Health News -- July 15, 2026: Western North Carolina residents are urged to understand the unique challenges of preventing cyclosporiasis, an intestinal illness caused by the parasite Cyclospora cayetanensis. The North Carolina Department of Health and Human Services (NCDHHS) has issued guidelines for proper produce safety, which are particularly vital due to the nature of this foodborne illness.
Cyclosporiasis is an intestinal infection caused by the microscopic parasite Cyclospora cayetanensis. It spreads when people ingest food or water contaminated with feces containing mature Cyclospora oocysts. Outbreaks in the U.S. are most commonly associated with fresh produce, including herbs, berries, lettuce, salad greens, and other leafy vegetables.Health officials emphasize this is a foodborne illness transmitted through the fecal-oral route, rather than one that typically spreads directly from person to person."
North Carolina has reported more than 200 cases of cyclosporiasis this season, with 145 cases cited since May 1, 2026, indicating rapid growth. While Wake County has the highest concentration of cases, Western North Carolina (WNC) has confirmed cases, including one in Buncombe County, three in Henderson County, two in McDowell County, and one in Rutherford County. NCDHHS officials note this is not a new illness, but one that typically appears during warmer months when fresh produce consumption and outdoor water exposure are higher.
The parasite is often associated with tropical and subtropical regions and has historically been linked to contaminated imported produce. Contamination generally occurs at the growing site when produce or irrigation water is exposed to human feces containing Cyclospora. Carl Williams, a state epidemiologist with NCDHHS, noted it "can contaminate any food product, but typically it's herbs and vegetables that become contaminated at the site where they're grown." Reported outbreak-linked foods include raspberries, other berries, cilantro, basil, parsley, bagged lettuce, salad mixes, leafy greens, green onions, and snow peas.
Symptoms usually begin about one to two weeks after consuming contaminated food or water. The most common symptom is severe, watery diarrhea, often described as "explosive." Other frequent symptoms include stomach cramps, abdominal pain, nausea, sometimes vomiting, loss of appetite, weight loss, fatigue, and body aches. Illness can last a few days to several weeks or longer if untreated, though NC officials emphasize it is "not usually life‑threatening" and no deaths have been reported in current North Carolina data. Standard treatment is the antibiotic trimethoprim-sulfamethoxazole (Bactrim), along with supportive care like rest and drinking plenty of fluids.
Prevention of cyclosporiasis is particularly challenging. Cyclospora is microscopic, meaning there is no way to tell by looking whether produce is contaminated. Many associated foods, such as salad greens, berries, and fresh herbs, are served raw and cannot be cooked. Sean Doyle, an NCDHHS spokesperson, stated that unlike many foodborne illnesses, cyclospora is "often associated with fresh herbs and produce that are served uncooked and so prevention is much more challenging." Furthermore, there is no evidence that soaking in water, vinegar, or commercial vegetable washes reliably removes Cyclospora, and health officials say washing may not fully remove the parasite.
To reduce infection risk, NCDHHS and FDA-aligned recommendations for WNC residents emphasize proper cleaning of fresh produce and hygiene. This includes washing hands with soap and warm water for at least
✅ Wash your hands with soap and warm water for at least 20 seconds before preparing food, before eating, and after using the restroom. This is the recommendation from the CDC and NCDHHS.
⚠️ Alcohol-based hand sanitizers are not considered a reliable substitute for Cyclospora. While they help reduce many bacteria and viruses, they are not known to reliably kill or remove Cyclospora parasites.
Hand sanitizer is better than nothing if soap and water aren't available, but you should wash with soap and water as soon as you can.
Health officials recommend washing hands thoroughly with soap and warm water for at least 20 seconds before handling food, before eating, and after using the restroom. Alcohol-based hand sanitizers can reduce many germs but are not considered a reliable substitute for soap and water against Cyclospora.