Two people in Michigan have died in connection with the outbreak of cyclosporiasis, health officials reported Monday.

These are the first known deaths related to the multi-state outbreak of explosive diarrhea in the United States.

“Two deaths have been identified as part of the cyclosporiasis outbreak affecting Michigan. According to medical records, both individuals had significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration. No additional information will be provided on these two cases,” according to the Michigan Department of Health and Human Services.

Deaths from cyclosporiasis are far from common, as the infection is “generally not a life-threatening illness,” the department said. A total of 11,234 cases have been reported in the state so far, including 193 that had been hospitalized.

The US Centers for Disease Control and Prevention said on its website that it “is aware of two cyclosporiasis-related deaths in people with underlying health conditions from Michigan as part of this outbreak.”