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. 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.