Maryland’s Summer of Ick: It’s more than parasites

Popular summer activities ― hiking in the woods, swimming in the bay, even eating a crisp salad — now seem to come with an unusually high level of risk.

There’s been a spike, in some cases to record levels, in infections that come with gross tummy issues, itchy rashes or much worse.

But what’s behind all the icky things?

Amy Sapkota, professor and chair of the department of global, environmental and occupational health at the University of Maryland, College Park, sums it up in one, if unsatisfying, take:

“There’s no one reason,” she said. ”They’re all so different, with different origins.”

Sapkota and others note Maryland has generally fared better than many states but isn’t immune from broader trends.

Some diseases, such as Lyme disease and measles, are old foes, and some, such as rabies, are still just a threat from foxes and beavers. (There are no cases of rabies in humans but exposures from hundreds of cases of rabies in animals a year.) One that wasn’t a household name, cyclosporiasis, has made the words “explosive diarrhea” trend.

Experts say the rise of the parasites, bacteria and viruses causing the infections points to the need for robust public health systems and public education.

That may be especially true when it comes to cyclosporiasis because the foodborne parasitic infection was so unknown to consumers. It causes days or weeks of diarrhea, but symptoms usually don’t surface right away, often not until after people forget what they ate.

Cases typically rise in summer. But more than 12,000 cases in Michigan alone since May — and thousands more in other states — aren’t normal.

Fabiana Berenguer Gil, a 30-year-old Baltimore architectural designer, was new to her position in late May when she began to feel terrible while on a job site. She said she’s typically healthy, with a strong gut, but she went weak in the knees.

“It was rough,” she said.

Weeks after a virtual doctor visit and recovery at home, she first heard the term cyclosporiasis. She had symptoms. She’d eaten at Taco Bell after one late night of work, though the restaurant was implicated only in other states.

She now wishes she’d been tested so, cyclosporiasis or not, public health officials would have another data point in the investigation. Maryland cases now number 190, almost a 50% increase from last year.

For now, Berenguer Gil is avoiding takeout and relying more on food she grows in her garden. Her concerned mother also began bagging dinner for her to grab when she’s nearby for ballet classes.

“Obviously our public health spending has been slashed,” she said. “Even if it wasn’t cyclosporiasis, outbreaks are bigger and more common and are taking longer to wrap up. It can make you lose faith.”

The “annihilated” public health infrastructure did likely delay the response to this “very large outbreak,” said Sapkota, the Maryland professor.

She said federal scientists reduced tracking of cyclosporiasis and other foodborne illnesses under FoodNet, a collaboration between federal agencies and 10 states including Maryland.

Another issue is the globalization of the U.S. food supply. Federal authorities potentially linked cases in some 15 states to shredded iceberg lettuce from Mexico delivered to restaurants and groceries. Taylor Farms has recalled the produce.

The company also recalled prepared foods with jalapeños potentially contaminated with the bacteria salmonella, though neither recall affected Maryland. Salmonella was also dropped from FoodNet.

Cyclosporiasis can spread through feces, often through contaminated irrigation water or poor worker hygiene, said Kalmia Kniel, professor of microbial food safety at the University of Delaware.

More processing offers more chances for contamination, she said. And most produce is consumed raw, while cooking could kill pathogens.

“We’re fortunate to have access to so much fresh produce; it’s wonderful and nutritious,” Kniel said. “But good hygiene and processes are essential.”

Other risk factors aren’t easily controlled, such as rising temperatures more hospitable for cyclospora and other pathogens, including vibrio, increasingly found in the Chesapeake Bay.

People can be infected with vibrio, a type of flesh-eating bacteria, when they swim with open cuts or eat raw shellfish, though swimmers are still more likely to be stung by a jellyfish. However, vibriosis cases in Maryland have been trending up for years and five people recently died in Louisiana from the disease, another victim of FoodNet.

Warmer weather is likely also promoting a longer season and larger territory for ticks and mosquitoes. That has meant more cases particularly of Lyme disease, which is on a two-decade climb. Lyme is known for a bull’s-eye rash and flu symptoms, and sometimes lingering fatigue and pain.

Emergency departments reported in May that visits for tick bites were up more than 25% from last year, and federal data shows bites remain higher this summer than many previous years. However, in Maryland, cases of Lyme disease from ticks, along with West Nile from mosquitoes, trail last year’s numbers.

But there’s a newer concern from ticks: a potentially life-threatening allergic reaction to red meat called alpha-gal syndrome.

And, not to be left out of the pathogen menagerie, a drug-resistant fungus is storming the country. Called Candida auris, it is often spread in healthcare settings. Federal data shows Maryland has had 79 cases in 2026.

However, measles is the infection often most worrying to public health officials because it’s highly contagious and often serious.

Maryland has logged 13 cases this year, more than the previous nine years combined, though a fraction of the record-busting cases in other states. Measles causes flu-like symptoms and a red rash, and it can lead to brain swelling and long-lasting immune system damage.

More people are refusing the highly effective shot for measles, mumps and rubella as authorities such as Robert F. Kennedy Jr., the U.S. health secretary, cast unfounded doubt on its safety. (Mumps cases also are on the rise.)

President Donald Trump just issued an executive order to break up the vaccine into three shots delivered over three doctor visits, among other childhood vaccine changes, a move the American Academy of Pediatrics called “unscientific and dangerous.”

The vaccination rate in Maryland hasn’t dropped as significantly as that in other states, remaining above the 95% threshold needed to provide wide protection. But small pockets of vulnerability remain, said Dr. Meg Sullivan, Maryland’s deputy secretary of public health services.

Sullivan said officials continue to promote vaccinations and monitor pathogens — consider last year’s flu season was a doozy and this season hasn’t even started.

The threats are real, but Sullivan had another message: Don’t be so fearful you stop going outside and enjoying yourself.

“We really try to toe the line between being aware and educated and not overly alarmed,” said Sullivan, adding that people can take precautions.

• Wash fruits and vegetables, and consider cooking them to avoid cyclosporiasis.
• Don’t swim in natural bodies of water if you have an open cut to avoid vibriosis.
• Wear protective clothing and use repellent with DEET to avoid mosquito-borne illnesses.
• Tuck your socks into your pants, stay at trail centers and do a tick check to avoid tick-borne illnesses such as Lyme.
• Get vaccinated to prevent measles.

Banner audience engagement editor Stokely Baksh contributed to this article.