Wake County reports 30 new cyclospora cases, total reaches 270

More than 30 residents of Wake County received a cyclospora diagnosis on Thursday, raising the county's total to 270 confirmed cases of the parasite that causes gastrointestinal illness. The county health department has identified five hospitalizations linked to the infection, and state officials report 14 hospitalizations across North Carolina.

The U.S. Centers for Disease Control and Prevention is monitoring over 1,500 cases in five states and has associated the outbreak in one state with shredded iceberg lettuce served at a fast-food chain. North Carolina has not yet pinpointed a source, and officials note that the long incubation period—typically 2 to 14 days—makes it difficult for patients to recall specific foods.

"Most patients don't get sick for at least a week, and by the time we interview them, and by the time we try to identify the source, no one can really remember where they ate or what they ate," said Dr. Christopher Chao, medical director at WakeMed Urgent Care.

"Foodborne disease investigations are complicated in general because you have to rely on interviews with the case patients to get their food history," added Dr. Carl Williams, state public health veterinarian.

Cyclospora infections tend to increase in the summer because the parasite is often found on raw fruits and vegetables. Past outbreaks in the state have been linked to ingredients such as cilantro, parsley and shrimp salads, but investigators say the short shelf life of fresh produce can hinder traceback efforts.

Health officials advise residents to wash fresh produce thoroughly and to seek medical care if severe diarrhea or other gastrointestinal symptoms persist for several days. Diagnosis is typically made through a stool sample, and clinicians recommend waiting at least seven days before testing unless symptoms are severe.