Since May 1, Wake County has reported more than 180 confirmed cyclospora cases, with four people hospitalized.
From May 1 to July 14, the North Carolina Department of Health and Human Services(DHHS) said statewide there have been 307 cases, and 13 of them had to be checked into a hospital for treatment.
"There is a surge this year here in Wake County," Public Health Deputy Director Jennifer Brown said. "We are doing our best to monitor that, inform the public, and work closely with our partners to share messages of prevention risk reduction, and then just to identify any links or common foods that need to be addressed."
NC reports increase in Cyclosporiasis cases, hospitalizations
At the Willard Rooftop Lounge, Chef Eryn Reagan said staff members are taking extra precautions with food deliveries as health officials investigate the outbreak.
"We feed a lot of people here," Reagan said. "We want to make sure that everything we're getting in is safe and clean, and we know where it's coming from."
Investigators have not identified a common source of the infections. In the meantime, health officials recommend thoroughly washing fresh produce and following safe food handling practices.
"Generally, you, you can't hold it in. You really, you're probably going to, so you could soil your shorts, so you're going to not you're not going to want to be too far from the restroom," said Dr. Josh McConkey, an ER doctor at Womack Army Medical Center.
McConkey said he has seen more patients coming in with explosive diarrhea.
"So, it's very voluminous, large volume. And explosive is probably the best term," he said.
McConkey said part of the problem is because symptoms can take up to two weeks to take hold. It's hard to trace where someone may have been exposed.
"So, that's why it's been so difficult to track most of the people that I've been seeing in the emergency department, especially this weekend," he said. "We're more of the worried, well, you know, they listen to the news, they hear about the outbreak. Oh my gosh, I've got diarrhea. I should go to the hospital. Certainly, if you have fevers, if you've got significant dehydration, those are things that should get you to the emergency department, especially if you have an intense abdominal pain."
Reagan said the outbreak has not changed the restaurant's menu plans for Restaurant Week, but it has reinforced the importance of strict food safety measures.
"We always make sure that we take steps when we're getting our produce and making sure we're washing it properly," Reagan said.
Although lettuce and bagged salads have been linked to previous cyclospora outbreaks, Wake County officials said they have not found that connection in the current outbreak.
For Raleigh residents Christine and Randall Thomson, the increase in cases is a reminder to take additional precautions when preparing food at home.
"We cook a lot of our vegetables, and I have one of those salad turners," Christine Thomson said.
"It does make us a little bit more conscious as we go through our shopping list," Randall Thomson said.
At WakeMed, medical providers have seen a 200% to 300% increase in patients reporting diarrhea or other gastrointestinal symptoms.
Because cyclospora infections can last for weeks, doctors generally test people who have experienced symptoms for at least seven days or who have other risk factors.
"If it's a few days, treat with supportive care," Dr. Christopher Chao said. "The reason why we recommend waiting a few days is because the majority of cases of diarrhea right now are still not caused by cyclospora. There's other pathogens out there."
Health officials said cyclospora is a foodborne illness and is not spread through casual person-to-person contact.
The Centers for Disease Control and Prevention said it is working to identify clusters of related cases, but officials have not confirmed a specific food source tied to the current multistate outbreak.
McConkey said that even though it's hard to remember what you might have eaten, it's good to at least tell your doctor if you have these symptoms and think you were exposed, since this is not something they would otherwise test for. And, he said, typically for treatment, depending on how severe it is, you could need an IV of antibiotics.
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