Two people in Michigan have died after contracting cyclosporiasis, a parasitic intestinal illness, marking the first fatalities in the United States since a widespread outbreak began in early May. Michigan health authorities confirmed that both individuals had "significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration," while stressing that death from the illness remains rare and that it is "not usually life-threatening."

The outbreak has grown to nearly 6,700 laboratory-confirmed cases across 45 states, according to the US Centers for Disease Control and Prevention (CDC). Michigan, a midwestern state, has been by far the hardest-hit, reporting more than 11,000 suspected cases and 193 hospitalisations — a striking anomaly given that the state typically records only around 50 cases of the intestinal disease per year. The CDC has also acknowledged more than 11,500 additional cases that have not been laboratory-confirmed, concentrated largely in Michigan. Nationwide, at least 423 people have been hospitalised.

Cyclosporiasis is caused by the Cyclospora cayetanensis parasite, which infects the small intestine and is transmitted through food or water contaminated with faecal matter — not from person to person. It causes profuse watery diarrhoea with frequent and sometimes severe bowel movements, and outbreaks typically occur in summer months. Federal health authorities have linked a significant portion of this year's cases to shredded iceberg lettuce supplied by Taylor Farms, a major produce company operating in central Mexico. Although an initial laboratory test on a Taylor Farms sample appeared to detect the parasite, it was subsequently identified as a false positive. Nevertheless, the US Food and Drug Administration (FDA) maintains that epidemiological data and supply chain investigations continue to point strongly to the company's lettuce. Taylor Farms has issued a voluntary recall, and fast-food chain Taco Bell has removed the supplier's lettuce from its menu. Taco Bell's customer visits fell by around 20 percent following the outbreak, though the company says numbers are recovering.

The CDC recommends washing all fresh produce under running water, even items labelled pre-washed, though washing alone may not eliminate the parasite. Cooking produce to at least 70°C (158°F) can kill it. Health authorities are also investigating whether other restaurants, retailers, and suppliers may be involved. The broader economic fallout has been significant: surveys suggest four in ten Americans have been buying less fruit and vegetables since the outbreak began. UK health officials have also issued warnings after cases were identified in travellers returning from the United States.