LANSING, Mich. (AP) — Two people have died in the cyclospora outbreak in Michigan in the first confirmed deaths in the U.S. related to the microscopic parasite, state health officials announced Monday.

The Michigan Department of Health and Human Services said both people had underlying health conditions that may have been impacted by the intestinal illness and dehydration.

The department said it will not be providing additional information about the deaths.

The parasite infects food that has come into contact with human feces, most commonly when produce is irrigated or washed with contaminated water. When ingested, it causes intestinal illness marked by “frequent and sometimes explosive bowel movements,” according to the Centers for Disease Control and Prevention.

Federal health officials have identified lettuce from Mexico served at Taco Bell locations across five U.S. states as a source of the widespread outbreak.

Overall, cyclospora cases have set a U.S. record. Since May 1, the CDC has received reports of more than 4,100 confirmed cases and is investigating more than 7,400 other likely cases across 41 states. Federal health officials have said other “brands, restaurants, retailers, or distribution channels” could be tied to the outbreak as the investigation continues.