The Ongoing Risk of Listeria:
Listeria monocytogenes is an organism, which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.
As of Friday the Centers for Disease Control and Prevention (CDC) reports that 28 people (although the Washington State Department of Health reports 29) have been infected with the outbreak strains of Listeria monocytogenes from 10 states linked to commercially produced, prepackaged caramel apples. The states reporting illnesses are:
- Arizona (4), California (1), Minnesota (4), Missouri (5), New Mexico (5), North Carolina (1), Texas (4), Utah (1), Washington (1) and Wisconsin (2).
Twenty-six ill people have been hospitalized. Among the 26 people hospitalized, five deaths have been reported. The States reporting deaths are:
- Minnesota (2), California (1), Texas (1) and Missouri (1).
Listeria was a contributing factor, but not cause of the Missouri death. I spoke this morning to family of 81-year-old woman who died of Listeria in California on December 2 after purchasing and consuming a caramel apple shortly before Halloween. The family has been informed that she is a link to the outbreak by California health officials. The same officials came and picked up discarded product that may be leftovers from the consumed product. The caramel apples were purchased at Safeway in Felton, California.
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.
The information CDC has at this time indicates that commercially produced, prepackaged caramel apples are the source of the outbreak
The most detailed information comes from the Minnesota Department of Health. Minnesota cases purchased prepackaged caramel apples from Cub Foods, Kwik Trip, and Mike’s Discount Foods, which carried Carnival brand and Kitchen Cravings brand caramel apples. Both brands are made by H. Brooks, a 110-year old company in New Brighton. The company only sells the caramel apples in Minnesota and Wisconsin.
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.
Public health investigators are using the PulseNet system to identify cases that may be part of this outbreak. DNA “fingerprinting” is being performed on the Listeria bacteria isolated from ill persons using pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). Two outbreak clusters were identified by the PFGE technique, and Listeria isolates within each cluster were found to be highly related by the WGS technique but distinct between the two clusters. CDC is investigating the two clusters together because one person was infected with both Listeria strains simultaneously and also because illnesses in the two clusters have occurred during a similar time period and in similar regions of the country.
Advise to Consumers from Health Officials:
Out of an abundance of caution, CDC recommends that U.S. consumers 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. If you are experiencing symptoms of listeriosis, please seek immediate medical attention.
What More Information to Expect in Coming Days:
- Given the long incubation period – 3 to 70 days – for a Listeria infection to manifest after eating the product, it is likely that the numbers of ill will increase that they are reported by hospitals to local and state health authorities and then to the CDC.
- It is expected that the Federal Food and Drug Administration (FDA) will announce Monday more information where the product was manufactured, shipped and sold.
- It is also expected to hear more from the CDC on the likely point of Listeria contamination in the production of this product.
It was a busy Friday helping explain to the media the issues surrounding this unusual and tragic Listeria outbreak.