(WASHINGTON) The first two deaths of the cyclosporiasis outbreak have been reported in Michigan, the state's health department announced Monday.

Both people had "significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration," the Michigan Department of Health and Human Services (MDHHS) added. No additional information will be provided, according to the department.

The deaths come as cases in the state have surpassed 11,000 for a total of 11,234, including 193 hospitalizations, MDHHS data shows.

MDHHS added that cyclosporiasis is typically not a life-threatening illness and that deaths are uncommon in the U.S.

Federal health officials have so far linked cases in Michigan and eight other states to shredded iceberg lettuce served at some Taco Bell restaurants. 

Taylor Farms, the supplier of the lettuce, issued a voluntary recall of all iceberg lettuce sourced from central Mexico. Consumers are being advised to throw out or return any iceberg lettuce.

Taco Bell said last month that it is no longer using lettuce from Taylor Farms de Mexico at any of its restaurants. 

The Centers for Disease Control and Prevention (CDC) wrote on its website that it "is aware of two cyclosporiasis-related deaths in people with underlying health conditions from Michigan as part of this outbreak. CDC will update its website to include laboratory confirmed cases, hospitalizations and deaths."

The CDC has previously said it is investigating other outbreaks and illnesses of cyclosporiasis nationally that are unrelated to the nine-state outbreak.

Since May 1, cases of cyclosporiasis have topped 18,000 in 45 states, according to data updated by the CDC on Wednesday.

There are at least 6,707 laboratory-confirmed cases of cyclosporiasis, including 423 hospitalizations, the data shows.

The agency is also aware of at least 11,500 additional cases that have not yet been laboratory confirmed or require further investigation and analysis.

The CDC said it can take up to six weeks to determine if a sick person should be counted in the agency's tally, meaning nationally reported cases may be lower than state totals.

Meanwhile, the UK Health Security Agency (UKHSA) published data last week showing a "sharp rise" in cyclosporiasis infections among travelers returning from Mexico.

Between April 30 and July 15, 67 cases have been reported among returning travelers in England, Wales and Scotland. Comparatively, an annual average of 93 cases has been recorded between 2022 and 2025.

UKHSA said it is advising all travelers to take precautions when traveling abroad including "maintaining good food and water hygiene to reduce their risk of infection."

Cyclospora, the parasite that causes infection, usually spreads through food or water contaminated with feces, according to the CDC.

Foodborne outbreaks of cyclosporiasis have been linked to various types of imported fresh produce, such as raspberries, basil, snow peas, mesclun lettuce and cilantro, the CDC says.

The most common symptom of cyclosporiasis is watery diarrhea "with frequent and sometimes explosive bowel movements," according to the CDC. Other symptoms nay include nausea, vomiting, abdominal pain or bloating.

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