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.

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 shelves.


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.

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 five each.


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