Thousands of Americans have been affected by a major outbreak of cyclosporiasis, an intestinal illness caused by the Cyclospora parasite, with two deaths reported in Michigan. The parasite can contaminate fresh produce and cause severe diarrhoea, stomach cramps, nausea, fatigue and weight loss, sometimes requiring hospital treatment. Ohio resident Moe Ayyad described becoming seriously ill after eating at a Taco Bell restaurant and has filed a lawsuit alleging that contaminated produce was responsible. Estimates of the scale of the outbreak vary considerably, with monitoring organisations reporting conflicting case numbers. Britain has also recorded dozens of cases, many involving travellers returning from Mexico. Despite official denials, critics argue that reductions in federal and state public-health funding have weakened laboratory capacity and delayed surveillance. In July, cases of measles in the USA hit a 35-year record high; vaccination rates have declined steadily since Robert Kennedy became health secretary.