Rising Cyclosporiasis Cases and Testing Challenges in North Carolina
North Carolina has seen a rise in cyclosporiasis cases, with 236 confirmed infections in Wake County and 307 statewide as of July 14, 2026, according to the North Carolina Department of Health and Human Services. The surge has strained healthcare systems, particularly urgent care facilities, as patients with persistent diarrhea seek diagnosis and treatment.
Testing Supply Pressures and Delays
Dr. Kimberly Caulway, regional medical director for Duke Urgent Care, reported that the system now sees roughly 20 patients in a day that request a stool test, a shift from rarely testing for the parasite. “It’s been difficult keeping pace with the demand for our stool testing supplies,” she said. Unreturned test kits and lab backlogs have delayed results, with some patients waiting up to a week for microscopic analysis.
WakeMed and UNC Health tell WRAL most urgent care patients are tested with PCR tests, which may be part of broader gastrointestinal panels. These tests may also carry greater costs for patients due to insurance, Caulway noted.
Diverging Testing Methods and Treatment Risks
Duke Health’s urgent care system relies on microscopic stool testing, which requires lab analysis and longer turnaround times. “This is something that we see, and we saw in the past when COVID would surge,” Caulway explained. “Currently, our expected time frame for our testing in our organization is three to six days. But, the more that we are exceeding our demand on the system, it may climb a bit.”
Most patients with positive test results are prescribed Bactrim, however the antibiotic may not work for everyone. “We definitely try to walk the line of doing no harm, and does the benefit of Bactrim exceed the risks of the illness,” Caulway said, emphasizing caution for vulnerable groups like young patients, older adults, and those with other medical conditions.
Outbreak Origins and Prevention Strategies
Cyclospora outbreaks in the U.S. have been tied to various produce, including leafy greens, herbs, and berries. Michigan health officials recently announced investigators are honing in on lettuce as a potential source of an outbreak tied to more than 3,700 cyclosporiasis cases in recent months.
Health officials recommend washing hands thoroughly before handling food and cleaning utensils and cutting boards during food preparation to reduce risk. However, most commercial produce washes do not eliminate Cyclospora, and cooking produce can kill the parasite. Many foods linked to Cyclospora outbreaks are typically eaten raw, complicating prevention efforts.
FAQ: Understanding Cyclosporiasis
How is Cyclospora Transmitted?
Cyclospora is transmitted by consuming food or water contaminated by human feces.
What Are the Symptoms?
Diarrhea for a week or longer, along with dehydration, lightheadedness, and poor appetite or difficulty retaining fluids, are key indicators. Seek medical attention if symptoms persist beyond seven days.
Pro Tip
When preparing fresh produce, consider cooking leafy greens or herbs to kill Cyclospora, even if they’re typically eaten raw.
Looking Ahead: What’s Next for Outbreak Response?
As cases climb, public health officials face challenges in tracing contamination sources and ensuring timely testing.
Did You Know?
Cyclospora can only be confirmed through a stool sample.
Stay Informed and Take Precautions
For updates on local outbreaks, visit the North Carolina Department of Health and Human Services. Share your experiences with foodborne illnesses in the comments below to help others stay alert.
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