North Carolina Reports Over 300 Cyclosporiasis Cases Led by Wake County

Cyclosporiasis Surge in Wake County and North Carolina

The number of confirmed cyclosporiasis cases in North Carolina has climbed to more than 300 in recent weeks, according to the North Carolina Department of Health and Human Services (NCDHHS). Wake County remains the epicenter of the state’s outbreak, with local health officials confirming that the county has recorded more than 300 cases since May 1, including 13 hospitalizations. Across Western North Carolina, cases have also surfaced in Buncombe, Henderson, McDowell, and Rutherford counties.

View this post on Instagram about Wake County, Taco Bell

Investigative Challenges and the Taco Bell Outbreak

While the U.S. Centers for Disease Control and Prevention (CDC) has linked more than 1,500 cases across five states to shredded iceberg lettuce served at Taco Bell, North Carolina officials maintain that their regional surge remains distinct. NCDHHS stated that the North Carolina cases does not appear to be associated with the outbreak in other states involving Taco Bell.

Identifying the exact source of a Cyclospora outbreak is notoriously difficult. Dr. Carl Williams, State Public Health Veterinarian for NCDHHS, explained that the incubation period—often 2 to 14 days after consuming contaminated food—means patients frequently struggle to recall their specific dietary history. Foodborne disease investigations are complicated in general because you have to rely on interviews with the case patients to get their food history, Williams told WRAL. If you wait too long, you tend to get food preferences as opposed to the specific history.

For more on this story, see North Carolina Reports Over 300 Cyclosporiasis Cases With Wake County Surge.

Surveillance Gaps and Diagnostic Advice

The difficulty in tracking the current surge is compounded by broader changes in public health surveillance. Former CDC Director Dr. Robert Redfield criticized these reductions, stating, Surveillance is sort of the key to early identification.

For individuals currently experiencing symptoms, clinicians advise patience regarding diagnostic testing. Dr. Christopher Chao, medical director at WakeMed Urgent Care, emphasized that the majority of diarrhea cases will resolve in a few days and cautioned against early testing. Dr. Schwartzman echoed this, advising that patients should seek immediate care if they experience significant abdominal pain, there’s blood in their stool, they’re unable to keep any kind of fluids down, [or] they’re vomiting.

Prevention and Future Monitoring

Health departments in North Carolina are collaborating with the state Department of Agriculture and Consumer Services to identify common food links, such as cilantro, parsley, and lettuce, which have been historically associated with outbreaks. While washing produce is a standard recommendation, officials acknowledge that the microscopic nature of the parasite makes it difficult to remove entirely from fresh fruits and vegetables. Public health officials continue to urge the public to monitor symptoms closely and maintain hydration while the investigation into the source of the North Carolina cases remains ongoing.