Five people in four states, including one who died, being infected with the same strain of Listeria monocytogenes has the federal Centers for Disease Control and Prevention (CDC) worrying about potentially contaminated cheeses that were distributed nationwide. According to the CDC, the ongoing investigation indicates that Les Frères, Petit Frère, and Petit Frère with Truffles cheeses made by Wisconsin’s Crave Brothers Farmstead Cheese Company is the likely source of the deadly outbreak. Crave Brothers recalled the cheese products on July 3. Illinois, Indiana, and Ohio each have reported one case associated to the outbreak strain. Two cases were confirmed in Minnesota, including the death case. All five ill persons were hospitalized. One illness in a pregnant woman resulted in a miscarriage. The Listeria outbreak is the subject of a continuing and collaborative investigation is involving local and state health agencies along with the U.S. Food and Drug Administration (FDA), and the Atlanta-based CDC. Crave Brothers, based in Waterloo, WS, distributed their cheese products through retail and food service outlets. The company also fulfilled customer orders by mail order. Consumers who purchased any of the recalled cheeses should not eat them and should throw away any remaining cheeses, according to CDC. It said the warning is especially important for pregnant women, older adults, and persons with weakened immune systems, who are at the highest risk for infection and serious outcomes. The nation’s premier public health laboratories says about 800 laboratory-confirmed cases of listeriosis are reported each year in the United States, and typically 3 or 4 outbreaks are identified and reported to CDC annually. It says some foods that have been linked to outbreaks in recent years are Mexican-style soft cheeses, imported ricotta salata cheese, whole cantaloupe, raw sprouts, and precut celery. Listeria is feared for its relatively high fatality rate, especially among those populations CDC is warning during the current outbreak. Listeria outbreaks involving ready-to-eat meats in Canada and cantaloupe in the U.S. ended with deaths of 30-40 percent of those infected. In the current investigation, CDC says public health investigators are using DNA “fingerprints” of Listeria obtained through testing with pulsed-field gel electrophoresis, or PFGE, to identify cases of illness that may be part of this outbreak. They are using data from PulseNet, the national subtyping network of state and local public health laboratories and federal food regulatory laboratories that performs molecular surveillance of foodborne infections. Among persons for whom information is available, dates that illness was diagnosed range from May 20, 2013 to June 17, 2013. All five ill persons were hospitalized. Ill persons range in age from 31 years to 67 years, with a median age of 58 years, and 80 percent are female. Clinical specimens that were collected after June 22, 2013 might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 3 weeks. In interviews, ill persons answered questions about foods consumed and other exposures in the month before becoming ill. All five ill persons reported consuming a soft cheese. Information about specific cheeses consumed is available for four of the ill persons. Of those, three either definitely or probably ate Les Frères cheese made by Crave Brothers before getting sick. Investigation of specific types of cheeses consumed by other ill persons is ongoing, according to CDC. Laboratory tests conducted by the Minnesota Department of Agriculture on samples of Les Frères and Petit Frère with Truffles cheeses made by Crave Brothers from two retail stores indicate the presence of the outbreak strain of Listeria monocytogenes. Further testing and confirmation of the results are pending. FDA is conducting an inspection at Crave Brothers’ processing facility, in coordination with the Wisconsin Department of Agriculture, to determine the exact cause of contamination. Meanwhile Friday, the upscale Austin, TX-based Whole Foods retail chain announced it was recalling all the potentially contaminated Crave Brothers cheeses that it sold, as did Kroger Stores.