Cases of cyclosporiasis, ‘explosive’ illness from parasite, are rising in NC

At least 110 cases of an illness causing “explosive bowel movements” have been reported in North Carolina since May 1.

Nearly 150 people have contracted cyclosporiasis, an illness caused by the parasite cyclospora, in the United States since May 1, according to the CDC. Other cases have been contracted outside the United States.

North Carolina is not reporting any outbreaks and has not identified a common source linking the cases as of Monday, July 6, according to the North Carolina Department of Health and Human Services.

Cyclosporiasis “usually causes watery diarrhea with frequent and sometimes explosive bowel movements.” according to the CDC.

Cyclosporiasis symptoms

According to the CDC, symptoms include:

• Watery diarrhea (most common)
• Loss of appetite
• Weight loss
• Cramping
• Bloating
• Increased gas
• Nausea
• Fatigue

Less common symptoms may include:

• Vomiting
• Body aches
• Headache
• Low-grade fever

“While many other foodborne illnesses are associated with meat and animal products and can be prevented by proper cooking and pasteurization, cyclospora is often associated with fresh herbs and produce that are served uncooked and so prevention is much more challenging,” NCDHHS Press Assistant Sean Doyle told The Charlotte Observer via email. “If present, Cyclospora can survive the trip from the field, where produce is grown, to the plate.”

Cyclosporiasis cases

Duke Medicine Professor Cameron Wolfe said that for many people, cyclosporiasis won’t be severe enough to bring them into a doctor’s office.

“Many people, in fact, probably have it mild enough that they never actually even present to their physician to get seen or tested, so chances are the actual number of cases is noticeably higher than that, and we sort of scratch the surface each year with the number of tests that we run,” Wolfe said.

Older people and immunocompromised people at high risk from illnesses that present with intestinal distress could be hit hard by cyclosporiasis, but the range of symptoms varies.

“I think for the general community this is not a big issue, it should be a healthy reminder to think about the way that GI parasites can be transmitted,” Wolfe said. “It’s spread by contaminated food and water, so it’s a good call out to wash your fruit and vegetables and salads, like we should probably be doing anyway.”

How is cyclosporiasis treated?

For some people, the illness passes in days and for others, weeks. Wolfe said some people have recurrent symptoms, after the body tries and fails to fully fight off the illness.

Wolfe said cyclosporiasis often lasts longer than food poisoning, which can cause similar symptoms.

“Salmonella or undercooked chicken or eggs, or these sorts of things, they’re usually one to three days and wash out of your system, literally,” Wolfe said. “Whereas I think cyclospora has the potential, in many cases, especially the at-risk people, for lasting much longer.”

Cyclosporiasis can be treated with a combination antibiotic, Trimethoprim-sulfamethoxazole. Most people recover without treatment.

How to properly clean produce

Wolfe said that without an identified cause, it is best to focus on food safety overall.

​​”People often take a few days between when you’ve consumed the contaminated food and when they actually get sick, so it’s really hard to actually remember (what they ate),” Wolfe said. “To pin down what might have been the contributing thing is actually really tricky.”

The FDA recommends taking these steps to properly clean produce:

• Wash hands for 20 seconds with warm water and soap before and after preparing fresh produce
• Cut away any damaged or bruised areas before preparing or eating produce
• Rinse produce before you peel it, so dirt and bacteria aren’t transferred from the knife into the flesh of the fruit or vegetable.
• Gently rub produce while holding under running water. Soap and produce wash are unnecessary
• Use a clean brush to scrub firm produce, such as melons and cucumbers
• Dry produce with a clean cloth or paper towel to further reduce bacteria
• Remove the outer leaves of a head of lettuce or cabbage

Eva Flowe

The Charlotte Observer

Eva Flowe is a North Carolina native and a graduate of the University of South Carolina. She joined the Charlotte Observer as part of the NC service journalism team in April 2026.