Cyclospora parasitic diseases have affected 28 counties in North Carolina and sickened more than 200 people

28 counties in the state have reported cases of Cyclospora parasitic diseases so far this year, according to the state Department of Health. However, the cause of the more than 200 cases in the state remains unclear.

Wake County leads the way with 125 cases, followed by 17 in New Hanover, 14 in Brunswick and Mecklenburg, and 13 in Guilford since January 1.

“Local health department staff are attempting to interview each of these cases to determine the dietary history of those affected and the likely source of exposure,” said Dr. Carl Williams, NCDHHS veterinarian.

In his role with the state, Williams works with the Division of Communicable Diseases and in medical consultations, with one of his areas of focus being food-borne illnesses.

With at least 206 cases in multiple counties, Williams said the cause “could have more than one source or be a widespread source.”

Further analysis of patients’ stool samples could also reveal details, he said.

“If it is a single point source that is widely distributed, it is more likely that you will find closely related samples from the patients. If there are multiple submissions from Cyclospora from multiple sources, you will see different genetic sequences,” Williams said.

The downside is that such diagnostic tests are not currently required in North Carolina and most samples are simply not kept in laboratories long enough to be considered useful, Williams said.

The government is also trying to trace the source by using things like grocery store membership cards and credit card receipts.

The Wake County Health Department said cyclosporiasis cases in North Carolina must be reported by physicians within 24 hours of a positive test. The department added that the state requires all reportable disease investigations to be completed within 30 days of the date of initial report.

Ben Chapman, a North Carolina state food safety expert, said the challenge with Cyclospora is how long it can take for someone to become ill after eating the infected product.

“Investigating an outbreak of something like Cyclospora is very similar to investigating something like other foodborne pathogens, where you’re really looking for: What common elements do these individuals have? Did they eat the same foods? Did they eat the same dishes? Did they eat at the same restaurants?” Chapman said.

He further explained: “The difference with pathogens like salmonella or listeria is that cyclospora can affect anyone. It’s not one of those pathogens that we look at and say, ‘Hey, it’s most likely to affect young people or older people or pregnant women or someone with a compromised immune system,’ which is what we focus on with listeria.”

It can take a few days to weeks for Cyclospora to make someone sick. Symptoms of something like Salmonella usually appear within 72 hours.

Anyone who believes they have a cyclosporiasis infection should contact their family doctor and arrange a targeted test for the parasite using a stool sample.