Health officials in Michigan reported on Monday that two people have died from cyclosporiasis, which are the first deaths from the latest outbreak of the parasite.

Symptoms of infection include severe diarrhea, nausea and other ‌gastrointestinal issues. Both individuals who died had underlying health conditions that may have been impacted by the dehydration that the parasite causes, Reuters reported. 

There have been 11,234 cases reported in the latest outbreak as of Monday, Michigan health officials reported, and 193 people have been hospitalized with infections. 

The Centers for Disease Control and Prevention have recorded 6,707 laboratory-confirmed cases of cyclosporiasis as of July 28, and more than 11,500 additional suspected cases are still awaiting confirmation or further investigation.

Earlier indications have linked the outbreak to iceberg lettuce, but nothing for certain has been confirmed.