Coming just in time to make the Food Safety News’ Top 10 list of the worst foodborne illnesses of 2014, an outbreak of listeria traced to pre-packaged caramel apples sold in California has reportedly killed five people and hospitalized dozens more.

A Christmas Day message from the California Department of Public Health (CDPH) warned people “not to eat all varieties of Happy Apple Brand Caramel Apples because they might be contaminated with Listeria monocytogenes.”

Happy Valley Co., which has manufacturing plants in Orosi, California, and Union, Missouri, voluntarily recalled caramel apples with “best-if-used-by” dates between August 25 and November 23. Symptoms sometimes don’t appear for 70 days. The source of the bacteria appears to be unclear. Was it the caramel, the apple, the stick?

Listeria monocytogenes can cause serious infections in young children, frail or elderly people, and people with immune system deficiencies. Symptoms include fever, headache, confusion and imbalance. It is sometimes fatal.

The federal Centers for Disease Control and Prevention (CDC) has reported Happy Valley-related illnesses in 10 states. One of the deaths was in California. The products are probably no longer in stores, but could be sitting in pantries or stuffed away with months-old fruitcake.

The family of Californian Shirlee Jean Frey, 81, filed a wrongful death lawsuit in Santa Cruz County Superior Court against Safeway after she bought caramel apples from one of their stores in Felton and died on December 2.

For those swearing off listeria in their diet, the ice cream, gelato, custard and sorbet from Snoqualmie Gourmet Ice Cream, Inc., which is distributed in California, should also be avoided. That Washington State-based company issued a voluntary recall last week of its products that were produced between January 1 to December 15. Those products that don’t sport the name Snoqualmie go by Emerald & Spruce Ice Cream or Top Pot Hand Forged Ice Cream.

The listeria outbreak was not the only California-related food poisoning to make the Food Safety News Top 10. The Foster Farms chicken Salmonella outbreak emanating from Livingston, California, garnered the Number 2 ranking on the list in 2013 and slopped over into the 2014, earning a Number 7 spot.

Listeria claims the top three spots in the national list, with the deadliness of the Happy Valley outbreak pushing it to the top. Salmonella shows up three times and the rest of the outbreaks on the list owe their presence to campylobacter, cyclospora and clostridium perfringens.

A 2011 report from the Emerging Pathogens Institute at the University of Florida said food poisoning costs the country $14 billion a year. Listeria and four other pathogens—salmonella, campylobacter, toxoplasma gondii and norovirus—are responsible for 90% of the cost.

Should more be done to reduce the incidence of food poisoning, or have we hit a sweet spot? That’s not a question bandied about much in the popular press, but it is the subject of numerous cost-benefit studies at FoodRisk.org. The site brings together the resources of the U.S. Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA), including tools, databases and risk assessment models.

One 2005 study, entitled “The Cost and Benefit of Listeria Monocytogenes Food Safety Measures,” admitted that “due to considerable lack of data, the optimal level of L. monocytogenes food safety measures could not be estimated. When better data become available, this study can serve as a template for estimating the optimal level of food safety.”  

–Ken Broder

To Learn More:

Safeway Pulls Caramel Apples from Shelves after Listeria Deaths, Lawsuit (by Daisy Nguyen, Associated Press)

Californians Warned to Avoid Caramel Apples after Listeria Outbreak (by Lisa Girion, Los Angeles Times)

First Wrongful Death Lawsuit Filed in Listeria Outbreak Linked to Caramel Apples (by Dan Flynn, Food Safety News)

The 10 Worst U.S. Foodborne Illness Outbreaks of 2014 (by James Andrews, Food Safety News)

Contaminated Food Costs U.S. More than $14 Billion a Year (by Noel Brinkerhoff and David Wallechinsky, AllGov)

Multistate Outbreak of Listeriosis Linked to Commercially Produced, Prepackaged Caramel Apples (Centers for Disease Control and Prevention)