Michigan reports two deaths as cyclospora outbreak spreads across 45 US states

Michigan health officials have confirmed the first two deaths linked to the ongoing cyclospora outbreak, a parasitic infection spread through contaminated food or water that can cause severe diarrhoea.

The two individuals had "significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration", state health authorities said in a statement.

The foodborne illness has spread to 45 states, with nearly 7,000 laboratory-confirmed cases reported nationwide, according to the US Centers for Disease Control and Prevention (CDC).

While the outbreak has infected thousands of people, the CDC says deaths from cyclosporiasis are far from common, as the infection is "not usually life-threatening". Michigan's health department did not provide further details about those who have died.

Michigan is at the epicentre of the current outbreak, with records showing more than 11,000 cases and 193 hospitalisations, although many have not been laboratory-confirmed.

The heat-loving parasite infects the intestines and is transmitted through faecal contamination. Past outbreaks have occurred when people consumed fruits or vegetables irrigated with water contaminated by faeces.

The CDC recommends washing all produce under running water, including those labelled as pre-washed. However, washing alone may not fully remove the parasite. Cooking produce to a temperature of at least 70°C (158°F) can kill it, the agency advises.

Officials have linked this year's widespread outbreak to lettuce imported from Taylor Farms in Mexico, a key supplier for many food establishments in the US. US fast-food chain Taco Bell has removed lettuce from this supplier from its menu, and Taylor Farms announced a voluntary recall of lettuce sourced from central Mexico.

UK health officials have also warned about the outbreak following recent cases contracted by returning travellers.