As of December 22, 2014, a total of 29 people infected with the outbreak strains of Listeria monocytogenes have been reported from 10 states: Arizona (4), California (1), Minnesota (4), Missouri (5), New Mexico (5), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3). Illness onset dates range from October 17, 2014, to November 27, 2014. Nine illnesses have been associated with a pregnancy (occurred in a pregnant woman or her newborn infant). No miscarriages or fetal losses have been reported. Among people whose illnesses were not associated with a pregnancy, ages ranged from 7 to 92 years, with a median age of 66 years, and 41% were female. Three invasive illnesses (meningitis) occurred among otherwise healthy children aged 5–15 years. All 29 ill people have been hospitalized and, five deaths have been reported. Listeriosis contributed to three of these deaths and it is unclear whether it contributed to a fourth. The fifth death was unrelated to listeriosis.
The information CDC has at this time indicates that commercially produced, prepackaged caramel apples may be contaminated with Listeria. Listeria can cause a serious, life-threatening illness. In interviews, ill people answered questions about foods consumed and other exposures in the month before becoming ill. To date, 20 (87%) of the 23 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. Although limited information is currently available about the specific brand(s) of commercially produced, prepackaged caramel apples consumed, the finding that most of the ill people reported consuming these apples suggests that these Listeria infections are likely related to commercially produced, prepackaged caramel apples. Investigators are rapidly working 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.
At this point in the investigation, CDC’s Advice to Consumers remains the same. 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.