Amid a rising trend in cyclosporiasis cases across the nation, North Carolina is also witnessing a significant increase. Between May 1 and July 14, 2026, the state recorded 307 cases, with 13 requiring hospitalization. The Department of Health and Human Services will provide weekly updates on the case numbers every Tuesday. Despite the steady cases from 2024 through 2026, authorities have yet to identify a specific product as the source of these infections in the state.
Cyclosporiasis is caused by a microscopic parasite ingested through contaminated food or water, resulting in symptoms like watery diarrhea, stomach cramps, and fatigue, typically manifesting about a week post-infection. Some individuals may remain asymptomatic. Treatment is available through specific antibiotics.
“If you are experiencing severe or persistent diarrhea, you should reach out to your health care provider,” said State Epidemiologist Dr. Zack Moore. “It is also important for everyone to follow routine safety practices like washing your hands with soap and water before and after handling or preparing food and washing all fresh produce under clean running water.”
Efforts are ongoing to determine potential exposure sources within North Carolina, where the surge in cases has not been linked to other state outbreaks. Most cases lack a common source, complicating the investigation process.
Investigations into foodborne illnesses in North Carolina involve collaboration between local, state, and federal entities until a source is confirmed. Unlike typical food contamination, cyclospora is linked to specific ingredients at their origin rather than contamination at food establishments.
“Many individuals may not even realize they have consumed the ingredient that is making them sick, which makes tracing the source of contamination more difficult,” said Dr. Carl Williams, State Public Health Veterinarian. “For example, someone may recall that they had pico de gallo with their dinner, but not that it included cilantro.”
While most foodborne illnesses can be mitigated through pasteurization or cooking, cyclospora poses a challenge as it is often found in fresh herbs and produce like parsley or cilantro, which are usually consumed raw. The parasite can survive from the field to the table if the produce isn’t washed or cooked properly.
The FDA offers these guidelines for handling fresh produce:
- Wash your hands for 20 seconds with warm water and soap before and after preparing fresh produce.
- If damage or bruising occurs before eating or handling, cut away the damaged or bruised areas before preparing or eating.
- Rinse produce BEFORE you peel it, so dirt and bacteria aren’t transferred from the knife onto the fruit or vegetable.
- Gently rub produce while holding under plain running water. There’s no need to use soap or a produce wash.
- Use a clean vegetable brush to scrub firm produce, such as melons and cucumbers.
- Dry produce with a clean cloth or paper towel to further reduce bacteria that may be present.
- Remove the outermost leaves of a head of lettuce or cabbage.
Additional information on cyclosporiasis is available on the NCDHHS website.
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