Two people have died amid the ongoing record-breaking outbreak of explosive diarrhea from the foodborne parasite Cyclospora, Michigan health officials announced Monday.

Cyclosporiasis fatalities are extremely rare, and despite the massive size of the outbreak, some experts were still surprised by the deaths. The Michigan Department of Health and Human Services on Monday said that medical records of both individuals indicated that they had “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration.”

MDHHS noted that both fell ill with the diarrheal infection before Taylor Farms recalled its shredded iceberg lettuce grown in Mexico, which has been linked to thousands of cases in at least nine states. Cyclospora is a unicellular parasite that spreads in human feces and is often transmitted via contaminated fresh produce, such as lettuces and other fruits and vegetables that have uneven surfaces for the parasite to grip. Past culprits have included fresh herbs, raspberries, green onions, and snow peas.

While news of the deaths made widespread headlines Monday, federal health agencies under the Trump administration were mostly silent. The Food and Drug Administration—which is conducting traceback investigations to identify foods contaminated with the parasite—has not updated its outbreak investigation page since July 24, nearly two weeks ago, as of publication time.

The Centers for Disease Control and Prevention, meanwhile, added a banner notice on its outbreak update webpage saying that the agency was “aware” of the two cases. But its reporting data was not updated to include the two deaths as of this publication.

Sluggish data

Ars Technica contacted the US Department of Health and Human Services about the un-updated numbers to ask if the CDC was still awaiting confirmatory data on the two deaths. In a response, HHS Press Secretary Emily Hilliard confirmed the information provided by Michigan’s health department on the two deaths and said that “FDA and CDC plan to update overall illness numbers, hospitalizations, and deaths this week.”