A nationwide Listeria monocytogenes outbreak has sparked urgent recalls across the United States after contaminated pasta meals linked to Nate’s Fine Foods and distributed by FreshRealm led to six deaths and at least 25 hospitalizations. Federal health officials warn that more illnesses may surface as the investigation continues.

How the listeria outbreak began

The Centers for Disease Control and Prevention (CDC) confirmed that the outbreak likely began months ago, with contaminated ready-to-eat pasta dishes sold under various retail brands.

Health agencies traced the source to Nate’s Fine Foods, a Roseville, California–based supplier whose products were used by FreshRealm, a nationwide meal prep company that distributes to Trader Joe’s, Kroger, Whole Foods, and other grocery chains.

Early in the investigation, several hospitalized patients reported eating chicken fettuccine alfredo before falling ill. Laboratory tests conducted by the FDA and USDA Food Safety and Inspection Service (USDA-FSIS) detected the outbreak strain in pasta and sauce components produced by Nate’s Fine Foods.

Subsequent testing revealed cross-contamination in both ingredients and finished meals, prompting the company to recall more than 245,000 pounds of pasta—including chicken carbonara, fettuccine alfredo, pasta primavera, and macaroni and cheese.

The scope of the outbreak

As of Friday, infections have been reported in 18 states, spanning nearly one-third of the U.S.

• Confirmed deaths: 6 (reported in Hawaii, Illinois, Michigan, Oregon, Texas, and Utah)
• Hospitalizations: 25 out of 26 confirmed cases
• Total reported illnesses: 27
• Pregnancy-related cases: 1 miscarriage linked to infection

The CDC emphasized that these numbers may underrepresent the true scale of the crisis, citing the three- to four-week lab confirmation window and undiagnosed mild infections.

“Because many of these meals are pre-packaged and refrigerated, they may still be in consumers’ homes,” warned Dr. Jennifer McQuiston, deputy director of the CDC’s Division of Foodborne Diseases.

Why listeria infections are so dangerous

Listeria monocytogenes is a resilient bacterium capable of surviving in cold environments, making it a significant threat in refrigerated, ready-to-eat foods such as salads, deli meats, and pasta meals.

Common symptoms include:

• Fever and muscle aches
• Nausea or diarrhea
• Headache or stiff neck

Symptoms may appear hours to 10 weeks after consumption. For vulnerable groups — pregnant women, older adults, and immunocompromised individuals — listeriosis can result in meningitis, miscarriage, or death.

The CDC urges anyone who has eaten the recalled pasta meals and experiences these symptoms to seek medical care immediately.

Which products are being recalled?

The recall includes multiple brands and store-label pasta dishes manufactured by Nate’s Fine Foods and distributed by FreshRealm.

While some Trader Joe’s and Kroger meals were pulled from shelves “out of an abundance of caution,” not all were directly contaminated.

Consumers can find a complete list of recalled items, brand names, and product codes on the CDC Food Safety Alerts page and the FDA recall database.

What consumers should do:

• Do not eat any recalled pasta products.
• Return them to the store or dispose of them immediately.
• Clean and sanitize refrigerators, shelves, and utensils that may have come into contact with recalled products.

Because Listeria thrives in cold temperatures, it can linger in appliances and surfaces for weeks even after contaminated items are removed.

Federal response and next steps

Both the FDA and USDA-FSIS have ramped up testing across production and distribution points to trace contaminated batches through the supply chain. Local health departments are also assisting in identifying unreported cases.

“This outbreak is a sobering reminder of how complex foodborne illness investigations can be,” said Sandra Eskin, USDA Deputy Undersecretary for Food Safety. “Our immediate priority is ensuring every recalled product is off the shelves and out of homes.”

The agencies have pledged to strengthen inspection protocols and cross-agency data sharing to prevent similar lapses in food safety.

Why this outbreak matters

Foodborne illness outbreaks have historically led to major shifts in food regulation and corporate accountability. This incident highlights ongoing vulnerabilities in the ready-to-eat meal industry, where long supply chains and private-label manufacturing can delay detection.

How to stay safe from listeria

• Always check recall notices on official government sites before consuming pre-packaged or refrigerated meals.
• Avoid eating expired ready-to-eat products, especially if you are pregnant or immunocompromised.
• Keep refrigerators below 40°F (4°C) and clean them regularly with hot, soapy water or a bleach-based cleaner.
• Reheat leftovers to at least 165°F (74°C) before eating.

The bottom line

The Nate’s Fine Foods pasta recall underscores how easily contaminated ingredients can enter the national food system — and how long they can remain in homes undetected.

With six confirmed deaths and dozens hospitalized, federal agencies continue to track the outbreak’s spread. Health officials stress vigilance: when in doubt, throw it out.