Ankara: A new parasitic outbreak from contaminated US produce has sickened 561 people in the state of North Carolina since May 1, according to media reports. According to Anadolu Agency, health officials in North Carolina said the surge of illnesses was caused by the parasite cyclospora, which appears to be linked to people who got sick after eating infected parsley and cilantro. The number of cases is nearly double that recorded in North Carolina last year. In addition to parsley and cilantro, state health officials mentioned that lettuce may also be on the list of produce items contaminated with the parasite because it "keeps showing up repeatedly" in interviews with infected people. However, they noted that the increase in parasitic cases does not appear to be related to the lettuce and produce in the cyclosporiasis outbreak which caused more than 4,300 illnesses in customers who ate shredded lettuce and other produce items at Taco Bell restaurants in Michigan, Indiana, Kentucky, Ohio, and West Virginia. "We have not noticed that association here," Carl Williams, a public health official at the North Carolina Department of Health and Human Services (DHHS), stated. "We can say that because we do a thorough investigation of all of these reported cases in collaboration with our local health departments." The US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA) identified lettuce producer Taylor Farms as the source of the cyclosporiasis outbreak at the Taco Bell locations, which led Taylor Farms to issue a recall of its produce in the United States. The CDC confirmed that in total, 1,645 cases of the parasitic illness were reported across 34 states, with the FDA issuing a warning that "consumers should avoid shredded iceberg lettuce from Mexico served at Taco Bell locations in the five affected states." North Carolina health officials noted that cilantro and parsley "appear to be among the first additional foods, aside from iceberg lettuce, that health officials have publicly linked to at least some of the thousands of cyclosporiasis cases reported in the US this year." The FDA has initiated investigations into a total of six outbreaks of cyclosporiasis so far this summer. The outbreak linked to iceberg lettuce at Taco Bell restaurants in five states is the only one that has been pinpointed. The agency has not yet identified the sources of the five other outbreaks, nor have they released information on which states those cases were located. It remains unclear whether the North Carolina cases are related to any of the five outbreaks of unknown origin. A spokesperson for the North Carolina DHHS declined to comment on whether the FDA was investigating the outbreak in North Carolina but issued a public warning regarding the contaminated parsley, cilantro, and lettuce, which have caused hundreds of cyclosporiasis illnesses in that state. "If using ingredients that have been identified to be associated with the increase in cyclospora cases in North Carolina like lettuce, pars ley, and cilantro, please consider removing or cooking fully to avoid getting yourself or others sick," the DHHS advised in a statement.