North Carolina has confirmed 561 cases of cyclosporiasis as of July 20, 2026, with 16 people hospitalized from the parasitic infection, according to state health officials. The outbreak, which began May 1, has grown rapidly, with 254 new cases reported in just one week before July 20.
The microscopic parasite that causes cyclosporiasis spreads through contaminated food or water, typically affecting produce and fresh herbs. Unlike many foodborne illnesses, it does not spread directly from person to person, making contaminated fresh produce the leading suspected source.
Despite weeks of investigation, the North Carolina Department of Health and Human Services has not identified a single food product or company responsible for the outbreak. Dr. Carl Williams, state public health veterinarian for NCDHHS, told reporters that the state’s outbreak may stem from multiple sources rather than one contaminated shipment. “Our thought is that it’s likely that there are multiple vehicles for cyclosporiasis. It’s not a single source or a single food product from a single company,” Williams said.
The challenge in tracing the source lies in how the parasite contaminates produce. Cyclospora originates in the field where crops are grown, often through irrigation or pesticide application with contaminated surface water from countries where the parasite is endemic. “Someone may recall that they had pico de gallo with their dinner, but not that it included cilantro,” Williams explained, noting that people often don’t realize which ingredient made them sick.
North Carolina’s cases are not epidemiologically linked to outbreaks in other states, according to NCDHHS. However, the outbreak is part of a nationwide surge: the Centers for Disease Control and Prevention reported 4,173 laboratory-confirmed cyclosporiasis cases across the United States as of July 21, 2026, with more than 7,400 suspected cases. Michigan has experienced the largest cluster, with cases also rising in Ohio, Kentucky, and West Virginia.
Cyclosporiasis typically causes watery diarrhea, stomach cramps, loss of appetite, and fatigue, with symptoms appearing about one week after infection. The illness can be treated with antibiotics, and most cases are not life-threatening, though severe dehydration poses risks for elderly or immunocompromised individuals. State Epidemiologist Dr. Zack Moore advised anyone experiencing severe or persistent diarrhea to contact their healthcare provider.
Prevention is difficult because the parasite survives on uncooked fresh produce. Cooking food to 165 degrees Fahrenheit kills the parasite, but most people do not cook fresh fruits, vegetables, and herbs. Thorough washing under running water helps reduce contamination risk, though washing alone does not guarantee removal of the parasite.
Some North Carolina schools have taken precautionary measures. Durham Public Schools decided to serve frozen or canned vegetables instead of fresh produce until September while investigations continue. The NCDHHS is consulting with the North Carolina Department of Public Instruction about risks as schools prepare for the fall term.
The outbreak reflects a broader pattern: North Carolina experienced consistent cyclosporiasis cases from 2024 to 2026, with 2024 marking a notable uptick from prior years. Cases tend to increase in summer months when consumption of fresh produce peaks. The CDC and NCDHHS are conducting twice-weekly calls to coordinate investigations and search for genetic linkages between specimens that might reveal common sources across states.
Sources
- News From The States — reported 561 confirmed cases as of July 20, 2026, and quoted Dr. Carl Williams on the likelihood of multiple outbreak sources
- North Carolina Department of Health and Human Services (NCDHHS) — official press release confirming 307 cases and 13 hospitalizations through July 14, and providing epidemiological context and prevention guidance
- ABC11 and NC Newsline — confirmed 16 total hospitalizations and 254 new cases in the week before July 20
- Centers for Disease Control and Prevention (CDC) — reported 4,173 confirmed laboratory cases nationwide since May 1, 2026, and surveillance data on geographic spread
