Five dead, 28 ill in 10 states, due to Listeria linked to prepackaged caramel apples

Multistate Outbreak of Listeriosis Linked to Commercially Produced, Prepackaged Caramel Apples

The FDA, CDC and state and local officials are investigating an outbreak of listeriosis potentially linked to commercially-produced, prepackaged caramel apples.  Investigators are working to identify the source of contamination and to determine what products may be contaminated.  New information will be provided as it becomes available.

What is the Problem and What is Being Done?
According to the CDC, as of Dec. 18, 28 people in 10 states have been reported as being infected with the outbreak strains of Listeria monocytogenes.  The CDC reports that 26 ill people have been hospitalized.  Five deaths have been reported.   

Listeriosis contributed to at least four of the deaths. Nine illnesses were pregnancy-related. Four illnesses were among otherwise healthy children ages 5–15 years.

The CDC reports that 15 of the 18 ill people interviewed reported eating commercially-produced, prepackaged caramel apples.  No illnesses related to this outbreak have been linked to apples that are not caramel-coated and are not prepackaged and no illnesses have been linked to caramel candy.

The Minnesota Department of Health has reported four illnesses.  The Minnesota cases purchased caramel apples from Cub Foods, Kwik Trip, and Mike’s Discount Foods, which carried Carnival brand and Kitchen Cravings brand caramel apples. These two brands are no longer available for purchase at retail locations.

What are the Symptoms of Listeriosis?

Listeriosis is a rare but serious illness caused by eating food contaminated with the bacterium called Listeria monocytogenes. Anyone who experiences fever and muscle aches, sometimes preceded by diarrhea or other gastrointestinal symptoms, or develops fever and chills after eating commercially-produced, prepackaged caramel apples should seek medical care and tell the health care provider about any history of eating those caramel apples. Symptoms can appear from a few days up to a few weeks after consumption of the contaminated food.

Who is at Risk?
Listeriosis can be fatal, especially in certain high-risk groups. These groups include the elderly, and people with weakened immune systems and certain chronic medical conditions (such as cancer). In pregnant women, listeriosis can cause miscarriage, stillbirth, premature labor, and serious illness or death in newborn babies.

What Do Consumers Need To Do?
Consumers should not eat commercially-produced, prepackaged caramel apples, including those containing nuts, sprinkles, chocolate, or other toppings, until more specific guidance can be provided.  Consumers should throw away any commercially produced, prepackaged caramel apples that they may have in their homes until more specific guidance can be provided.

Recommendations for preventing listeriosis are available at the CDC Listeria website: http://www.cdc.gov/listeria/prevention.html.
Listeria monocytogenes can grow at refrigerator temperatures, as low as 40 degrees Fahrenheit (4 degrees Celsius). The longer ready-to-eat refrigerated foods are stored in the refrigerator, the more opportunity Listeria has to grow.

For refrigerators and other food preparation surfaces and food cutting utensils that may have come in contact with commercially-produced, prepackaged caramel apples, including those containing nuts, sprinkles, chocolate, or other toppings, it is very important that the consumers thoroughly clean the following areas:

• Wash the inside walls and shelves of the refrigerator, cutting boards and countertops; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used. 

In addition, consumers can follow these simple steps for food safety:

• Wash hands with warm water and soap for at least 20 seconds before and after handling food.
• Wipe up spills in the refrigerator immediately and clean the refrigerator regularly.
• Always wash hands with warm water and soap following the cleaning and sanitization process.

Highlights

• Read the Advice to Consumers and Retailers
• CDC is collaborating with public health officials in several states and with the U.S. Food and Drug Administration (FDA) to investigate an outbreak of Listeria monocytogenes infections (listeriosis) linked to commercially produced, prepackaged caramel apples. Listeria can cause a serious, life-threatening illness.
• The information CDC has at this time indicates that commercially produced, prepackaged caramel apples may be contaminated with Listeria and may be causing this outbreak.
  • Out of an abundance of caution, CDC recommends that U.S. consumers do not eat any commercially produced, prepackaged caramel apples, including plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings, until more specific guidance can be provided.
  • Although caramel apples are often a fall seasonal product, contaminated commercially produced, prepackaged caramel apples may still be for sale at grocery stores and other retailers nationwide or may be in consumers’ homes.
  • This investigation is rapidly evolving. New information will be provided as it becomes available.
• As of Dec. 18, a total of 28 people infected with the outbreak strains of Listeria monocytogenes have been reported from 10 states.
  • 26 ill people have been hospitalized. Among the 26 people hospitalized, five deaths have been reported. Listeriosis contributed to at least four of these deaths.
  • Nine illnesses were pregnancy-related (occurred in a pregnant woman or her newborn infant).
  • Three invasive illnesses (meningitis) were among otherwise healthy children aged
    5–15 years.
  • To date, 15 (83%) of the 18 ill people interviewed reported eating commercially produced, prepackaged caramel apples before becoming ill.
  • At this time, no illnesses related to this outbreak have been linked to apples that are not caramel-coated and not prepackaged or to caramel candy.
• Investigators are working quickly to determine specific brands or types of commercially produced, prepackaged caramel apples that may be linked to illnesses and to identify the source of contamination.
• This investigation is rapidly evolving, and new information will be provided as it becomes available.