What is the parasite, food-borne illness spreading in North Carolina?

An outbreak of cyclospora has been spreading in North Carolina in recent months, according to the state health department.

The parasite spreads when people eat or drink food or water contaminated with feces.

The Wake County Health Department told WRAL News in a statement, “It is most attributed to produce and herbs exposed to contamination during growing and packaging.”

Illnesses appear to be confined to Wake County

WRAL first reported on an outbreak of cyclospora cases on Aug. 7. The Wake County Health Department confirms 135 cases have been reported.

NCDHHS confirmed it is also investigating cyclospora clusters elsewhere in the state adding, “the number of reported cases linked to an outbreak is likely to change.”

Exactly where those additional clusters may be outside of Wake County is still unclear.

Durham County Health Department officials notified WRAL that one case had been reported in July, but no more recent cases have followed.

Johnston and Cumberland Counties confirmed no cases have been reported in recent months.

Neither NCDHHS nor Wake County Health Department officials have provided additional details regarding which businesses in Wake County have been investigated, despite repeated requests from WRAL.

Wake County Health Director Rebecca Kaufman previously told WRAL three restaurants were investigated.

Illnesses stem from dirty vegetables or herbs

“The reason we’re not naming them is because when a patient names them to us we go out and do a restaurant inspection. Those inspections happened but didn't turn up anything," Kaufman said. "We think the source is truly the vegetables or herbs and not something the restaurant has done."

Kaufman added none of the restaurants were in the same town in Wake County.

She also specified only 22 of the 135 current cases were linked to the restaurants, none of those cases in recent weeks.

When asked if this could mean the affected produce spread elsewhere, including grocery stores or farmer’s markets, Kaufman said that it was possible and no direct source has been identified.

Diarrhea, symptoms can last weeks

Cyclosporiasis infections are usually characterized by diarrhea, nausea, body aches, fever and other flu-like symptoms.

Some WRAL viewers have reported they have sought medical attention at local hospitals for symptoms lasting for weeks.

The parasite is identified through a stool sample. In some cases, patients may have to submit more than one sample for the parasite to be detected.

Dr. Nicholas Turner with Duke Health explained to WRAL the diagnosis of a cyclosporiasis infection can be challenging.

If you feel sick, ask for this test

“A stool sample can be used to test for Cyclospora, but it’s not part of most of our routine rapid panels for parasite checks,” Turner stated. “When there are local outbreaks, it’s necessary for the ordering doctor to notify the lab that Cyclospora is the specific infection they are testing for.”

Previous cases in the U.S. have been linked to raspberries, basil, cilantro, snow peas and mesclun lettuce, commonly found in salad mixes.

The CDC reports cases typically rise between late May through August.

The FDA is reporting it has initiated traceback protocols in multiple cyclospora outbreaks this summer. If any of those include North Carolina cases is unclear.

Consumers are advised to thoroughly wash hands and produce and cut away bruised or damaged areas, though the FDA notes washing produce may not always be enough to kill the parasite.

Cooking produce rather than consuming it raw does kill cyclospora.