Two neighboring western North Carolina counties reported this week that they've logged more cases of a rare intestinal parasite than they typically see in a year combined. In news releases issued this week, Henderson County said it has confirmed seven cases of cyclosporiasis since July 2, and Buncombe County said it has confirmed four since June 24. Neither county has identified a common source linking its cases, according to the releases, and both say their communicable disease teams are coordinating with local health care providers, environmental health specialists and neighboring counties to watch for additional cases.
The local cases add to an increase playing out across North Carolina and the country, as dozens of states report a rise in the parasitic infection. Between May 1 and July 14, the state reported 307 cases of cyclosporiasis and 13 hospitalizations, according to the North Carolina Department of Health and Human Services. Most of the state's cases are in Wake County, which has reported 270 so far this year.
The illness takes hold through an unglamorous route: A microscopic parasite called Cyclospora cayetanensis passes into food or water through contact with feces, according to the CDC. State health officials say contamination most often occurs on the farm, when tainted water is used to irrigate or wash crops, and it's commonly linked to fresh produce and herbs eaten raw, including cilantro, parsley and lettuce.
Symptoms, typically appear about a week after infection, according to NCDHHS, they include watery diarrhea, nausea, fatigue, cramping and bloating,. Some infected people never show symptoms at all. The illness is treated with antibiotics.
That farm-to-table path is also what makes cases hard to trace, said Carl Williams, the state's public health veterinarian, in a July 14 news release. "Many individuals may not even realize they have consumed the ingredient that is making them sick," Williams said. "For example, someone may recall that they had pico de gallo with their dinner, but not that it included cilantro."
Henderson and Buncombe county health departments say they are monitoring for new cases. Anyone experiencing symptoms, particularly persistent diarrhea, is encouraged to contact a healthcare provider, who can test for the parasite.
State health officials recommend washing hands before and after handling produce, rinsing fruits and vegetables under running water even if labeled "prewashed," and cooking produce when possible to further reduce risk.
For more food safety tips, visit the CDC's website.
To see the latest case counts in North Carolina, visit NCDHHS's dashboard, which is updated weekly.