The Minnesota Departments of Health and Agriculture are working with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) on a multi-state outbreak of Listeriosis linked to eating caramel apples. Four people in Minnesota have become ill as part of this outbreak. All were hospitalized, and two died. All were adults ages 59 to 90 years. They became ill in late October and November. Health officials are warning consumers who may have purchased any pre-packaged, commercially produced caramel apples, including caramel apples with other toppings such as nuts, chocolate, and sprinkles, to not eat them until more information from the investigation becomes available. The Minnesota cases purchased caramel apples from Cub Foods, Kwik Trip, and Mike’s Discount Foods, which carried Carnival brand and Kitchen Cravings brand caramel apples. These two brands are no longer available for purchase at retail locations; however, health officials are concerned that persons who purchased them may still have them in their homes. The investigation is evolving, and other caramel apple brands and locations may also be impacted. Minnesota officials are working with national partners to determine the scope of products impacted. Consumers should not eat any brands of commercially produced pre-packaged caramel apples until additional information is available. At this time, no illnesses related to this outbreak have been linked to apples that are not caramel-coated and not pre-packaged. Listeriosis is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes. The disease affects primarily older adults, pregnant women, newborns, and persons with weakened immune systems. On average, seven cases of Listeriosis are reported in Minnesota each year. Symptoms of Listeriosis include fever, muscle aches, headache, stiff neck, confusion, loss of balance, and convulsions. Infected pregnant women may experience only a mild, flu-like illness; however, infections during pregnancy can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. Symptoms begin from three to 70 days after consuming the bacteria. Anyone who believes they may have become ill with Listeriosis should contact their health care provider.