Four deaths and 19 hospitalisations have been recorded in a US listeria outbreak linked to prepared-meals firm FreshRealm.

The US Food and Drug Administration (FDA), US Department of Agriculture Food Safety and Inspection Service (USDA FSIS), and Centers for Disease Control and Prevention (CDC), working with state and local officials, said illnesses have been connected to prepared meals.  

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As of Thursday (25 September), 20 infections had been reported across 15 states, according to an FDA statement.   

Of 13 people interviewed, seven said they had eaten pre-cooked meals, and four specifically reported chicken fettuccine alfredo.  

One illness occurred in a pregnant mother and resulted in a foetal loss, the FDA added.

The FDA said FreshRealm began testing ingredients used in its Marketside brand of pasta meals and began recalls on 25 September.  

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The company confirmed to the FDA that its contracted lab reported listeria monocytogenes in linguine pasta samples. 

On Saturday (27 September), FreshRealm informed the FDA that whole genome sequencing by its contracted lab showed the linguine sample was positive for the same strain identified in the company’s chicken alfredo meals, which were recalled on 17 June.  

The agency said it is the same strain linked to illnesses in the outbreak. 

USDA FSIS on Friday (26 September) updated its public health alert to include an additional product that may be contaminated with listeria monocytogenes: Plastic tray packages labeled ‘Trader Joe’s Cajun Style Blackened Chicken Breast Fettucine Alfredo’ with best if used by dates of the 20, 24, and 27 of September.

FreshRealm does not sell the affected products directly to retail and is working with the FDA and customers to assess whether further recalls are needed, the regulator added.

The FDA said it will continue to work with federal and local partners and involved firms and will provide updates as new information emerges. 

On other instances away from the reported outbreak, an infant had died and nine others were hospitalised in a multi-state listeria outbreak in November linked to ready-to-eat meat and poultry products of US-based Yu Shang Food. 

A month earlier, TreeHouse Foodsexpanded a recall linked to the potential presence of listeria to encompass “all products” manufactured at a facility in Ontario, Canada. 

During the same month, BrucePac also initiated a recall of approximately 9.9 million pounds of products due to a listeria outbreak. 

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