WASHINGTON — A cyclosporiasis outbreak that has grown into the largest on record in the United States has caused its ‌first known deaths, two people in Michigan, the state's health department said on Monday.Cyclosporiasis, an intestinal illness caused by the Cyclospora parasite, is generally not life-threatening. Michigan, citing medical records, said the two who died had significant underlying health conditions that may have been affected by the disease and related dehydration.“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, including 193 people who 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.”Cyclosporiasis is caused by a microscopic parasite that can contaminate fresh food or water and lead to severe diarrhea in those infected. Some cyclosporiasis infections may improve on their own, but without treatment, symptoms may last a month or longer, and persistent diarrhea can make it difficult to stay hydrated. Dehydration from frequent bouts of diarrhea can also cause severe illness.Cases of cyclosporiasis are known to rise during spring and summer months in the US, with a typical season running from the start of May through the end of August, according to the CDC. But case counts are particularly high this year.The CDC has identified more than 18,000 cases of domestic cyclosporiasis this season; 6,707 cases are confirmed, and about 11,500 others are undergoing further laboratory testing and analysis to determine whether the illness was acquired in the US.Multiple clusters of cyclosporiasis cases are being investigated this year by the US Food and Drug Administration in collaboration with the CDC and state partners, including the particularly large multistate outbreak centered in the Midwest.Iceberg lettuce supplied by Taylor Farms has been recalled, and it’s likely that contaminated products have already been eaten or removed from shelves.