A deadly outbreak of Listeria monocytogenes infections linked to ready-to-heat pasta meals produced by FreshRealm Inc. and California Ranch Food Company has expanded to 15 states, sickening 20 people and resulting in 19 hospitalizations and four deaths. The products, which were made with a contaminated product supplied by a third party, Nate’s Fine Foods, have been sold under various brand names at stores including Walmart, Kroger, and Trader Joe’s.

The U.S. Food and Drug Administration (FDA), the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), and the U.S Centers for Disease Control and Prevention (CDC), in collaboration with state and local partners, are investigating the multistate outbreak.

Of the 13 outbreak patients who were interviewed, seven (54 percent) reported eating precooked meals, and four (57 percent) specifically reported eating chicken fettuccine alfredo. Ill people purchased the products from the refrigerated section at Walmart and Kroger.

As of September 30, affected stores and products include:

• Kroger: Home Chef Chicken Fettuccine Alfredo Meals (FreshRealm)
• Trader Joe’s: Trader Joe’s Cajun Style Blackened Chicken Breast Fettucine Alfredo (California Ranch Food Company)
• Walmart: Marketside Chicken Fettuccine Alfredo Meals, Marketside Linguine with Beef Meatballs & Marinara Sauce (FreshRealm).

On June 17, FreshRealm announced a voluntary recall of prepared chicken fettuccine alfredo products, sold under the Marketside and Home Chef brand names, after routine USDA-FSIS product sampling detected a strain of L. monocytogenes that matched clinical isolates from people who fell ill as early as August 2024. At the time, there were 17 illnesses and three deaths associated with the outbreak, spanning 13 states. Additionally, one of the pregnancy-associated illnesses resulted in a fetal loss.

In response to the investigation, FreshRealm began testing individual ingredients used to produce its Marketside-brand linguine with beef meatballs and marinara sauce meal, and the company’s ingredient testing of linguine pasta samples were confirmed positive for L. monocytogenes by FreshRealm’s contracted lab. On September 27, FreshRealm informed FDA that whole genome sequencing (WGS) performed by the company’s contracted lab confirmed the linguine sample to be positive for the same strain of L. monocytogenes that was detected in the company’s recalled chicken alfredo meals.

On September 25, Nate’s Fine Foods, the supplier that sold the affected pasta to FreshRealm, recalled certain lots of pre-cooked pasta after a sample of linguine collected and tested by FreshRealm tested positive for L. monocytogenes. The pasta supplier does not sell the affected products direct to retail. WGS results are pending to determine if the strain detected in Nate’s Fine Foods’ pasta is the same strain making people sick. The firm is working with its customers and with FDA to determine if additional recalls are needed.

For full recall information, see USDA-FSIS’ public health alert and FDA’s outbreak advisory.