U.S. listeria outbreak causing four deaths tied to caramel apples

Four people have died and 26 people have been hospitalized due to a listeria outbreak, according to the Centers for Disease Control and Prevention.

The CDC has linked the cases to prepackaged caramel apples, with 83 percent of those who are ill reporting having eaten caramel apples before getting sick. Investigators are still working to determine specific brands and to identify the source of contamination.

At this time, the CDC said that no illnesses related to this outbreak have been linked to apples that are not caramel-coated, not prepackaged, or to caramel candy in general.

Ten states have reported cases so far. While Iowa has not seen any cases yet, there have been multiple cases in Minnesota, Wisconsin, and Missouri.

Listeria can cause a serious, life-threatening illness. The disease primarily affects older adults, pregnant women, newborns, and adults with weakened immune systems, according to the CDC.

Symptoms generally include fever, muscle aches, and diarrhea. Infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.

The CDC estimates that listeria is responsible for 1,600 illnesses and 260 deaths each year. In 2012, there were 4 confirmed outbreaks and 1 suspected outbreak of listeriosis in the United States.

The largest listeriosis outbreak was in 2011, when cantaloupe from a single farm caused 147 illnesses, 33 deaths, and one miscarriage across 28 states.