California Department of Public Health (CDPH) Director Dr. Ron Chapman warned consumers today not to eat all varieties of Happy Apple Brand Caramel Apples because they may be contaminated with Listeria monocytogenes. CDPH is coordinating with the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) and other state and local agencies in the investigation of 29 cases of Listeriosis in 10 states which appear to be linked to the consumption of multiple brands of caramel apples. All 29 cases have been hospitalized and five deaths have been reported. A single case-patient in California has died.

Happy Apple Company, with manufacturing facilities in Orosi, CA and Union, MO, is voluntarily recalling all varieties of Happy Apple Brand Caramel Apples, after learning of the recall of apples used to produce the caramel apples by one of their apple suppliers. These caramel apples were packaged in clear, plastic containers as a single pack, three pack, four pack, or eight pack. All Happy Apple Brand Caramel Apples with “Best if used by dates” between August 25, 2014 and November 23, 2014 are being recalled.

The Happy Apple Brand caramel apples were sold at multiple retail, club and discount store  locations throughout California, Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Washington, and Wisconsin. Although the recalled caramel apples are not likely to remain on grocery store shelves, consumers may still have the caramel apples in their homes. Anyone in possession of the recalled caramel apples should place them into a garbage bag and dispose of them in the trash.

The CDC continues to recommend that U.S. consumers not eat any commercially produced, pre-packaged caramel apples, including plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings, until the investigation can determine all of the brands that may be implicated in the outbreak. Whole in-tact apples, apple based beverages such as juice or cider, and apple sauce do not appear to be associated with this outbreak.

Symptoms of Listeria infection may include high fever, headache, and neck stiffness. Infants, the elderly, and people with weakened immune systems are at highest risk for severe illness and death. Listeria infection in pregnant women can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn baby.