higher than usual, states are scrambling to monitor where the pests are showing up, what diseases they may be carrying and how to warn residents before a bite turns into something far more serious.

The federal Centers for Disease Control and Prevention reported in April that emergency department visits for tick bites were higher than expected across much of the United States and at their highest levels for that point in the year since 2017. 

In June, there were 112 tick-related ER visits per 100,000 people, compared with 110 per 100,000 during the same period last year, according to the CDC’s online tick bite tracker. That suggests this year’s summer trend may be in line with 2025.

Nationwide, the latest available data show an estimated 65 tick bite-related emergency department visits per 100,000 people, up from 47 per 100,000 last year. This year’s current figures are preliminary and subject to change, but if they hold, this year’s rate may be the highest since 2017.

Health officials say the trend reflects a combination of expanding tick populations, changing environmental conditions and increased human exposure during warmer months.

The concern extends well beyond Lyme disease.

The lone star tick, once found primarily in the Southeast, has steadily expanded its range and is known for its aggressive host-seeking behavior, often actively crawling toward people and animals. An adult female is distinguished by a white dot or “lone star” on her back.

The species has been linked to alpha-gal syndrome, an allergy that can cause people to develop severe reactions after eating beef, pork and other mammalian products. Researchers also continue to monitor ticks that carry Rocky Mountain spotted fever, anaplasmosis and other illnesses.

Tick surveillance by state health officials varies widely across the country. Some states maintain active surveillance programs that collect and test ticks to identify where disease-carrying species are becoming established. Other states rely more heavily on human disease reports or passive tick submissions, making it harder to detect changes before infections begin to rise.

Those differences can leave public health officials with an incomplete picture of how quickly tick populations are changing — and where people may face the greatest risk.

Several states, including Massachusetts, Missouri and Oklahoma, have expanded surveillance efforts in recent years or launched public education campaigns as tick habitats shift. All three joined the list of states that now or will soon mandate reporting of alpha-gal syndrome. Other states are studying the spread of lone star ticks and the increasing recognition of the syndrome, which experts believe remains underdiagnosed. 

Some experts say warmer winters in many parts of the country have allowed ticks to remain active for longer periods each year while expanding into regions where they were once uncommon. At the same time, growing white-tailed deer populations and changing land use have created more opportunities for people and ticks to cross paths.

Public health officials say the best defense remains preventing bites altogether. They recommend using insect repellents registered by the Environmental Protection Agency, wearing permethrin-treated clothing, including long sleeves and pants in wooded or grassy areas, checking people and pets for ticks after spending time outdoors and removing attached ticks as soon as they’re found.

For states, the challenge is becoming less about responding to tick season and more about adapting to a future in which, in many places, the season is lasting longer — and the tiny hitchhikers are turning up in places they never did before.

Stateline reporter Amanda Watford can be reached at awatford@stateline.org.

WASHINGTON — The Centers for Disease Control and Prevention announced Friday that public health officials have linked the ongoing outbreak of cyclosporiasis in five states to shredded iceberg lettuce from Taco Bell restaurants.

The fast food chain wrote in a statement that it plans to remove the “potentially impacted lettuce” from its “supply chain nationwide and will be replaced within 24 hours in select states.”

“While no official advisory has been issued, we believe public health is a shared responsibility among restaurants, their suppliers, and authorities, and we are proud to have consistently acted quickly and proactively to protect our guests,” the statement said. “Taco Bell has taken precautionary action, and we encourage all relevant restaurants, retailers, and foodservice operators to do the same.”

The CDC statement said it had linked the ongoing outbreak to Taco Bell restaurants in Indiana, Kentucky, Michigan, Ohio and West Virginia. The statement didn’t say whether the lettuce was the cause of the severe gastrointestinal illness caused by a parasite in other states. 

Taylor Farms wrote in a statement that based on information from the U.S. Food and Drug Administration “Taylor Farms de Mexico is voluntarily removing all iceberg lettuce sourced from central Mexico.”

“While the FDA traceback is indicating a specific independent farm that represents less than 1% of the U.S.’s iceberg lettuce supply as the potential source of the outbreak, we have removed all iceberg lettuce from the region indefinitely,” the statement said. 

Taylor Farms added that none of their “salads or kits are associated with this outbreak.”

The CDC has confirmed more than 1,600 cases in 34 states since the outbreak began. Nearly 150 of those people were hospitalized, though no deaths have been reported so far. 

The CDC writes on a webpage about the outbreak that it expects the number of confirmed cases will continue to increase given the six-week “reporting lag between illness onset and case reporting to CDC.”

WASHINGTON — President Donald Trump’s pick to lead the Centers for Disease Control and Prevention didn’t appear to secure the support needed to take over the public health agency during a lengthy and often tense confirmation hearing Wednesday. 

While Dr. Erica Schwartz told lawmakers on the U.S. Senate Committee that oversees health policy she would “never betray the science,” she didn’t seem to win the trust of Democrats or key Republicans needed to advance. 

Chairman Bill Cassidy, R-La., repeatedly questioned Schwartz about whether she would follow the example set by former CDC Director Susan Monarez, who testified last year that she was fired after refusing to pre-approve vaccine recommendations or fire career officials for no reason.

“We need unbiased leaders who make decisions based upon science, not politics or ideology, and are committed to protecting children’s health,” Cassidy said in his opening statement. 

More than two hours later, at the end of the hearing, Cassidy told Schwartz he believed administration officials had overprepared her and that some of her answers missed the mark. 

“I felt like you were always trying not to answer my question, which was disappointing,” he said. 

Cassidy, or any Republican on the committee where the party holds a thin 12-11 majority, could effectively block Schwartz’s nomination if Democrats unanimously oppose it.

Restoring trust

Schwartz, who worked as a Navy occupational medicine physician, earning the rank of admiral, and deputy surgeon general, testified that, if confirmed, she would work to rebuild the CDC’s reputation among all Americans. 

“My first priority will be restoring trust in public health institutions through radical transparency and unwavering scientific integrity,” Schwartz said. “As CDC director, my sacred responsibility is to provide the American people with public health guidance that is clear, honest and evidence-based.”

Schwartz said she would work to “modernize the CDC into a near real-time public health enterprise” while ensuring local, state and tribal governments become the “operational backbone of American public health.”

Schwartz testified in response to questions from both Democrats and Republicans on the Health, Education, Labor and Pensions Committee that she “accept(s) that evidence” that vaccines don’t lead to an autism diagnosis. She said mRNA vaccine “technology is safe and effective.”

Tracking abortions

Missouri Republican Sen. Josh Hawley asked Schwartz to look into the possible health implications for people who live close to a data center, saying his constituents regularly ask him about it and he doesn’t know what to tell them. 

Schwartz said she didn’t know whether the National Institute for Occupational Safety and Health, which is housed within the CDC, had done any research on potential data center health implications. If confirmed, she committed to working with Hawley and his staff to look into the issue. 

Hawley also asked Schwartz if she would ensure the CDC secures data from every state in the country on when and how abortions take place. 

“The CDC collects data on abortions that are committed in the United States of America through a system called the Abortion Reporting System,” Hawley said. “This system is voluntary, and so a number of states, not coincidentally large blue states, do not turn over any data, so that it’s difficult to get a picture of just how many abortions and under what circumstances are committed in this country.” 

Schwartz testified she would look into the issue if confirmed, adding that “abortion surveillance is absolutely a critical component of what the CDC is currently doing.”

“But I also want to also make sure that certain states are not conflating emergency services and hiding abortions in that emergency services case definition,” she said. “We need to make sure we’re pulling out true abortions and making sure that we’re really having clear case definitions regarding abortions, so the data is actually accurate.” 

Cyclosporiasis

Washington Democratic Sen. Patty Murray asked about the ongoing outbreak of cyclosporiasis and the CDC’s disease monitoring programs during her round of questions. 

Schwartz said she believed “that one of the core missions of the Centers for Disease Control and Prevention is tracking outbreaks domestically and also internationally.” 

Schwartz said she was unaware the Trump administration moved to make reporting of cyclosporiasis optional last year after Murray asked whether there would be “any scientific or medical justification for CDC having eliminated mandatory reporting of that parasite.”

“The CDC used to conduct surveillance on this very infection through a program called FoodNet, but in July of ’25, thanks to Trump, CDC made reporting on that illness optional,” Murray said. “Now we are here a year later, and we’re already seeing over 7,000 confirmed or under investigation cases and over 100 hospitalizations with no single cause having yet been identified.”

Schwartz didn’t commit to reinstating mandatory reporting of cyclosporiasis if confirmed to run the CDC, but said she would work with Murray and her staff to understand why that stopped and what the options would be moving forward.