Michigan has reported the first known deaths tied to the nationwide cyclosporiasis outbreak, with two residents dying after contracting the food-borne parasite as the number of suspected cases in the state has climbed past 11,000.

State health officials said both victims, whose identities have not been released, suffered from “significant underlying health conditions,” according to the Michigan Department of Health and Human Services.

Federal investigators believe the outbreak is linked to contaminated iceberg lettuce supplied by Taylor Farms de Mexico. The lettuce was reportedly served at Taco Bell locations and distributed to retail stores before the contamination was identified.

Across the country, health officials recorded at least 6,707 laboratory-confirmed cases of cyclosporiasis between May 1 and July 27, with Michigan emerging as the hardest-hit state.

Michigan authorities say the outbreak has expanded even further within the state, estimating that more than 11,200 people had likely been infected as of Aug. 3, though most of those cases have not yet been confirmed through laboratory testing.

As of July 30, 193 Michigan residents had been hospitalized because of the illness.