ASHEVILLE, N.C. (828newsNOW) — North Carolina health officials say they are continuing to investigate a growing outbreak of cyclosporiasis, a foodborne illness caused by a parasite, as the number of reported cases climbs above 500 statewide.

The North Carolina Department of Health and Human Services reported 561 cases of cyclosporiasis as of July 20, 2026 — an increase that officials say is consistent with a broader rise in cases being reported across the country.

“We are definitely seeing more cases this year, and that is in line with what we’re seeing nationally,” said Dr. Carl Williams, North Carolina’s state public health veterinarian, during a virtual media briefing Tuesday.

Health officials said they have not identified a single food product or company responsible for the North Carolina cases. While other states have linked some illnesses to an outbreak involving lettuce and Taco Bell restaurants, investigators have not found that same connection in North Carolina.

Instead, officials believe multiple foods may be involved.

“It’s likely, maybe probable, that there are multiple vehicles for Cyclospora,” Williams said. “It’s not a single source or a single food product from a single company.”

Why a veterinarian is leading part of the investigation

Williams’ role as state public health veterinarian may seem unusual during a human illness outbreak, but officials say foodborne disease investigations often involve experts who understand the entire food supply chain.

Although Cyclospora cayetanensis infects humans and is not considered an animal disease, investigators are focused on how contaminated food moves from farms and distributors to consumers.

The investigation includes detailed interviews with people who become sick, looking for common foods they ate at home, restaurants, gatherings or events.

Health officials said leafy greens and fresh herbs — including lettuce, parsley and cilantro — have appeared frequently in patient interviews. That does not necessarily mean those foods are the confirmed source, but repeated mentions can help investigators identify possible links.

“When something keeps showing up repeatedly, a certain type of herb like parsley or cilantro or a certain type of vegetable like lettuce, we start to think that’s probably implicated,” Williams said.

That information can then be shared with state agriculture officials for possible traceback investigations.

Cases spread across North Carolina

Officials said cases have been reported across the state, from Western North Carolina to the coast.

Wake County has reported the largest concentration, with about 350 cases, but health officials said they have not identified another county or region with a similar cluster.

The number of cases reported this year is higher than previous years.

Williams said North Carolina typically sees more cases during June and July, but this year’s numbers are higher than expected.

Health officials also said 16 people have been hospitalized because of the illness.

No testing of lettuce products underway

During Tuesday’s briefing, officials were asked whether North Carolina is testing lettuce products, including Taylor Farms lettuce, because of concerns about connections to outbreaks in other states.

Anita MacMullan, director of the Food and Drug Protection Division with the North Carolina Department of Agriculture and Consumer Services, said the state is not conducting lettuce testing related to the outbreak.

Officials said they continue to work with local health departments, the state agriculture department, the Centers for Disease Control and Prevention and other partners to investigate possible sources.

How Cyclospora spreads

Cyclospora is a parasite that can contaminate fresh produce. Officials said contamination often occurs when human waste enters water supplies used for irrigation or food production.

Unlike meat products, fresh fruits and vegetables typically do not undergo a cooking process that kills pathogens before they are eaten.

“That’s what makes this difficult,” Williams said. “There isn’t a kill step before you eat the food.”

Cooking food to 165 degrees Fahrenheit will kill Cyclospora, officials said, but they recognize most people do not cook fresh produce.

Health officials recommend:

  • Washing fresh fruits and vegetables thoroughly, even if they are labeled pre-washed.
  • Paying attention to food recalls.
  • Practicing safe food handling habits.
  • Seeking medical care if experiencing prolonged diarrhea or other symptoms.

Symptoms of cyclosporiasis can include diarrhea, bloating, fatigue and gastrointestinal problems that may last for weeks without treatment.

CDC investigation continues

Health officials said North Carolina has submitted hundreds of specimens to the CDC for genetic testing to determine whether cases are connected to outbreaks in other states.

Williams said CDC testing has identified some genetic clusters among North Carolina cases but has not yet linked the state outbreak to the illnesses reported elsewhere.

He said genetic testing takes time, especially as states across the country are seeing increased case numbers.

“The molecular work is not quick,” Williams said. “It’s not something that can get turned around in a day.”

Officials said certain groups, including older adults and people with weakened immune systems, should take extra precautions because dehydration caused by prolonged diarrhea can become serious.

Health officials also emphasized that fresh fruits and vegetables remain an important part of a healthy diet and encouraged people not to avoid produce altogether.

“I think this is also a wonderful time to visit some of our North Carolina farmers markets,” said MacMullan. “Maintaining access to those commodities is really important.”