North Carolina is in the middle of the largest cyclosporiasis outbreak the state has ever recorded. State health officials have counted 561 cases since May 1, 2026, along with 16 hospitalizations, and they have named parsley, cilantro and lettuce as the foods that keep coming up in interviews with people who got sick. No single food, brand, grower or supplier has been identified as the cause. Pritzker Hageman’s food safety team is following the investigation and has published its own report on the North Carolina cyclospora outbreak.
How many people are sick in North Carolina?
As of July 20, 2026, the North Carolina Department of Health and Human Services (NCDHHS) reported 561 cyclosporiasis cases and 16 hospitalizations statewide going back to May 1. The majority of those cases have been reported in Wake County, which includes Raleigh, but illnesses have turned up across the state. NCDHHS says the 2026 count has already passed the full-year totals for both 2024 and 2025.
The state updates its case count weekly on Tuesdays, so the number above is a snapshot rather than a final tally. Cyclosporiasis is also underdiagnosed, because a routine stool test does not look for this parasite unless a doctor specifically orders that test. The true number of people affected is very likely higher than the reported count.
You can read the state’s own summary in the NCDHHS update on cyclosporiasis in North Carolina and on the Division of Public Health’s cyclosporiasis page, which carries the current case count.
What food is under investigation?
NCDHHS and the North Carolina Department of Agriculture and Consumer Services are working the case together. When investigators interviewed people who became ill, three items came up again and again: parsley, cilantro and lettuce.
In its July 17 update, NCDHHS wrote that while this kind of information “can suggest which types of produce are more likely to be contaminated, it does not prove with certainty that any of these were the source of infection.” No product has been recalled in connection with the North Carolina illnesses.
An epidemiologist with the NCDHHS Division of Public Health, told reporters on July 21 that “it’s likely, maybe probable, that there are multiple vehicles for cyclospora,” and that the outbreak is “not a single source or a single food product from a single company.” Fresh herbs and leafy greens are eaten raw, move quickly through the supply chain and are often mixed from several growers, which makes traceback slow and sometimes inconclusive.
Is this the same outbreak as the Taco Bell lettuce cases?
No, according to state health officials. NCDHHS said that the increase in North Carolina “does not appear to be associated with the outbreak in other states involving Taco Bell.”
That separate investigation is a nine-state outbreak that the U.S. Centers for Disease Control and Prevention (CDC) has linked to iceberg lettuce. As of the CDC’s July 24, 2026 update, that outbreak accounts for at least 1,947 illnesses and 98 hospitalizations, with no deaths reported. On July 17, Taylor Farms de Mexico recalled all iceberg lettuce sourced from central Mexico, after the U.S. Food and Drug Administration’s traceback work pointed to that supplier. Pritzker Hageman is covering that investigation separately in its report on the multistate iceberg lettuce cyclospora outbreak.
The CDC notes that the agency “is also investigating other outbreaks and illnesses of cyclosporiasis nationally that are unrelated to this outbreak.” 2026 has been an unusually heavy year for this parasite across the country, as Food Poisoning Bulletin explains in its look at how big the nationwide cyclospora outbreak has become. Pritzker Hageman’s cyclospora outbreak news coverage tracks each of these investigations as they develop.
What is cyclospora, and what are the symptoms?
Cyclospora is a microscopic parasite, Cyclospora cayetanensis, that causes an intestinal illness called cyclosporiasis. People get it by swallowing food or water contaminated with human waste, most often fresh produce that was irrigated or rinsed with tainted water and then eaten raw. The parasite usually needs days to weeks outside the body before it can infect anyone else, so it is rarely passed person to person. That same biology is part of why outbreaks are so hard to trace back to a specific field or shipment. Pritzker Hageman explains the illness and the legal questions it raises in its overview of cyclosporiasis and cyclospora lawsuits.
Symptoms usually start about a week after exposure, though the range runs from two days to two weeks or more. They include:
- Watery diarrhea, often frequent, which is the hallmark symptom
- Loss of appetite and unexplained weight loss
- Stomach cramps, bloating and increased gas
- Nausea and fatigue
- Vomiting, body aches, headache or low-grade fever in some people
Left untreated, symptoms can drag on for a month or longer and can come and go in waves. Over-the-counter anti-diarrheal medicine does not clear the infection. The standard treatment is a course of the antibiotic trimethoprim-sulfamethoxazole, sold as Bactrim or Septra. If you have had watery diarrhea that keeps returning this summer, ask your doctor specifically about testing for cyclospora, since it will not show up on a standard stool panel. The CDC’s clinical overview of cyclosporiasis covers testing and treatment in more detail.
How to protect yourself
- Follow the weekly NCDHHS updates and any warnings from your county health department while the investigation is open.
- Know that washing helps but does not guarantee safety. NCDHHS says rinsing produce may remove some parasites without removing all of them. Food Poisoning Bulletin explains which common cleaning methods do not destroy Cyclospora and what does.
- Consider cooking or leaving out the items North Carolina has flagged, which are parsley, cilantro and lettuce. Cooking kills the parasite, and NCDHHS advises cooking foods to 165 degrees Fahrenheit.
- Wash your hands for 20 seconds with soap and water before eating or preparing food, after handling produce and after using the bathroom.
- See a doctor if watery diarrhea lasts more than a few days, and ask whether you should be tested for cyclospora.
- If you are diagnosed, hold on to your test results, receipts and a list of what you ate and where. That record matters if investigators later identify a source.
Do you have a cyclospora case?
When an outbreak is tied to a specific product, grower, grocery store or restaurant, the people who were sickened may be able to recover compensation for medical bills, lost wages and other harm. Early documentation is what makes a claim provable later, which is why it is worth understanding your rights while receipts and medical records still exist.
The food safety attorneys at Pritzker Hageman have represented clients in nearly every major U.S. cyclospora outbreak of the last decade. Their national cyclospora legal team will talk with you at no cost about whether you may have a claim, including whether you can sue a grocery store or restaurant for cyclospora. The firm’s Bad Bug Law Team handles these cases nationwide, and you can learn more about the firm’s food poisoning attorneys and their food safety litigation practice.
This is a developing investigation. The North Carolina case count is expected to keep moving as more test results come in, and we will update this page as state officials learn more about what is making people sick.
