WASHINGTON — Health officials are warning
consumers to avoid prepackaged caramel apples because
they are linked to four deaths and more than two dozen
illnesses in 10 states, including Wisconsin.
Caramel apples are most popular around Halloween, and
the outbreak started just before then, in mid-October.
But the commercially produced variety can have a shelf
life of a month or more, and some may still be on store
The Centers for Disease Control and Prevention said it
knows of 28 cases in which people were sickened with the
same strains of the bacterial illness listeria, and at
least 26 were hospitalized. Of those, five died.
Listeriosis contributed to four of the deaths; a fifth
person who died had a strain of listeria linked to the
caramel apples, but health officials do not think
listeriosis caused that person's death.
The agency said that 83 percent of the ill people who
were interviewed reported eating commercially produced,
prepackaged caramel apples before getting sick.
The CDC said the investigation into the deaths and
illnesses is "rapidly evolving." Christopher Braden, an
epidemiologist at the CDC, said the agency is still
trying to determine which brands are involved and how
caramel apples may have become infected. He said there
is no reason at this point to stop eating plain apples
or other caramel products.
Two of the deaths were in Minnesota, and health
officials in that state said those who fell ill there
purchased the caramel apples from the stores Cub Foods,
Kwik Trip, and Mike's Discount Foods. Those stores
carried Carnival brand and Kitchen Cravings brand
caramel apples, none of which are still available for
purchase, according to the Minnesota Department of
Health. They said other brands and store locations may
be impacted as the investigation continues.
The CDC said the other two deaths were in Texas and
California. The agency said illnesses also occurred in
Arizona, California, Missouri, New Mexico, North
Carolina, Texas, Utah, Washington, and Wisconsin.
Missouri and New Mexico had the most illnesses, with
Listeria is a foodborne illness that is especially
dangerous to pregnant women, newborn babies, the elderly
and those with compromised immune systems. It rarely
causes serious illness in healthy people and can be
treated with antibiotics. Symptoms include fever, muscle
aches, nausea and diarrhea.
Because it can be so serious for some people, outbreaks
of listeria generally cause more deaths than other
pathogens such as salmonella or E. coli. An outbreak of
listeria linked to Colorado cantaloupe in 2011 caused 33
The CDC said that the outbreak linked to the caramel
apples began Oct. 17 and the last known illnesses
started Nov. 27. The agency said illnesses that have
occurred since early December may not have been reported
yet. Those sickened ranged from seven to 92 years old,
with a median age of 64 years.
Nine of the illnesses involved either a pregnant woman
or an infant, the CDC said. Listeria is dangerous for
pregnant women because the illness can be passed to an
unborn baby even if the mother is not showing signs of
illness. It can sicken a newborn or lead to miscarriage,
preterm delivery or stillbirth. The CDC said no
miscarriages or fetal losses were reported in this
Unusually, three cases of meningitis linked to the
listeria were reported in older children, the agency
said. Those three children were not among the deaths,
Braden said, but the CDC is "very concerned" that those
cases occurred in otherwise healthy children. While
listeria can infect newborns, "usually we would not see
this kind of infection in healthy older children,"
Braden said there may have been more illnesses in
children because kids are more likely to eat caramel
apples, or possibly because the apples were heavily
He said anyone with commercially produced, prepackaged
caramel apples at home should throw them away, taking
care to wrap them up well so animals or people going
through trash don't eat them.