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Authorities in the US state of Michigan say that they have confirmed the deaths of two people in a cyclospora outbreak, the first fatal cases of a disease related to the microscopic parasite recorded in the United States.

The Michigan Department of Health and Human Services said on Monday that both individuals had significant underlying health conditions and had been affected by intestinal illness and dehydration.

“This development highlights the importance of identifying the source of the outbreak and preventing additional illnesses,” Wade Syers, food safety specialist at Michigan State University Extension, told the Reuters news agency.

The US Department of Health and Human Services said that it was aware of the reports in Michigan, and the state agency told Reuters that there were no updates on the investigation.

Cyclospora is a microscopic, spherical parasite that commonly causes watery diarrhoea “with frequent and sometimes explosive bowel movements,” according to the Centers for Disease Control and Prevention. Outbreaks tend to occur most often in the late spring and summer.

The CDC says the illness it causes, called cyclosporiasis, is rarely deadly.

Symptoms include severe diarrhoea, nausea and other gastrointestinal issues.

Lettuce from Mexico served at the fast-food chain Taco Bell in five states has been identified as the source of the outbreak by federal authorities, which continue to search for additional possible sources.

Nationwide, the CDC has recorded 6,707 laboratory-confirmed cases of cyclosporiasis as of July 28, with more than 11,500 additional suspected cases still awaiting confirmation or further investigation.

Michigan health authorities said on Monday that the Midwestern state has recorded 11,234 outbreak-linked cases, up from 461 announced during an update on Friday. The health department has said the outbreak has resulted in 193 hospitalisations.

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