Is it lettuce? What we know about cyclosporiasis outbreak, food safety in NC

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Federal health officials haven’t identified the food products consumers should avoid amid a national increase in cases of a parasitic infection that causes prolonged intestinal distress.

The parasite cyclospora takes up to two weeks to cause symptoms, which include watery diarrhea and loss of appetite, making it difficult and sometimes impossible to track the cause of an outbreak.

The Centers for Disease Control and Prevention anticipates that cases will continue to rise, possibly through August, officials said Tuesday, July 14, during a call with media outlets on the response on the outbreaks.

As of Tuesday, the CDC has received reports of at least 1,645 lab-confirmed cases of cyclospora in the United States. Another 5,100 cases require further analysis to confirm.

North Carolina is reporting more than 300 cases statewide, with more than 180 reported in Wake County. At least 81 to 160 were acquired domestically, per the most recent CDC data.

The Washington Post reported state health departments are investigating some cases as potentially tied to the fast food giant Taco Bell, which has voluntarily removed some products — like lettuce and pico de gallo — from menus. Taco Bell has yet to respond to requests for comment from The Charlotte Observer.

The Michigan Department of Health and Human Services has said preliminary evidence in the state points towards leafy lettuce as a culprit.

“We don’t have any foods that folks should avoid at this point. We are tracing, of course, multiple produce items, and as soon as we have actionable information for consumers, we will put that on our website,” Donald Prater, FDA Acting Deputy Commissioner for Food, said in Tuesday’s call.

Cases have been determined in 34 states, including North Carolina. Four of the states are considered to be part of an outbreak: Michigan, Ohio, West Virginia, and Kentucky. Other cases are not accounted for.

“There are a lot of cases that are not accounted for as part of that multi-state outbreak, and there are a number of other investigations that are going on, some single state investigations, as well as investigations for the cases that are not currently linked to a cluster or outbreak,” said Gwen Biggerstaff, Deputy Director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases.

The true number of cases is almost certainly higher, Biggerstaff said. Not everyone who is infected will seek medical care, or be tested for cyclospora when they do. The CDC recommends anyone who is showing symptoms and seeks medical care request a cyclospora test, as it is not routine.

The CDC traditionally updates the public on cyclospora cases monthly in the summer, but will now update at least once a week.

“I would say the same thing that I say to my friends and family: to follow the food safety advice that we have about how to safely prepare food and to follow the information that we’re able to share,” Biggerstaff said.

Washing produce under running water, washing your hands and cooking produce are the best ways to mitigate risk.

Very young, old and immunocompromised people are at higher risk of a severe infection. Cyclosporiasis may take up to two weeks to cause symptoms, and often lasts longer than food poisoning.

According to the CDC, symptoms include:

Less common symptoms may include:

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

Portions of this story were previously published in The Charlotte Observer.

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This story was originally published July 14, 2026 at 3:23 PM with the headline “Is it lettuce? What we know about cyclosporiasis outbreak, food safety in NC.”