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Public health authorities are urging people to throw away certain pre-cooked pasta meals sold at two popular retailers over concerns that they could be contaminated with listeria and connected to a worsening nationwide outbreak.

 late last week about two products with specific use-by dates in late September and early October: Marketside Linguine with Beef Meatballs & Marinara Sauce sold at Walmart, and Trader Joe's Cajun-style Blackened Chicken Breast Fettuccine Alfredo.

The USDA says the pasta in those products may be contaminated with 

 — and appear to be genetically related to a deadly listeria outbreak that has already spread to 15 states: California, Florida, Illinois, Indiana, Louisiana, Michigan, Minnesota, Montana, North Carolina, Nevada, Ohio, South Carolina, Texas, Utah and Virginia.

That outbreak made headlines in June, when listeria concerns prompted recalls of several brands of ready-to-eat 

 — made by FreshRealm, Inc. and sold at Kroger and Walmart — and triggered an investigation.

 FreshRealm began testing the ingredients it uses to make its Marketside-brand meatball linguine dish. Last week, its pasta samples came back positive for listeria.

Further genetic testing confirmed it was the same strain of listeria that was detected in FreshRealm's previously recalled chicken Alfredo meals, the Food and Drug Administration (FDA) said on Monday.

"It is also the same strain of Listeria that is linked to causing illnesses in this outbreak," 

The outbreak has killed four people and sickened at least 20, all but one of whom required hospitalization, according to the 

Centers for Disease Control and Prevention

 (CDC). It also sickened a pregnant mother, resulting in a fetal loss.

The CDC says it has interviewed 13 of those people, seven of whom reported eating precooked meals before they got sick. Four specifically mentioned eating chicken fettuccine Alfredo.

 have been reported since June, according to the CDC. But it says that's likely an undercount, since some people recover from the infection without medical care. For those who do require medical attention, it usually takes three to four weeks to determine if their illness is part of an outbreak.

Listeria infection, or listeriosis, is most likely to sicken pregnant people and newborns, adults over 65 and people with weakened immune systems.

Symptoms — which include fever, muscle aches, gastrointestinal issues, stiff neck, confusion and loss of balance — usually start within two weeks of eating contaminated food, but could start as soon as the same day or as late as 10 weeks later, the CDC says.

The CDC and FDA are urging customers who purchased these meals to throw them away, clean their refrigerators, containers and surfaces that may have come into contact with them and contact their health care provider to report any symptoms of listeriosis.

These may not be the only products affected 

At this point, the two pasta products listed on the latest health alert — plus the chicken Alfredo dishes recalled in June — are more likely to be in customers' fridges and freezers than on store shelves.

The chicken pasta meals sold at Trader Joe's, for example, have use-by dates of Sept. 20, Sept. 24 and Sept. 27 on their front labels.

 they were only for sale in its stores in Arizona, California, Nevada, New Mexico and Utah, and that all other versions of that dish sold in other states and with other sell-by dates are unaffected.

Trader Joe's says there have been no positive listeria tests for this particular dish, nor have there been reports of illness associated with those specific production codes.

But it says it issued its guidance — will refund those who purchased the product — out of 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."

Walmart similarly says there have been no reported illness complaints for the Marketside beef meatball and linguine dish. The impacted products, which have use-by dates that all fall between Sept. 22 and Oct. 1, have been removed from its shelves.

"We have removed these products from our impacted stores and we are working with the supplier to investigate," Walmart spokesperson Annie Patterson told NPR over email.

FreshRealm did not respond to NPR's request for comment in time for publication. But it told The 

 in a statement that it has "long maintained that the source of the listeria was likely an ingredient supplied by a third party."

The USDA identified the pasta supplier as 

, which supplies precooked pasta and grains to wholesale food service and the restaurant industry, according to its website. The USDA adds that it does not sell the affected products directly to retail.

"The firm is working with the FDA and their customers to determine if additional recalls are needed," it says, adding that consumers should 

The U.S. has seen its share of listeria outbreaks in the past year, including a 2024 outbreak tied to deli meat that left 10 people dead and dozens more hospitalized across the country. A January USDA report blamed "

" at a since-closed Boar's Head facility in Virginia and listed 

 the agency would take to better protect the public from listeria.

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Rachel Treisman

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The USDA says the precooked pasta products, sold at Trader Joe's and Walmart, could be connected to a nationwide listeria outbreak that has killed four people and sickened at least 20 others.

Pasta meals from Trader Joe's and Walmart may be linked to a deadly listeria outbreak

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