Cyclosporiasis Outbreaks: Understanding the Recent Rise in Infections

Between May 1 and July 14, state health officials confirmed 307 cases and 13 associated hospitalizations. While investigations into the source of the infections remain ongoing, the NCDHHS reports that these cases have not been linked to outbreaks in other states. The department provides weekly updates on case counts every Tuesday.

Understanding Cyclosporiasis Transmission

Cyclosporiasis is a foodborne illness typically acquired by consuming water or fresh produce contaminated with the Cyclospora parasite.

In North Carolina, state health officials note that the current surge is consistent with fresh herbs and vegetables. Dr. Carl Williams, the state public health veterinarian, emphasizes that identifying the specific food item responsible for an outbreak is often difficult because affected individuals frequently struggle to recall the exact ingredients of every meal consumed.

Recognizing Symptoms and Seeking Care

Symptoms of cyclosporiasis typically manifest about one week after initial exposure to the parasite. The most common clinical presentation is frequent, watery diarrhea. Other reported symptoms include:

• Stomach pain or cramping
• Loss of appetite and weight loss
• Abdominal bloating and gas
• Nausea
• Fatigue and flu-like symptoms

Some individuals may carry the parasite without showing any symptoms at all.

Reducing the Risk of Infection

While the current investigation into the source of the North Carolina cases continues, the NCDHHS recommends standard food safety practices to minimize the risk of infection. Because Cyclospora is often associated with produce consumed raw, such as cilantro and parsley, proper preparation is essential:

• Hand Hygiene: Wash hands thoroughly with soap and water before and after handling food.
• Produce Cleaning: Rinse all fruits and vegetables under clean, running water. For items with firm skins, such as cucumbers or melons, use a produce brush to scrub the surface.
• Preparation Steps: Always rinse produce before peeling, as this prevents transferring surface contaminants to the flesh of the fruit or vegetable.
• Drying: Use a clean cloth or disposable paper towel to dry produce after washing.
• Leafy Greens: Remove and discard the outermost leaves of lettuce and cabbage heads.

While cooking foods to an internal temperature of 165 degrees Fahrenheit is the most effective way to eliminate many foodborne pathogens, this is often not practical for fresh produce. Consequently, rigorous washing remains the primary line of defense for consumers handling raw ingredients at home.