Food Safety News reports that in the past week, the number of children affected by extremely high levels of lead in certain cinnamon applesauce pouches has grown.

On Feb. 13, the Centers for Disease Control and Prevention reported that as of Feb. 9, it had received reports of 101 confirmed cases, 284 probable cases, and 37 suspected cases for 422 cases from 44 different states. That is up from 413 total cases in 43 states reported on Feb. 2.

The Food and Drug Administration has seen a leveling off in the reports it has received. As of Feb. 13, the agency had 90 reports, the same number reported in late January. The CDC and FDA use different reporting structures, and cases may overlap, so the agencies’ numbers should not be added together.

Reports of elevated lead levels in children who ate the applesauce from the implicated pouches began in the fall of 2023. Health officials in North Carolina reported those findings to federal officials, and the investigation began a few weeks later.

Three brands of cinnamon applesauce pouches were affected in the United States and have been recalled. Those brands are Wanabana, Schnucks and Weis. The products have a long shelf life, so health authorities are still urging parents to check their homes for the recalled products.

Parents and caretakers should consult a healthcare provider and ask for blood tests if they suspect a child may have been exposed to the recalled cinnamon applesauce products. 

Short-term exposure to lead could result in the following symptoms: headache, abdominal pain/colic, vomiting, and anemia. 

Longer-term exposure could result in additional symptoms: irritability, lethargy, fatigue, muscle aches or muscle prickling/burning, constipation, difficulty concentrating/muscular weakness, tremors, and weight loss. 

Permanent consequences can lead to developmental delays and brain damage.

The investigation

The FDA and officials in Ecuador — where the applesauce was produced — continue to investigate the situation. Some of the tests of cinnamon used to make the implicated applesauce showed 2,000 times the amount of lead considered safe.

Earlier this month, the U.S. Food and Drug Administration revealed the name of the company that supplied tainted cinnamon used to make applesauce marketed for children in the United States. On Feb. 6, officials in Ecuador reported to the FDA that Carlos Aguilera of Ecuador was the processor of ground cinnamon used in making applesauce sold in pouches in the United States.

The cinnamon supplier sold the tainted spice to Negasmart, which sold the cinnamon to Austrofoods, the end producer of the applesauce. The FDA’s investigation is ongoing to determine the point of contamination and whether additional products are linked to illnesses.

According to the U.S. Food and Drug Administration, the cinnamon supplier is currently not in business. The FDA’s deputy commissioner for human foods, Jim Jones, has said he believes the cinnamon was intentionally contaminated. Adding lead to spices and other products can increase the product’s weight and, therefore, its value.

“The FDA has limited authority over foreign ingredient suppliers who do not directly ship product to the U.S. This is because their food undergoes further manufacturing/processing before export. Thus, the FDA cannot take direct action with Negasmart or Carlos Aguilera,” according to a statement from the agency.

“FDA does not indicate that this issue extends beyond these recalled products and does not have any confirmed reports of illnesses or elevated blood lead level adverse events reported for other cinnamon-containing products or cinnamon.”

According to health officials in Ecuador, unprocessed cinnamon sticks used in recalled products were sourced from Sri Lanka. They were sampled by Ecuadoran officials and found to have no lead contamination.