ASHEVILLE, N.C. (828newsNOW) — North Carolina health officials say they are narrowing their investigation into a growing outbreak of cyclosporiasis, with parsley, cilantro and lettuce emerging as the foods most commonly reported by people who became sick.
The North Carolina Department of Health and Human Services said Friday that 307 cases of the intestinal illness and 13 hospitalizations had been reported statewide between May 1 and July 14. The total exceeds the number of cases reported during all of 2024 and 2025, and additional cases continue to be identified.
Buncombe County has confirmed four cases.
State officials said the increase in North Carolina cases does not appear to be connected to the multistate outbreak linked to Taco Bell restaurants. Instead, interviews with patients in North Carolina have most frequently identified parsley, cilantro and lettuce as foods they consumed before becoming ill.
Health officials cautioned that those ingredients have not been confirmed as the source of the outbreak.
“While this type of information can suggest which types of produce are more likely to be contaminated, it does not prove with certainty that any of these were the source of infection,” NCDHHS said in a news release.
The investigation is being led by NCDHHS in partnership with the North Carolina Department of Agriculture and Consumer Services, local health departments and federal agencies. State agriculture officials are tracing ingredients reported by patients to identify possible suppliers or sources of contamination.
Cyclosporiasis is caused by the microscopic parasite Cyclospora, which spreads through contaminated food or water. Symptoms typically begin about a week after exposure and can include watery diarrhea, stomach cramps, nausea, fatigue, bloating, weight loss and loss of appetite. The illness is treatable with antibiotics but can require hospitalization in some cases.
Because the parasite is most commonly associated with fresh produce eaten raw, officials are urging restaurants and consumers to take extra precautions.
Washing fruits and vegetables under running water may remove some of the parasite but does not guarantee it will be be eliminated, health officials said. Cooking foods to at least 165 degrees Fahrenheit is effective against most foodborne illnesses, including cyclosporiasis, but herbs and leafy greens linked to the outbreak are often served uncooked.
State health officials said restaurants and home cooks should consider removing or thoroughly cooking ingredients such as parsley, cilantro and lettuce if they are concerned about the current outbreak.
Local health departments continue interviewing patients to identify common exposures while investigators work to determine whether a single source is responsible for the increase in cases.
828newsNOW contacted the U.S. Department of Agriculture seeking comment on the investigation. A USDA spokesperson referred questions to the U.S. Food and Drug Administration, which regulates the safety of most fresh produce. The FDA had not responded to a request for comment as of publication.