Rising Cyclospora Cases in North Carolina
North Carolina is facing an uptick in Cyclospora cases, a tiny parasite that causes some pretty unpleasant gastrointestinal issues, including what many describe as “explosive diarrhea.” It spreads when someone consumes food or drink tainted with fecal matter.
As of July 2, 2026, officials from the North Carolina Department of Health and Human Services confirmed to WRAL that there have been 69 reported cases of cyclosporiasis since early June, mostly concentrated in Wake County, which is the largest county in the state.
This rise coincides with a broader investigation by the U.S. Centers for Disease Control and Prevention (CDC), which is looking into over 140 cases of cyclosporiasis across 17 states, resulting in at least 20 hospitalizations. The cases in question involve individuals who became ill between May 1 and July 16, 2026. While North Carolina is among those reporting cases, no hospitalizations from this spike have been noted.
Current health officials are still trying to pinpoint the exact cause of the rises in cases across the country and aren’t sure if they stem from similar sources.
Dr. Carl Williams, the State Public Health Veterinarian for NCDHHS, indicated that North Carolina’s recent cases don’t yet qualify as an outbreak.
“We’ve seen cases in people of all ages, including kids and seniors over 65,” he told WRAL. “We do expect cases to increase during June and July, so it’s possible we might see more reports soon.”
Typically, cyclospora cases surge in the summer months, mainly because this parasite is often found in fresh fruits and vegetables, which many people consume raw.
Williams elaborated that tracking the source of an outbreak can be a lengthy and complicated process. Symptoms usually don’t present until 2-14 days after consuming contaminated food, making it difficult for people to remember precisely what they ate. “Investigating foodborne illnesses is tricky,” Williams explained. “If too much time passes, we end up with general food preferences rather than specific details.”
This investigation is particularly challenging since cyclospora is often linked to ingredients like cilantro and parsley, which can easily be overlooked in meal preparation.
This was exactly the situation investigators faced during North Carolina’s largest cyclospora outbreak. In 2024, an outbreak involving over 130 cases was traced back to at least three restaurants in Wake County. Health officials later revealed that the outbreak resulted from a shrimp and parsley salad, a detail that came to light only after interviewing multiple patients.
In response to that outbreak, NCDHHS enhanced its investigative approach, forming a collaborative group that includes the Wake County Health Department, CDC, FDA, and the North Carolina Department of Agriculture and Consumer Services. Now, these agencies coordinate food history interviews and conduct ingredient tracebacks to better connect cases.
“We’ve been working closely with them for the last couple of years to streamline our investigations and enhance our food history collection,” Williams added.
Williams mentioned that the approach includes interviewing patients to identify common ingredients. “What all states and local health departments aim to do is, through that analysis of ingredients, find what’s found most frequently in the food history of these cases,” he said. “Where did they eat? If it was a restaurant, where did they source the cilantro? This surveillance aims to locate and eliminate the contaminated product if possible, but identifying it can be quite difficult.”
Another hurdle is that fresh produce often has a short shelf life. By the time the common ingredient is identified, the contaminated food may already be gone from the market.
As the search for a common source continues, health officials suggest the best preventive measure is to wash fresh produce thoroughly. If someone experiences severe symptoms, they should seek medical attention.
“If there’s one temperature to remember, it’s 165 degrees Fahrenheit,” Williams advised. “Cooking your food to that temperature typically eliminates things like Shiga toxin, E. coli in ground beef, Trichinella in pork, and salmonella in chicken; it’s generally safe.”
He also cautioned those preparing food during the Fourth of July weekend to avoid the “temperature danger zone” between 40°F and 140°F, as bacteria can multiply rapidly in that range, sometimes doubling in as little as 20 minutes.
People who experience severe diarrhea or other gastrointestinal symptoms should reach out to a healthcare provider. Diagnosing cyclospora usually involves analyzing a stool sample, and Williams noted that testing is crucial for public health officials to track infections and investigate potential outbreaks.
