Multiple deaths and hospitalizations from frozen ready meals contaminated with Listeria have been reported in the US. 

The CDC has raised an alert regarding pasta dishes available at Walmart, Trader Joe’s, and Kroger after a listeria outbreak caused the deaths of four individuals and hospitalized 19 others in 15 different states.

One pregnancy-associated illness also resulted in a fetal loss.

The source of the listeria outbreak was identified as beef meatball marinara linguine and chicken fettuccine alfredo meals manufactured by FreshRealm, a company located in New Jersey. These meals were then distributed and sold by major retailers throughout the country.

Even though the affected products have been recalled and are no longer on shelves, health experts warn that they may still be present in some home refrigerators or freezers.

It is believed that the true number of people impacted by the outbreak is likely higher than the number reported as many cases are undiagnosed.

Health officials say this is because some people recover without medical care and are not tested for Listeria.

In addition, recent illnesses may not yet be reported as it usually takes three to four weeks to determine if a sick person is part of an outbreak. 

The ready-to-eat meals that are contaminated are packaged in a 12-ounce clear plastic tray and include establishment numbers ‘EST. 50784’ and ‘EST. 47718’ within the USDA inspection stamp.

The USDA reported on Thursday that Marketside Linguine with Beef Meatballs & Marinara Sauce, found in Walmarts across the nation, tested positive for Listeria monocytogenes.

The fatalities due to this outbreak occurred in Illinois, Michigan, Texas, and Utah, and the CDC cautions that ‘this outbreak could extend beyond the states where illnesses have been reported.’

The FDA warns consumption of food contaminated with listeria monocytogenes can cause listeriosis, a serious infection that primarily affects older adults, people with weakened immune systems, and pregnant women and their newborns. 

Symptoms include high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea. 

In more serious cases, it can cause confusion, loss of balance and convulsions if it spreads to the nervous system. 

The US Department of Agriculture (USDA) announced on September 25 that Marketside Linguine with Beef Meatballs & Marinara Sauce, sold at Walmart stores nationwide, tested positive for Listeria monocytogenes.

The ready-to-eat meal comes in a 12-ounce clear plastic tray and bears establishment numbers ‘EST. 50784’ and ‘EST. 47718’ inside the USDA inspection mark. 

Affected products have best-by dates of September 22, 24, 25, 29, 30, and October 1, 2025, according to the warning.

On Friday, the USDA’s Food Safety and Inspection Service (FSIS) expanded the alert to include Trader Joe’s Cajun Style Blackened Chicken Breast Fettuccine Alfredo. 

The frozen meal is sold in 16-ounce trays with establishment number ‘P- 45288’ and best-by dates of September 20, 24, and 27 this year. 

Trader Joe’s said stores in California, Arizona, Nevada, New Mexico, and Utah may be affected.

‘We are issuing this guidance in an abundance of caution because testing of another brand with a shared ingredient source indicated this product may have the potential to be contaminated with Listeria monocytogenes,’ Trader Joe’s said in a statement on its website.

The CDC also added a range of chicken fettuccine alfredo meals that were distributed to retail locations nationwide to the alert. 

These were sold under the Marketside brand and the Home Chef brand at Walmart and Kroger stores.

The CDC also added a range of chicken fettuccine alfredo meals that were distributed to retail locations nationwide to the alert

Establishment number ‘EST. P-50784,’ ‘EST. P-47770,’ or ‘EST. P-47718’ appears on the label in the USDA mark of inspection, with the best-by dates being June 27, 26, 19 or prior.

These meals were sold in the refrigerated section and assembled for microwaving.

FreshRealm, the company which manufactured the pasta meals, said tests confirmed the presence of Listeria monocytogenes in its products.

A spokesman for the firm said: ‘We have long maintained that the source of the listeria was likely an ingredient supplied by a third party.’ 

The ‘contaminated’ ingredient is believed to be linguine pasta sourced from Nate’s Fine Foods of Roseville, California, according to the FSIS warning.

As part of the investigation, one of the manufacturers collected samples of the pre-cooked pasta used in the meals. 

Tests confirmed contamination with listeria, and further analysis is underway to determine if the strain is genetically linked to the earlier outbreak.

The USDA has since confirmed that the meals may contain the same listeria strain associated with a June 2025 outbreak tied to chicken fettuccine Alfredo sold at Walmart and Kroger stores.

That outbreak resulted in four deaths and at least 20 reported illnesses. 

On Friday, the USDA’s Food Safety and Inspection Service (FSIS) expanded the alert to include Trader Joe’s Cajun Style Blackened Chicken Breast Fettuccine Alfredo (pictured)

Trader Joe’s said stores in California, Arizona, Nevada, New Mexico and Utah may be affected

The frozen meal is sold in 16-ounce trays with establishment number ‘P- 45288’ and best-by dates of September 20, 24, and 27, 2025

Listeria can contaminate everything from raw vegetables, unpasteurized dairy and deli meats, and is behind about 47 recalls every year.

According to the CDC, about 1,600 people contract listeriosis each year in the US, and approximately 260 die.

In pregnant women, the infection can cause miscarriages, stillbirths, premature delivery or life-threatening infection of the newborn. 

In addition, serious and sometimes fatal infections in older adults and persons with weakened immune systems. Listeriosis is treated with antibiotics. 

Federal officials are now urging consumers not to eat the affected meals. 

‘Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase,’ the FSIS warning states.

Walmart has removed the affected meals from its stores, following guidance from FreshRealm earlier this week. 

Trader Joe’s is offering full refunds to customers who purchased the impacted fettuccine Alfredo.

The FSIS says more products could be identified as the investigation continues and is advising consumers to monitor updates on its website.