Six fatalities and 25 hospitalizations have been linked to precooked pasta meals recalled due to a listeria outbreak, according to federal health agencies. The Food and Drug Administration (FDA) confirmed the outbreak was tied to multiple ready-to-eat pasta products.

The incident first came to light in June when concerns over listeria contamination prompted recalls of several brands of ready-to-eat chicken fettuccine Alfredo meals produced by FreshRealm Inc. These items were sold under the Home Chef brand at Kroger and the Marketside brand at Walmart. Further testing by FreshRealm detected listeria in samples, leading to additional recalls.

In mid-September, the FDA reported that genetic analysis confirmed the presence of the same listeria strain found in earlier recalled products. This led to further recalls of two more items: Marketside Linguine With Beef Meatballs & Marinara Sauce and Trader Joe’s Cajun Style Blackened Chicken Breast Fettuccine Alfredo. Both were distributed by Walmart and Trader Joe’s, respectively.

Nate’s Fine Foods, a supplier of precooked pasta and grains to the food service industry, expanded its recall in late September after testing revealed listeria contamination in linguine samples. The affected products included fettuccine, linguine, and farfalle (bowtie) pasta.

The Centers for Disease Control and Prevention (CDC) and FDA urged consumers to check their refrigerators and freezers for recalled items. Cases have been reported across 18 states, including California, Florida, Hawaii, Illinois, Indiana, Louisiana, Michigan, Minnesota, Missouri, North Carolina, Nevada, Ohio, Oregon, South Carolina, Texas, Utah, Virginia, and Washington.