Two North Carolinians share what it's like to test positive for diarrhea-causing cyclospora

Christina Serafino thought she had food poisoning when she woke up feeling sick on Father’s Day.

Three weeks later, the Wake County woman learned she was battling Cyclospora, a microscopic parasite that can cause weeks of severe gastrointestinal illness. 

The parasite is most often linked to fresh produce, including leafy greens, herbs and fruits. Health officials recommend washing fresh produce before eating it, though rinsing fruits and vegetables may not completely remove cyclospora if it's present. Thorough cooking can kill the parasite, but many foods linked to cyclospora are typically eaten raw. 

Serafino told WRAL she decided to get tested after recognizing her symptoms from WRAL's Cyclospora coverage on social media.

"I was like, 'Oh my gosh, this sounds familiar!' This is everything I'm dealing with: the cramping, the aching," she said.

A stool sample collected on July 7 confirmed the diagnosis two days later.

“I have never been so exhausted in my life,” Serafino said. “I tried to come to work one day and they were like, ‘You look terrible, go home.”

Serafino is one of 240 people diagnosed with cyclosporiasis in North Carolina since May 1, according to the North Carolina Department of Health and Human Services (NCDHHS). 

Nationwide, the U.S. Centers for Disease Control and Prevention (CDC) has confirmed 843 cases this season, with more than 1,500 additional reports still under investigation. The United States routinely sees a rise in cases during spring and summer months.

Ray Watkins of Wake County found himself in a similar situation as Serafino last summer. 

“For me it was the duration of the explosive diarrhea that everyone's talking about,” Watkins shared. “It was a long time. It wasn't just like I had an extra cup of coffee and things are bad. No, it was several days worth of dehydration and just feeling generally fatigued.”

Watkins also recalled losing a significant amount of weight while suffering from his symptoms. 

“I’m a pretty big guy. I’m about 230 pounds normally, and I got down to about 215 to 210 pounds. I lost a lot of weight,” he said. “I was making sure I was drinking plenty of fluids and had plenty of Gatorade and electrolytes, but it was not fun.”

Watkins said he was contacted by the Wake County Health Department after his test was confirmed positive in 2025. He recalled speaking with a food investigator for 45 minutes. 

“It was a very thorough conversation,” he recalled. “We talked about where I had eaten in the past and what was different between what I had eaten versus the rest of my family. I was looking back at credit card receipts.” 

Even after investigators reviewed Watkins’ food history, they were unable to identify the source of his illness. 

Dr. Carl Williams, State Public Health Veterinarian for NCDHHS, explained to WRAL that determining the source of an outbreak can take weeks or even months because symptoms often don't appear until 2-14 days after someone eats contaminated food. By then, many people struggle to remember exactly what they ate.  

"Foodborne disease investigations are complicated in general because you have to rely on interviews with the case patients to get their food history," NCDHHS State Public Health Veterinarian Dr. Carl Williams told WRAL. "If you wait too long, you tend to get food preferences as opposed to the specific history."  

Williams told WRAL another challenge is the short shelf life of fresh produce. By the time investigators identify a common ingredient among patients with Cyclospora, the contaminated product may have already been discarded from the food supply.  

Looking back, both Watkins and Serafino say they waited too long to seek medical care. Each assumed they were dealing with food poisoning, norovirus, or a stomach bug that would resolve on its own in a few days.

Both were eventually prescribed antibiotics after their test results confirmed they were infected with Cyclospora. Both report almost immediate relief. 

“It was night and day,” Watkins said. “I took it at like 8 a.m. on a Monday, and then on Tuesday morning I felt like a totally different person. I felt like a human being again.”

Serafino agrees she also wished she had taken action sooner. 

“It went on too long for me, I probably should have done something sooner,” she said. “I was busy, but hopefully people will do it sooner. If it’s like this for a couple of days, just bite the bullet and go find out.”

The CDC says Cyclospora season typically runs from May through August.