Outbreak of Listeria Infections Linked to Enoki Mushrooms

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Posted April 17, 2020 at 3:00 PM ET

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Listeria monocytogenes infections linked to enoki mushrooms.

Recall and Advice to Consumers, Retailers, Restaurants, and Food Service Operators
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At A Glance

Enoki mushrooms are white, with long stems and small caps.

Recall Information
Advice to Consumers, Retailers, Restaurants, and Food Service Operators
  • Do not eat, serve, or sell any recalled enoki mushrooms from H&C Food Inc., Guan’s Mushroom Co., or Sun Hong Foods, Inc.
    • Check your refrigerator for recalled enoki mushrooms. Return them to the purchase location or throw them away.
    • If you don’t know which company your enoki mushrooms are from, throw them away.
    • Do not eat any food made with recalled enoki mushrooms, even if some has already been eaten and no one became sick.
  • CDC advises that people who are more likely to get Listeria infections – pregnant women, adults age 65 or older, and people with weakened immune systems, such as people with cancer or on dialysis – avoid eating any enoki mushrooms from Korea (Republic of Korea), even if they are not part of the recalls, until we learn more about the source and distribution of the enoki mushrooms.
    • At home, check your refrigerator for any enoki mushrooms from Korea. If you have them or don’t know which country they are from, don’t eat them. Instead, throw them out and clean any surfaces and containers where they were stored.
    • When you buy, order, or eat out, check with stores and restaurants to make sure they do not use enoki mushrooms from Korea. If they don’t know where their enoki mushrooms are from, don’t buy or order the product.
  • Wash and sanitize any surfaces and containers that may have come in contact with the recalled enoki mushrooms. Listeria can survive in refrigerated temperatures and can easily spread to other foods and surfaces.
    • Follow these five steps to clean your refrigerator.
    • Wash surfaces with hot, soapy water.
    • Wash containers with hot, soapy water or in the dishwasher.
    • FDA recommends that food processors, restaurants, and retailers who received recalled enoki mushrooms use extra vigilance in cleaning and sanitizing any surfaces and containers that may have come in contact with these products, to reduce the risk of cross-contamination.
Latest Outbreak Information
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  • Since the last update on April 8, no additional illnesses have been reported.
  • Epidemiologic, traceback, and laboratory evidence indicates that enoki mushrooms labeled as “Product of Korea” are the likely source of this outbreak.
  • Green Co. LTD, a supplier of enoki mushrooms in the Republic of Korea, has been placed on two import alerts (Import Alert 99-23external icon and 99-35external icon).
  • Laboratory testing identified the outbreak strain of Listeria monocytogenes in a sample of enoki mushrooms from Guan’s Mushroom Co.
  • CDC will provide updates when more information is available.
Symptoms of Listeria Infection
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  • Listeriosis can cause different symptoms, depending on the person and the part of the body affected.
    • Pregnant women typically experience only fever and other flu-like symptoms, such as fatigue and muscle aches. However, infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.
    • People other than pregnant women: Symptoms can include headache, stiff neck, confusion, loss of balance, and convulsions in addition to fever and muscle aches.
  • Symptoms for invasive listeriosis usually start 1 to 4 weeks after eating food contaminated with Listeria. Some people have reported symptoms starting as late as 70 days after exposure or as early as on the same day of exposure.
Investigation Details

April 17, 2020

Since the last update on April 8, no additional illnesses have been reported.

As of April 17, 2020, 36 people infected with the outbreak strain of Listeria monocytogenes have been reported from 17 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.

Listeria was identified in ill people’s samples from November 23, 2016, to December 13, 2019. Ill people range in age from less than 1 to 97 years, with a median age of 67. Fifty-eight percent of ill people are female. Of 32 ill people with information available, 30 hospitalizations have been reported. Four deaths have been reported from California, Hawaii, and New Jersey. Six cases are pregnancy-associated and two resulted in fetal loss.

Investigation of the Outbreak

Epidemiologic, traceback, and laboratory evidence indicates that enoki mushrooms labeled as “Product of Korea” are the likely source of this outbreak.

State and local public health officials interviewed ill people about the foods they ate in the month before they became ill. Twelve out of 22 (55%) reported eating mushrooms, including enoki, portobello, white, button, cremini, wood ear, maitake, and oyster.

FDA collected samples of enoki mushrooms at import from Green Co. LTD of the Republic of Korea for testing. On April 6, testing results showed that two samples yielded the outbreak strain of Listeria monocytogenes. As a result, on April 7, Green Co. LTD was placed on Import Alert 99-23external icon and H&C Foods Inc. recalled enoki mushrooms supplied by Green Co. LTD. On April 13, FDA placed Green Co. LTD on Import Alert 99-35external icon.

On March 10, the California Department of Public Health collected enoki mushrooms for testing from grocery stores. Testing identified Listeria monocytogenes in one sample. These mushrooms are labeled as “Product of Korea” and were distributed by Guan’s Mushroom Co. On March 23, Guan’s Mushroom Co. recalled its enoki mushrooms. On April 13, whole genome sequencing results confirmed the outbreak strain of Listeria monocytogenes in these recalled enoki mushrooms.

On February 25, the Michigan Department of Agriculture and Rural Development collected mushrooms for testing from a grocery store where an ill person purchased enoki mushrooms. Two samples of enoki mushrooms yielded the outbreak strain of Listeria monocytogenes. These mushrooms are labeled as “Product of Korea” and were distributed by Sun Hong Foods, Inc. On March 9, Sun Hong Foods, Inc. recalled its enoki mushrooms.

Consumers, food service operators, and retailers should not eat, serve, or sell recalled enoki mushrooms.

On March 18, the Korean Ministry of Food and Drug Safety issued a press release about their investigation findings. They detected Listeria monocytogenes in enoki mushrooms produced by two firms in Korea.

CDC is concerned that enoki mushrooms from Korea (Republic of Korea) may be contaminated with Listeria monocytogenes. We are advising people who are more likely to develop a Listeria infection – pregnant women, adults age 65 or older, and people with weakened immune systems – to avoid eating any enoki mushrooms from Korea, until investigators determine the source of contamination and if additional products are linked to illness.

CDC will provide updates when more information is available.

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