Michigan health officials have confirmed the first two deaths linked to the ongoing cyclospora outbreak, a parasitic infection spread through contaminated food or water that can cause severe diarrhoea.

The two individuals had “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration”, state health authorities said.

The foodborne illness has spread to 45 states, with nearly 7,000 laboratory-confirmed cases reported nationwide, according to the US Centers for Disease Control and Prevention (CDC).

While the outbreak has infected thousands of people, the CDC says deaths from cyclosporiasis are far from common, as it is “not usually life-threatening”.

Michigan’s health department did not provide further details about those who have died.

The state is at the epicentre of the current outbreak and its records show more than 11,000 cases and 193 hospitalisations, although many have not been laboratory-confirmed.

The heat-loving parasite infects the intestines and is transmitted through faecal contamination.

Past outbreaks have occurred when people consumed fruits or vegetables irrigated with water contaminated by faeces.

The CDC recommends washing all produce under running water, including those that are labelled as pre-washed.

But washing alone might not be enough to rid produce of the parasite. Cooking produce to a temperature of at least 70°C (158 °F) can kill the parasite, the agency recommends.

Officials have linked this year’s widespread outbreak to lettuce imported from Taylor Farms in Mexico, a key supplier for many food establishments in the US.

US fast-food chain Taco Bell said it has removed lettuce from the supplier from its menu. Taylor Farms itself announced a voluntary recall of lettuce sourced from central Mexico.

UK health officials too have warned about the outbreak following recent cases contracted by returning travellers.