Michigan has reported the first two deaths associated with the ongoing cyclosporiasis outbreak, according to an announcement Monday from the state's health department. The grim update comes as the total number of cases across the United States surpasses 11,000.

Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. It is typically transmitted through contaminated food or water. Symptoms often include diarrhea, loss of appetite, weight loss, cramping, bloating, increased gas, and fatigue. Nausea, vomiting, and fever may also occur.

The U.S. Centers for Disease Control and Prevention (CDC) has been investigating the outbreak, tracking cases and attempting to identify common sources of infection. Public health officials advise thorough washing of all produce and prompt handwashing, especially after using the restroom and before preparing or eating food, to help prevent infection.