Editor’s note: This July 15 interview was conducted before federal officials confirmed shredded iceberg lettuce as a source of one cyclospora outbreak; investigations into other cases are ongoing.

A growing cyclospora outbreak across the U.S., including a recently confirmed travel-related case in Hawaiʻi, is raising questions about how the foodborne parasite spreads and how people can protect themselves. Erika Noel, an assistant professor at the University of Hawaiʻi at 惭腻苍辞补 (JABSOM), answers common questions about cyclospora, including its symptoms, treatment and simple food safety practices that can help reduce the risk of illness.

Q: Why is this outbreak more concerning than previous years?

Cyclospora is something that we see annually, particularly in the spring and summer months from May through August. But what has been so concerning about this current outbreak is that we don’t currently know the main source. In previous years, it has been traced back to things like raspberries, pre-washed salad mixtures, and other produce.

Q: Can cyclospora spread from person to person?

Cyclospora is not contagious, as it cannot be passed from person to person. It is transmitted when people consume food or water that is contaminated with human feces containing the oocysts, or the eggs, of the parasite.

Q: What symptoms should people watch for?

The symptom range looks like a typical stomach bug: diarrhea, nausea, fatigue, cramping and bloating. Because of that, many cases fly under the radar. Some people ride the illness out at home rather than seeing a doctor. Most of the time, people will recover from the illness on their own, with symptoms resolving within about a week. So, it is definitely not something to panic about. Again, it is important for us to be aware, but not panic, about the cyclospora outbreak during this time.

Q: What are the best ways to reduce your risk?

The best way to prevent illness is to, first and foremost, follow standard hygiene and food safety practices. Washing our hands with soap and water after using the bathroom and before and after preparing food is important, as alcohol-based hand sanitizers do not kill cyclospora; however, soap and water do. Cleaning produce with vinegar has been more effective than just running water alone. For example, use one part vinegar to three parts water. It doesn’t kill the cyclospora, but it helps the parasite detach from the fruits and vegetables, which has been shown to reduce the risk of getting sick or making the illness less severe. Produce is safest when it is heated to 158°F degrees or higher, which actually kills the cyclospora.

Q: So when in doubt, just cook it?

Absolutely. When in doubt at this time, the best thing to do is cook. For fruits with crevices, such as raspberries or strawberries with bumpy surfaces, we actually recommend cooking them in pies or jams to greater than 158°F degrees, because we know that those have been linked to previous cyclospora outbreaks. Freezing them can reduce the number of parasites, but probably not entirely, so we do recommend cleaning. Other things like cilantro and basil, which have small leaves, should be washed thoroughly, separating the leaves in order to decrease the chances of an outbreak. For green onions, we would like for you to trim the root end and remove the outer layer.

Q: What should people know if they become infected?

It is part of the reportable diseases to the Department of Health, and we do see some cases every year throughout the nation. So, it is relatively common in the sense that it happens every year, just not to this degree. One of the greatest things about cyclospora is that there are treatments for it. We always say do not take over-the-counter anti-diarrheal medications like Imodium or Pepto-Bismol without the consultation of your primary care physician. What is interesting is that even though it is a parasite, it has been found that an antibiotic is very effective in treating cyclospora.

Q: What is your final advice?

Even though we cannot eliminate our risk completely, it is just important for us to go back to the basics and always wash our hands. If you are sick, please do not prepare food for yourself or other people. Make sure to call out sick, and know that alcohol-based hand sanitizers do not kill cyclospora. So, always go back to hand washing with soap and water for at least 20 seconds.

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Researchers at the and 糖心视频 惭腻苍辞补 (JABSOM) were awarded more than $12 million from the National Institutes of Health (NIH) to establish the Pacific Center for Artificial Intelligence and Data Science in Medicine (PAC-AID)—a new research center dedicated to accelerating biomedical discoveries through artificial intelligence and data science to benefit people in Hawaiʻi and the Pacific region, and worldwide.

Funded through the NIH‘s (COBRE) program, the five-year award will provide approximately $12 million through February 2031. The award was administered by the National Institute of General Medical Sciences, with a federal award date of June 4, 2026.

The center will be led by Principal Investigators John Shepherd and Youping Deng. Shepherd is chief scientific officer at the 糖心视频 Cancer Center, and B.H. and Alice C. Beams Endowed Professor in Cancer Research at JABSOM. Deng is co-director, Genomics and Bioinformatics Shared Resource, at the 糖心视频 Cancer Center; and professor and director, Bioinformatics Core Facility, at JABSOM.

PAC-AID will serve as a central hub integrating AI into biomedical research to improve health outcomes in Hawaiʻi. Over five years, the project will renovate the 糖心视频 Cancer Center Data Center to establish a new Medical AI Core (MedAI Core), providing advanced, high-performance computing resources and AI expertise. Physically located within both the 糖心视频 Cancer Center and JABSOM on the shared Kakaʻako campus, PAC-AID will directly fund four major inaugural research projects and establish a Pilot Projects Program to support more than eight new, locally relevant pilot studies.

“At the heart of our mission as a flagship research university is the drive to translate innovation into meaningful impact,” said Vassilis Syrmos, incoming chancellor of 糖心视频 惭腻苍辞补. “PAC-AID is a vital expansion of that mission, enabling our faculty to harness the power of artificial intelligence to pioneer new avenues of biomedical inquiry that were previously unreachable, solidifying the University of Hawaiʻi at 惭腻苍辞补’s role as a global leader in health innovation.”

“AI has the potential to unlock major medical breakthroughs and help people live healthier lives, and we need to take advantage of it,” said U.S. Sen. Brian Schatz, who played a pivotal role in securing the grant. “This new funding will help Hawaiʻi continue to attract top-tier talent and develop treatments and cures that will benefit people across the state.”

“The $12 million over five years will substantially strengthen AI and data science capabilities and support the development of the next generation of investigators,” said 糖心视频 Cancer Center Director Naoto T. Ueno. “The research advances made possible by PAC-AID will further the 糖心视频 Cancer Center鈥檚 work toward new understandings and treatments for cancer, to save lives in Hawaiʻi and the Pacific, and across the globe.” In addition, high paying jobs generated by this project will have a strong economic benefit for our local communities.

“At JABSOM, our mission is to improve the health of Hawaiʻi through education and research,” said Sam Shomaker, JABSOM dean. “This investment will help accelerate discoveries that address the real health challenges facing our communities and ensure that advances in AI translate into better outcomes for patients.”

Enabling workforce development

Shepherd and Deng will oversee efforts to build research capacity, as well as foster the next generation of independent investigators using artificial intelligence and advanced data science approaches to address critical medical and public health challenges. Beyond funding research, this award establishes a workforce development mechanism to support the next generation of faculty investigators.

“This COBRE award provides the critical infrastructure to bridge advanced AI computational methods with our specific clinical and community health challenges,” Shepherd said. “By fostering a collaborative environment for our investigators, we are equipping them with the technical capabilities to tackle the most persistent health disparities in our islands and turn complex data into actionable health solutions.”

“By the end of this project, we expect to have a nationally competitive Medical AI Core, four independently funded research leaders, and more than 10 pilot projects,” said Deng. “Through these efforts, alongside workshops and collaborative research opportunities, we will significantly strengthen Hawaiʻi‘s capacity for AI-enabled biomedical research and innovation to address important health challenges in our region and beyond.”

Transforming medical research with AI

Artificial intelligence is increasingly transforming healthcare and biomedical research by helping scientists analyze large and complex datasets, identify patterns that may otherwise go undetected, and accelerate the development of new approaches to disease prevention, diagnosis, and treatment.

AI has the potential to unlock major medical breakthroughs and help people live healthier lives, and we need to take advantage of it.
—U.S. Sen. Brian Schatz

Shepherd, who leads the , is using a massive breast imaging database to develop AI biomarkers that predict cancer risk specifically for Asian and Pacific Islander populations.

The new PAC-AID will support similar faculty-led research projects, provide funding for pilot studies, and establish shared research resources that can be used by investigators across disciplines.

Initial funded projects include AI-driven research by 糖心视频 Cancer Center researchers Kevin Cassel (using full-body imaging to triage skin lesions) and Elizabeth Nakasone (studying pancreatic cancer in Native Hawaiian and Japanese populations); 糖心视频 惭腻苍辞补 public health researcher Jonathan Huang (modeling environmental toxicant effects on fetal development); and JABSOM researcher Yiqiang Zhang (identifying genetic traits in congenital heart disease).

COBRE Phase 1 grants focus on the development of independent biomedical researchers and research centers, and are designed to have a 15-year cycle.

“PAC-AID is specifically designed to develop six to eight early-stage faculty members at the University of Hawaiʻi and across Pacific Island institutions who will use artificial intelligence and data science to address cancer and chronic disease outcomes in one of the nation’s most medically underserved and understudied regions,” Shepherd said.

He added that the expected impact to Hawaiʻi is substantial. “Our benchmark for success is that the funded faculty projects, four initially and two to four more when those graduate in year 3, and will later achieve independent NIH R01 (Research 01 level university) funding at an estimated $3.25 million per award. That represents a projected $19.5 million in additional federal research funding returned to the State of Hawaiʻi (six funded R01s) on top of the initial $12 million COBRE award itself — a combined potential economic and research impact of more than $31 million for Hawaiʻi‘s research and healthcare workforce. These estimates are for the first 5-year period.”

PAC-AID joins a growing portfolio of NIH-funded Centers of Biomedical Research Excellence at 糖心视频 惭腻苍辞补, including the , and the .

For University of Hawaiʻi at 惭腻苍辞补 medical student Kalpana Balaraman, a summer spent in the Republic of the Marshall Islands offered a transformative lesson in health care and cultural humility.

Balaraman, a second-year student at the (JABSOM), joined classmates Kaela Akina-Magnussen and Trini Leung in Majuro Atoll, in the capital of the Marshall Islands, this past summer. The month–long training gave them firsthand exposure to providing care in a resource-limited environment.

From the start, the experience challenged expectations. Balaraman recalled receiving her boarding pass just 24 hours before departure, with no fixed departure time. “This lay the foundation for the ‘island time’ that we would experience over the next month and probably most importantly, that a lot of things outside of my own control will determine what I’m able to do and when I’m able to do it.”

Climate change, access to care

Climate change also shaped her stay. Torrential rains and rough seas disrupted travel to outer islands, revealing the challenges Marshallese residents face in accessing hospitals, food and medications. With only two public hospitals in the country, one in Majuro and another in Ebeye, safe weather conditions often determine whether residents can reach essential care.

“What ended up being a missed opportunity for me is what everyday life can be for the people of the Marshall Islands,” she said.

Much of her clinical work focused on non-communicable diseases, especially diabetes. “I was wholly unprepared for the severity of the degree of diabetes in Majuro, and the routine plentitude of peripheral neuropathy, regular infections and amputations,” Balaraman shared.

She found it difficult to advise patients on healthy diets, given limited access to fresh foods and reliance on processed staples such as rice and ramen.

Shaping future patient care

Beyond clinical challenges, Balaraman said the most important takeaway was a deeper understanding of cultural perspectives in health care.

“While I will never be able to truly understand any culture that is not my own, what my time in Majuro gave me was assurance that my relationship with these cultures and my patients is dynamic,” she reflected.

Balaraman hopes to carry those lessons forward into her future career in Hawaiʻi. “By living for a short period of time in a culture that is so different from my own… I am hopefully getting more and more competent in caring for my patients in a culturally concordant manner with each encounter.”

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Long ambulance response times, costly and unreliable non-emergency transportation, and insufficient insurance coverage for travel-related health care expenses are among the key findings of a new report released by the (糖心视频 RHRPC).

underscores the widespread challenges faced by residents in rural and neighbor island communities when trying to access timely and affordable health care, and offers policy solutions to address barriers.

Although about 30% of Hawaiʻi鈥檚 population lives in rural areas spread across six publicly inhabited islands, most specialty care is located on Oʻahu. The report found that residents of Molokaʻi and 尝腻苍补ʻ颈 routinely face flight delays or cancellations, often missing urgent medical appointments and waiting months for rescheduling.

The report also highlights gaps in insurance coverage, especially for patients who do not qualify for Medicaid, and the high out-of-pocket costs for travel, lodging, and food associated with medical visits. Maternal-fetal health services are particularly challenging, with some pregnant patients needing to relocate from neighbor islands to Oʻahu for prenatal and delivery care or risk emergency medevac transport.

“Improving access will require coordinated efforts across healthcare, transportation and policy sectors,” said John Desfor, 糖心视频 RHRPC policy and data analyst. “We hope this research will guide meaningful action to improve transportation access for healthcare in rural communities across Hawaiʻi.”

Some of the shared policy options to address these challenges include:

• Enhance emergency air and ground ambulance fleets
• Support community paramedicine programs and expand primary care teams
• Mandate non-emergency medical transportation coverage in Medicare and private/employer-based insurance in Hawaiʻi
• Establish a grant program for community-based organizations to support housing for maternal-fetal patients relocating for prenatal and delivery care
• Support regional health hubs and mobile maternal health clinics in rural areas
• Expand interisland flight programs and explore cost-effective and sustainable alternative modes of transportation for health services
• Address airline reliability concerns and increase airline competition by leveraging the U.S. Department of Transportation Essential Air Service program
• Enable hospitals and clinics to be reimbursed for transportation

This project was supported with funding from the Hawaiʻi State Department of Health Office of Primary Care and Rural Health.

The four-part report features a literature review, interviews with 40 stakeholders, policy recommendations and a focused sub-report on maternal-fetal telehealth. .

“We appreciate the significant community engagement in this project from start to finish,” said Aimee Grace, 糖心视频 RHRPC principal investigator and 糖心视频 Strategic Health Initiatives director. “Many stakeholders met with our team to share their stories or contribute context and policy ideas. We look forward to working together to share these policy options further.”

The Hawaiʻi Public Health Institute will host a webinar on this project on August 18, 2025, noon–1 p.m. ().

A new report from the University of Hawaiʻi Economic Research Organization (糖心视频ERO) reveals deepening disparities in health, access to care, and basic needs across Hawaiʻi, including that almost 40% of young adults are unable to access mental healthcare. (PDF).

The 糖心视频ERO Rapid Health Survey has tracked more than 2,000 adults statewide since 2022. The most recent results from December 2024 show:

• Declining health: Only 40% of residents rate their health as excellent or very good鈥攄own from 44% in 2023. Among Native Hawaiian and Pacific Islander (NHPI) and low-income respondents, ratings dropped from 40% to 23%—a 17 percentage point decrease in 18 months.
• Mental Health Strain: 31% report symptoms of depression; 1 in 10 low-income individuals show severe symptoms. Those who missed needed mental healthcare rose from 5% (mid-2023) to 22% (December 2024)—a 17 point increase. For young adults aged 18⏻34, the rate surged from 8% to 39%—a 31 point increase.
• Barriers to care: Mental healthcare access worsened significantly, especially among young adults (39% unable to access care).
• Food and housing insecurity: Nearly 30% report low or very low food security, and one-third live in rental or unstable housing.

The report calls for equity-driven policy solutions, expanded community health services, and stronger investment in housing, food security and real-time data systems to guide public health decisions. 糖心视频ERO created an for the findings.

For Melanie Ako, graduating from this spring with a is more than just a milestone—it鈥檚 a turning point.

“I didn鈥檛 finish high school. I got my GED in 2005 and thought that was enough,” Ako said. “I didn鈥檛 have the support back then to follow through with anything. But now, with the support I have, I鈥檝e proven to myself that I can finish what I start.”

Honestly, I feel like this program chose me.
—Melanie Ako

Ako enrolled at Kapiʻolani CC in fall 2024 while working full time at 7-Eleven in M膩kaha, raising four children—the youngest in fourth grade— and caring for her family. She discovered the Community Health Worker (CHW) program during a telehealth visit at Waiʻanae Coast Comprehensive Health Center (WCCHC) and was immediately drawn to it.

“It just spoke to me. Honestly, I feel like this program chose me,” she said.

• Meet more amazing 糖心视频 spring graduates

Connecting with coursework, community

The CHW program trains students to become trusted connectors between healthcare systems and underserved communities. Ako鈥檚 practicum at WCCHC allowed her to engage in meaningful work—conducting outreach, shadowing case managers and coordinating events for k奴puna.

“These experiences were so valuable,” she said. “They helped me grow professionally and gave me a purpose in serving my community.”

While the program was mostly online, Ako found a deep connection with her coursework and instructors. She credits Phoebe Hwang, assistant professor at the , with helping her stay motivated.

“Phoebe is amazing,” Ako said. “Her lessons and assignments were thoughtful and made the material feel applicable to real life. She really helped me build confidence in myself.”

Strong commitment to serving

Hwang said: “I’ve had the pleasure of having Melanie in two CHW courses. Despite not having been in a traditional academic setting in a while, having to care for her children and family members, while working full time, she performed exceptionally well. She consistently engaged with the program in a way that showed depth, reflection and a strong commitment to serving others.”

Ako hopes to continue her work at WCCHC, helping others as she was once helped.

“Being a community health worker allows me to support others, just like someone once did for me,” she said.

—By Lisa Yamamoto