The Trump administration continues to respond sluggishly to the explosive, nationwide outbreak of Cyclospora—a unicellular parasite spread from human feces that has now sickened nearly 23,000 people in 47 states, killing two and sending over 500 to the hospital.

Michigan health officials reported the two deaths Monday, and The Washington Post first reported Tuesday that federal health officials have expanded a list of states with linked cases from nine to 15. But those updates still have not appeared on public outbreak pages for the Centers for Disease Control and Prevention or the Food and Drug Administration, and Americans are struggling to understand the risk of eating fresh fruits and vegetables.

In comments to Ars Technica on Monday, a spokesperson for the Department of Health and Human Services, which oversees CDC and FDA, said the outbreak information will be updated sometime "this week." Sources for The New York Times said that the CDC plans to set up a "formal response team" for the outbreak sometime this week. Cases in the outbreak began in June.

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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.

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