After eating prepackaged caramel apples, five people in the United States have died as a result of a listeria infection. At least 26 people became sick after eating the apples and had to be hospitalized in 10 states.

Having interviewed 83 percent of the people who had become sick, it was discovered that each of them had eaten caramel apples. The caramel apples were commercially produced, and not home-made. It is not believed that the Listeria came from fresh produce.

The Centers for Disease Control and Prevention (CDC) has found that it is the same strain of listeria in all of the cases – which means they had a common source. At this time, they do not know which brand of caramel apples caused the outbreak. The agency does not believe that there is any reason to not go on eating plain apples or other products with caramel in or on them.

The listeria bacteria cause an infection called listeriosis. It will primarily affect seniors, pregnant women, newborns, and those who have a weakened immune system. About 90 percent of cases affect people in these categories, but healthy people can sometimes become infected as well.

Because the apples may have been left over from Halloween, it is possible that some of the illnesses were caused from eating apples made some time ago. The first listeria cases occurred sometime in mid-October. The shelf life of a commercially made pre-packaged caramel apple could be more than a month, which means that some could still be being sold in stores.

The outbreak has affected states all over, and it is not limited to a specific part of the U.S. The five states where the most people were infected include Minnesota, Missouri, Texas, New Mexico and Arizona. The other five states include Washington, California, Utah, Wisconsin, and North Carolina. Missouri and New Mexico had the most cases with five in each.

Listeria is especially dangerous for pregnant women. In this outbreak, listeria has affected nine pregnant women or their newborn infants. Three other cases involved children who were otherwise healthy. They were between 5 and 15 years old. In three more people, the listeria led to meningitis infections. In Minnesota, it was determined that the four who were infected there were between the ages of 59 and 90 – and two of them have died.

The dates of the infections run between Oct. 17 and Nov. 27. It is quite possible that any new cases that occurred after Dec. 3 have not been reported yet.

After becoming infected, there are several symptoms to watch for. These includes muscle aches, fever, gastrointestinal problems, diarrhea, and sometimes even death. The normal treatment is antibiotics.

The bacteria can take up to 70 days before any symptoms are noticed. This is especially true in people who are in good health.

The CDC has not yet discovered the exact source of the listeria bacteria. People are advised not to eat any commercially prepared and packaged caramel apples. This includes caramel apples that have other toppings on them, too, such as chocolate, nuts, or sprinkles.

Caution needs to be given to avoid listeria bacteria. Most people who ingest it will require hospitalization, and the CDC reports that about one out of five people who become infected will die. It is the third leading cause of food poisoning deaths in the United States.