Health
What to know about the FDA's paralytic shellfish poisoning warning
- The U.S. Food and Drug Administration says consumers should avoid eating shellfish from Oregon and Washington state as they may be contaminated with toxins that cause paralytic shellfish poisoning.
- Oregon and Washington have prohibited shellfish harvesting on their coastlines, but shellfish have already been distributed across the country.
- At least 31 people have been sickened by paralytic shellfish poisoning so far.
The U.S. Food and Drug Administration says consumers should avoid eating shellfish from Oregon and Washington state as they may be contaminated with toxins that cause paralytic shellfish poisoning. At least 31 people have been sickened in Oregon so far, according to state health officials. Here’s what to know about the federal agency’s advisory.
What did the FDA say about shellfish?
The warning says to avoid oysters and bay clams harvested from Netarts and Tillamook bays in northern Oregon since May 28, as well as shellfish harvested from areas around Willapa Bay in southern Washington since May 26. They may be contaminated with high levels of paralytic shellfish poisoning, or PSP, a naturally occurring toxin produced by algae.
Shellfish harvested from those areas during that period were distributed beyond Oregon and Washington to Arizona, California, Colorado, Hawaii, Nevada, New York. The FDA has warned restaurants and retailers in those states not to serve it.
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What do we know about the shellfish poisoning outbreak so far?
Elevated levels of toxins were first detected in shellfish on the Oregon coast on May 17, state fish and wildlife officials said.
Since then, a paralytic shellfish poisoning outbreak has sickened at least 31 people in Oregon, according to the Oregon Health Authority. The agency has asked people who have harvested or eaten Oregon shellfish since May 13 to fill out a survey intended to help investigators identify the cause of the outbreak and the number of people sickened.
Oregon authorities have closed the state’s entire coastline to the harvesting of mussels, razor clams and bay clams. Agriculture officials have also closed three bays, including those named in the FDA advisory, to commercial oyster harvesting.
Grasses and yearling oysters, growing on the large “mother” shells planted throughout the bed, are seen at low tide on May 1, 2015, in Willapa Bay near Tokeland, Washington. The FDA says consumers should avoid shellfish from Oregon and Washington state as they may be contaminated with toxins that cause paralytic shellfish poisoning. (AP Photo/Elaine Thompson, File)
Officials in neighboring Washington have also closed the state’s Pacific coastline to the harvesting of shellfish, including mussels, clams, scallops and oysters, a a shellfish safety map produced by the Washington State Department of Health shows.
What is paralytic shellfish poisoning?
Paralytic shellfish poisoning, or PSP, is caused by saxitoxin, a naturally occurring toxin that’s produced by algae. Saxitoxin is a neurotoxin, meaning it can damage nerve tissue.
People who eat shellfish contaminated with high levels of saxitoxins usually start feeling ill within 30 to 60 minutes, according to Oregon health officials. Symptoms include numbness of the mouth and lips, vomiting, diarrhea, shortness of breath and irregular heartbeat in severe cases.
There is no antidote to PSP, according to the health agency. Treatment for severe cases may require mechanical ventilators to help with breathing.
Authorities warn that cooking or freezing contaminated shellfish doesn’t kill the toxins or make it safe to eat.
What causes paralytic shellfish poisoning?
A “very large” algal bloom has resulted in “unprecedented levels” of PSP toxins along Oregon’s coast, Matthew Hunter, shellfish program manager for the Oregon Department of Fish and Wildlife, said during a briefing.
The toxins have accumulated in the shellfish, sickening some people who have eaten them.
While the factors that create harmful algal blooms are not well understood, certain factors — resulting from both natural processes and human activities — are believed to play a role, according to the National Oceanic and Atmospheric Administration.
“Studies show that many algal species flourish when wind and water currents are favorable,” the agency says on a webpage dedicated to explaining harmful algal blooms. Some blooms, it says, stem from “sluggish water circulation, unusually high water temperatures, and extreme weather events like hurricanes, floods, and drought.”
Algae growth can also increase when nutrients used in fertilizers, mainly phosphorus and nitrogen, flow into bodies of water, according to the agency.
How long will shellfish be unsafe to eat?
Oregon officials said it may take weeks, months or even up to a year for toxin levels to subside, depending on the type of shellfish.
Mussels can accumulate paralytic shellfish poison rapidly, but also rid themselves of it quickly, according to Hunter, the Oregon fish and wildlife official. Because of this, it may take anywhere from two weeks to a month for mussels to eliminate the toxin.
Razor clams, however, are slower to do so. It may take them several months to a year to cleanse themselves due to the current high levels of toxin, Hunter said.
How common is paralytic shellfish poisoning?
Such high levels of paralytic shellfish poison haven’t been detected in Oregon in decades, according to Hunter, who cited a previous shellfish harvesting closure in the state in 1992.
However, PSP has been prevalent in the regional waters for centuries, he said.
What’s the economic impact of the outbreak?
The harvesting closures may deal a blow to Pacific Northwest fisheries.
The shellfish industry generates $270 million each year for the region’s economy, according to the National Oceanic and Atmospheric Administration, and employs some 3,200 people.
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A Cyclospora parasite outbreak has put lettuce in the spotlight as investigators examine a possible link to Taco Bell, raising concerns among consumers about whether it’s still safe to eat fresh greens.
While investigators have not identified a specific product or supplier as the source of the outbreak, interviews with sick patients have repeatedly pointed to lettuce and other salad greens as common exposures, and many of those patients also reported eating at Taco Bell before becoming ill.
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State and federal health officials – including the Michigan Department of Health and Human Services (MDHHS), CDC and FDA – are investigating a possible link between fresh ingredients served at certain Taco Bell locations and the Cyclospora outbreak.
The chain has voluntarily removed select fresh ingredients at certain locations while public health officials continue their investigation.
A Cyclospora parasite outbreak has put lettuce in the spotlight as investigators examine a possible link to Taco Bell, raising concerns among consumers about whether it’s still safe to eat fresh greens. (iStock, Getty)
In a statement to Fox News Digital, California-based Taco Bell Corp. said, “The health and safety of our guests is our top priority. Public health officials have not confirmed a link to Taco Bell or any specific ingredient, supplier, restaurant or retailer. While authorities continue their broader review, Taco Bell has voluntarily and temporarily removed limited ingredients at select restaurants as a precautionary measure. We will continue to closely monitor the situation and follow the guidance of public health authorities.”
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What is Cyclospora?
Cyclospora is a microscopic parasite (Cyclospora cayetanensis) that infects the small intestine after people consume contaminated food or water, according to the CDC.
The agency confirmed that 1,645 domestic Cyclospora cases have been reported since May 1, most often linked to fresh produce, including leafy greens, cilantro and berries.
State and federal health officials – including the Michigan Department of Health and Human Services (MDHHS), CDC and FDA – are investigating a possible link between fresh ingredients served at certain Taco Bell locations and the Cyclospora outbreak. (AP Photo/Jeff Amy, File)
The CDC is also investigating more than 5,100 additional suspected cases, with a total of 145 people having been hospitalized with the infection.
“Cyclosporiasis is not generally a life-threatening illness for most people,” Tammy Lundstrom, M.D., senior vice president and chief medical officer of Trinity Health in Michigan, told Fox News Digital.
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“The biggest concern is that it can cause severe, prolonged diarrhea that may last for weeks or even longer if it’s not diagnosed and treated.”
People should seek medical attention if they have lasting, severe diarrhea. The symptoms can be very prolonged in people with compromised immune systems, Lundstrom noted.
Experts share food safety guidance
Dr. Marc Siegel, Fox News senior medical analyst, said the parasite has been primarily identified in packaged lettuce and salad bags, but no particular brand has been pinpointed.
“In the meantime, the best strategy is to wash lettuce and all salad greens thoroughly and to wash your hands with soap and water before and after preparing food,” he told Fox News Digital, adding that “the chances of acquiring it still remains extremely low.”
Doctors say the parasite has been primarily identified in packaged lettuce and salad bags, but no particular brand has been pinpointed. (iStock)
Registered dietitian nutritionist Caroline Margolis, the on-staff registered dietitian at Lifeway Foods, an Illinois-based company best known for its kefir and other cultured dairy products, also weighed in on the risk.
“While health officials have identified lettuce as the likely culprit, the exact source remains unknown,” she told Fox News Digital.
For now, she recommends skipping prewashed, bagged lettuce and salad mixes.
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“Instead, choose whole heads of lettuce, discarding the outer two to three leaves, and wash and rinse thoroughly,” Margolis advised. “If you do develop cyclosporiasis, stay hydrated and seek medical care if needed.”
“Be sure to support your recovery with nutrient-rich, easy-to-digest foods and probiotic options like kefir, yogurt, bananas, apples and oatmeal.”
The parasite can cause severe, prolonged diarrhea that may last for weeks or even longer if it’s not diagnosed and treated. (iStock)
Lundstrom reiterated that it’s unclear whether any specific fresh produce is responsible, though past outbreaks have sometimes been linked to fruits and vegetables.
“Federal public health authorities have not issued any warnings to avoid lettuce or other fresh produce at this time,” she told Fox News Digital. “It is recommended to thoroughly wash lettuce and other leafy greens, which can significantly reduce the amount of any pathogen present.”
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Until further information is known, Lundstrom said iceberg is currently a better option for lettuce. She recommends first washing the entire head, then discarding the outermost leaves.
“Be sure to wash your hands thoroughly when handling and preparing fresh produce,” she added.
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For those who wish to take further precautions, frozen and canned produce may be safer options, according to the dietitian.
“It’s important to follow CDC recommendations for safe food and vegetable handling and preparation to help reduce the risk of illness,” she said.
The CDC recommends washing all fruits and vegetables thoroughly under running water before eating, cutting or cooking. (iStock)
Those recommendations include the following.
- Wash hands with soap and water before and after handling or preparing raw fruits and vegetables.
- Wash all fruits and vegetables thoroughly under running water before eating, cutting or cooking.
- Fruits and vegetables that are labeled “prewashed” do not need to be washed again at home.
- Scrub firm fruits and vegetables, such as melons and cucumbers, with a clean produce brush.
- Cut away any damaged or bruised areas on fruits and vegetables before preparing and eating.
- Refrigerate cut, peeled or cooked fruits and vegetables as soon as possible (within two hours).
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Lundstrom added, “It’s important to remember that fruits and vegetables in all forms are an essential part of our daily healthy diet — and by exercising these practical preventive steps, people can still enjoy these nutritious foods.”
For years, the opioid supply in Arizona was dominated by little blue pills pressed and stamped to look like 30 milligram oxycodone tablets, often called “blues.” But two years ago, that began to change. Now the market is mostly powdered fentanyl, and drug deaths are rising. In Phoenix, this shift in the illicit drug supply has combined with heat, meth and homelessness to create an emerging crisis of overdose deaths in America’s fifth-largest city.
Marck Martinez grew up outside Phoenix, and when he first encountered fentanyl, it was those blue pills. But when he relapsed this past February, he had trouble finding them. “I tried to look for blues again, and there were no blues at all,” he said. In their place, he found fentanyl powder, which was stronger and less predictable.
With the switch to powder, he began to overdose much more frequently, most recently in April in a public park next to his 5-year-old son. He survived only because his mother found him and called paramedics, who were able to revive him with naloxone. After being driven to a hospital, Mr. Martinez, 26, fled to a gas station bathroom to smoke fentanyl again.
Harm reduction workers, local researchers and people who use drugs all echoed the same idea: Blues with significant quantities of active ingredients have been disappearing. Blues didn’t vanish all at once, they said. Rather, over the past year or two, it became increasingly difficult to find pills with enough fentanyl in them to have any effect at all. For the most part, the pills remaining on Phoenix streets today are “fake,” Mr. Martinez said, no longer containing enough fentanyl to prevent withdrawal. For drug users in Phoenix, it’s mostly powdered fentanyl that remains.
Brian Clark, associate chief of operations for the Drug Enforcement Administration’s Pacific and Southwest region, said the suppliers of fentanyl haven’t changed, with the Sinaloa and Jalisco New Generation cartels remaining the primary movers of fentanyl across the southern border. But he couldn’t say why these cartels shifted from counterfeit pills to powder in Arizona.
Neighboring New Mexico is seeing the same transition from pills to powder, said Dave Daniels, harm reduction manager for the New Mexico Department of Health. These two Southwestern states had the largest increases in the drug death rate in 2025, all while drug deaths in West Virginia, once the center of the opioid epidemic, have plummeted. According to a New York Times analysis of provisional mortality data from the Centers for Disease Control and Prevention, the drug death rate in Arizona last year overtook West Virginia’s for the first time since the proliferation of prescription painkillers in the late 1990s. Arizona and New Mexico now have the highest rate of drug deaths in the contiguous United States.
The rising drug deaths in the Southwest are in sharp contrast to the large-scale decline that has returned the U.S. drug death rate to its pre-Covid level. The reasons for this decline are still a matter of debate. “Epidemic curves can only go up for so long,” said Caleb Banta-Green, a research professor at the University of Washington. And the shift to powdered fentanyl in the Southwest already happened in much of the country years ago.
The surge of powder in Arizona, however, has spread through a population that is not accustomed to using it. “People adapt to market changes,” said Raminta Daniulaityte, a professor at Arizona State University who researches illicit drug use. “But initially when things change, it can have devastating consequences because people haven’t developed strategies to adapt.”
Margarita Macías, Marck’s mother, remembers coming home one day to find him lying limp in the driveway, soon after he’d returned from four months in rehab, after powdered fentanyl had taken over. Foam was coming out of his mouth. She screamed for her husband. “I felt so helpless,” she said in Spanish, “seeing things spiraling out of control and being unable to do a thing.”
Powdered fentanyl sold on the streets is particularly dangerous because of its higher variability. One recent study of the fentanyl supply in Los Angeles, for example, found that one gram of what was sold as “fentanyl” contained anywhere from less than one milligram of fentanyl to almost 650 milligrams. The variability combined with the potential for extreme potency makes it difficult to dose properly. “With the powder, you would overdose instantly if you weren’t careful,” said Francisco Cabrera, who has used fentanyl for over a decade.
Among the people interviewed for this article who use opioids, most expressed a preference for blues over powdered fentanyl, all else being equal. But ultimately they would use whatever product was available to stave off withdrawal, which causes debilitating pain, vomiting and mental anguish. “It’s like your blood is itching,” said Mr. Martinez, who would scratch himself so severely that his mother would often find him bleeding through his shirt.
‘It is like a blast furnace’
Phoenix, the largest city in Maricopa County and the center of the broader metro area, sits low in the Salt River Valley, under a blanket of warm air at the northeastern edge of the Sonoran Desert. The relentless heat of the city has only compounded the dangers of the fentanyl supply shift. Drug deaths in Phoenix typically peak during the summer months, when temperatures routinely exceed 110 degrees, often remaining above 90 degrees even at night.
The hot nights make it harder for vulnerable populations to recover from hot days spent in a city with wide boulevards and relatively sparse tree cover. “There’s nowhere to hide,” said Scott Greenwood, C.E.O. of Sonoran Prevention Works, a local harm reduction agency. “It is like a blast furnace. It’s like taking a hair dryer and pointing it at your face. That’s what it feels like when there’s a breeze here in July.”
According to a Times analysis of data from the Maricopa County medical examiner’s office from 2024 through March 2026, when the daily high in Phoenix crossed 110 degrees, drug deaths in the county increased by 40 percent. On the 17 days in that period when the temperature reached 115 degrees, drug deaths nearly doubled.
Drug deaths begin to rise once temperatures in Phoenix cross 110 degrees. Above 115 degrees, they nearly double.
In Maricopa County, drug deaths rise along with the temperature
As part of the street medicine team for Circle the City, a nonprofit organization that provides medical care to homeless people in Maricopa County, Dr. Matt Evans has witnessed these dangers firsthand, describing patients who had passed out from fentanyl and suffered third degree burns from pavement superheated by the desert sun. “Substance use and extreme heat do not mix,” he said.
These dangers are aggravated by the widespread use of methamphetamine. Ms. Daniulaityte said 80 to 90 percent of fentanyl users in the region also use meth. The depressive effects of fentanyl are so strong that many drug users said they use meth just to function, smoking fentanyl to bring themselves down and then meth to bring themselves back up again. Several described using methamphetamine to ease the pain of withdrawal.
The combination of heat and meth can be deadly. Whereas a fentanyl overdose causes the brain to stop reminding the body to breathe, methamphetamine kills by pushing the body past its limits, effects that are heightened by heat exposure, lack of sleep and dehydration. “It raises your body temperature, it makes you tachycardic,” Dr. Evans said. “It puts you at risk for heat exhaustion, heat illness, heat stroke in a way that is very dangerous.” The body can quite simply overheat.
In 2025, over half of heat-related deaths in Maricopa County involved drugs. At least 19 people in Maricopa County have died from heat exposure already in 2026, with drug use implicated in 11 of those deaths. In all but one of those drug-related cases, methamphetamine intoxication was listed among the causes.
The interplay between heat and meth is one of the reasons the Maricopa County Department of Public Health broadened its internal definition of drug deaths in 2024 to include any death where drug toxicity was a contributing factor. “There really isn’t a bright line” between a heat death and a meth death, said Dr. Jeffrey Johnston, the chief medical examiner for Maricopa County.
The twin pressures of heat and meth are felt by the large homeless population in the area, who have few options to escape the heat and often use meth as a tool of survival, to stay vigilant. Annual surveys estimate that on any given night there are about 10,000 homeless people in Maricopa County; roughly half are unsheltered, living on the streets, in parks and river beds. Sustained meth use can easily trigger meth-induced psychosis, in which a person begins hearing voices. One man described starting using fentanyl merely to quiet the voices in his head so he could sleep.
According to Arlene Mahoney, the executive director of the Southwest Recovery Alliance, displacement from homeless encampments — like the 2023 dismantling of “the Zone,” the city’s largest encampment — has further heightened the risk. When people can no longer find the drug supply they’re used to, they’re forced to choose between the agony of withdrawal or new, untested sources. “It’s about destabilization,” Ms. Mahoney said. “People are losing the places and people they rely on.”
Advocates for the homeless are especially concerned about a new city parks ordinance that restricts the provision of medical care and food in city parks. City officials have defended the measure as a way to improve safety and sanitation. Outreach workers and medical providers say it will make it harder to reach people who already have little access to health care, at a time when city parks, with shade and grass, can provide a rare respite from the heat. “I think what’s coming here is terrifying,” Ms. Mahoney said. “That’s not public health, that’s not public safety.”
A ‘wake-up call’
After Mr. Martinez overdosed in the park, he returned to living on the streets. Shortly after, a close friend who’d just left rehab, unable to find the blues he was used to, turned to fentanyl powder. The friend died. A few days later, Mr. Martinez checked into the HOPESS Residential Recovery Center.
“It was kind of like my wake-up call,” Mr. Martinez said. He guesses he’s entered inpatient treatment around a dozen times, but he’s determined to make this visit his last. “Every time I come across fentanyl now,” he overdoses, he said. “I’m not gonna make it, you know? It just gets worse and worse.”
The initial data from 2026 appears promising. Reports of nonfatal overdoses in Phoenix through June are 17 percent lower this year than last. Data pulled from the Maricopa County medical examiner’s office shows drug deaths through March tracking lower than last year. It’s possible the crisis has begun to ebb. But it takes months to classify many drug deaths; a complete picture won’t emerge until well after summer is over.
Mr. Martinez has entered a sober living house and has started taking classes at the local community college, where he hopes to pursue welding. Ms. Macías follows his progress closely, eager to see the return of the son she knew from before he started using: “People would say to me, ‘Listen, why do you keep chasing after him?’ But I’d say: I have to help him. If I don’t, who will?”
Methodology
The chart of drug death rates is a Times analysis of mortality data from the Centers for Disease Control and Prevention. Deaths before 1999 reflect the underlying cause of death, using ICD-9 codes E850-E858, E950.0-E950.5, E962.0 and E980.0-E980.5. Deaths from 1999 onward include all deaths in which acute drug toxicity was listed among the contributing causes, using ICD-10 codes X40-X44, X60-X64, X85 and Y10-Y14.
Drug death numbers for Arizona in 2008 are omitted due to a known data issue. Death numbers for 2025 are preliminary, with rates calculated using the Vintage 2025 state population estimates from the Census Bureau.
The chart of Maricopa County drug deaths classifies a death as drug-related if either the primary or contributory cause of death contains any of these words: acetaminophen, alprazolam, amphetamine, amlodipine, buprenorphine, buproprion, bupropion, caffeine, chlordiazepoxide, citalopram, cocaine, codeine, cyclobenzaprine, diphenhydramine, doxepin, fentanyl, fluoxetine, gabapentin, heroin, hydrocodone, ketamine, kratom, kratum, lorazepam, methadone, methamphetamine, mitragynine, morphine, oxycodone, phenobarbital, polydrug, polysubstance, sertraline, tramadol, venlafaxine or zolpidem; or the phrases acute drug, drug intoxication or drug toxicity. It excludes homicides, in which causes of death are redacted. Drug deaths classified as homicides are rare. Some case data is preliminary and subject to change.
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Eating a diet rich in fruits, vegetables, fish and olive oil may help keep the mind strong even into old age, according to new research.
Older adults in England who followed a Mediterranean diet — which is primarily composed of the above foods — during the height of the COVID-19 pandemic reported higher psychological well-being than peers who did not.
The researchers tracked more than 3,000 adults between the ages of 50 and 90 to determine how their daily food choices related to their long-term outlook on life, according to a press release.
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The participants filled out specialized surveys that measured positive psychological traits, including their sense of autonomy, life satisfaction, purpose and control over daily routines.
Each participant also received a score based on how closely their eating habits matched a traditional Mediterranean dietary pattern.
The boost in well-being was not driven by differences in caloric intake, meaning the specific types of food eaten played an important role, the researchers said. (iStock)
Adults who stuck closely to the Mediterranean diet reported a significantly stronger sense of overall well-being.
This finding held even after researchers accounted for factors like income, education, physical activity, smoking habits and general physical health.
The boost in well-being did not appear to be driven by differences in caloric intake, which suggests the specific types of food played an important role.
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As the researchers tracked the participants over several years, they were able to measure how their well-being shifted during the early months of the pandemic.
While emotional well-being and happiness dropped across the entire group during the lockdowns, the study – which was published in BMJ Open – showed the decline was less intense for people who stuck to the Mediterranean diet.
The Mediterranean diet is naturally packed with anti-inflammatory elements, such as antioxidants called polyphenols found in extra virgin olive oil. (iStock)
Previous research points to a few explanations for this.
“This study shows what we’ve been seeing in other research,” Kim Kulp, registered dietitian nutritionist and owner of the Gut Health Connection in the San Francisco Bay Area, told Fox News Digital.
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The Mediterranean diet is naturally rich in anti-inflammatory nutrients, including omega-3 fatty acids from fish and antioxidants called polyphenols found in extra-virgin olive oil.
These nutrients help to lower inflammation in the brain and support a healthy gut microbiome, which is directly linked to the chemical production of mood-regulating hormones, experts say.
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“Since the Mediterranean diet is loaded with a variety of plant foods, it provides an increase in nutrients for the body and brain, special compounds that reduce inflammation, and prebiotics to feed the good gut microbes,” said Kulp, who was not involved in the study.
The participants shared how they felt about their sense of autonomy, life satisfaction, purpose and control over their daily routines. (iStock)
Researchers noted some limitations to the data, including the fact that the study relied on self-reported dietary surveys, which can sometimes be inaccurate.
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Additionally, the participants who completed the tracking tended to be healthier and wealthier than the general public, meaning the results might not fully apply to more diverse or vulnerable populations.
The Mediterranean diet can help reduce stress and depression and improve a sense of well-being, a nutritionist confirmed. (iStock)
“There were only two days of dietary data, and the psychological well-being test was only administered on two occasions, both early on during COVID,” Kulp noted. “Two days of data may not be enough to form conclusions.”
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Because the study was observational, it could not prove a direct cause-and-effect relationship between the diet and improved mental health, the researchers acknowledged.
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“Eating a diet rich in fruits, vegetables, whole grains, nuts, seeds and legumes provides the ultimate combination of nutrients to improve overall health as we age,” said Kulp.
“Together, this diet can help reduce stress and depression and improve a sense of well-being, even during the toughest times.”
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