Four deaths in 13-state Listeria monocytogenes outbreak

June 18, 2025

The US Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA) and the US Department of Agriculture’s Food Safety and Inspection Service (FSIS) are reporting today on a 13-state outbreak of Listeria monocytogenes infections linked to consumption of chicken fettuccine alfredo products manufactured under FSIS supervision by FreshRealm.

Four deaths have been recorded, including one fetal death resulting from a pregnancy-associated illness.

A total of 17 outbreak cases have been confirmed so far. Sixteen of the victims were hospitalized.

Illnesses have been reported from 13 states: Florida (1), Illinois (1), Indiana (1), Louisiana (2), Michigan (2), Minnesota (1), Missouri (1), Nevada (1), Norh Carolina (1), Ohio (1), Souh Carolina (1), Texas (3), and Virginia (1).

Outbreak victims range in age from 4 to 92 years, with half of the victims aged 79 or over. Of eleven people interviewed, seven reported eating pre-cooked meals and four of those specifically mentioned chicken fettuccine alfredo, purchased from the refrigerated section at Walmart and Kroger.

The outbreak, which has been under investigation by the FSIS and the FDA since April 2025, began in August 2024. The most recently reported illness was detected in May 2025.

FreshRealm has recalled the following products, manufactured in the company’s establishments in San Clemente, Calif., Montezuma, Ga., and Indianapolis, Ind.

MARKETSIDE GRILLED CHICKEN ALFREDO WITH FETTUCCINE Tender Pasta with Creamy Alfredo Sauce, White Meat Chicken and Shaved Parmesan Cheese (32.8-oz. tray packages; Best by 06/27/25 or prior)
MARKETSIDE GRILLED CHICKEN ALFREDO WITH FETTUCCINE Tender Pasta with Creamy Alfredo Sauce, White Meat Chicken, Broccoli and Shaved Parmesan Cheese (12.3 oz. tray packages; Best by 06/26/25 or prior)
HOME CHEF Heat & Eat Chicken Fettuccine Alfredo with pasta, grilled white meat chicken, and Parmesan cheese (12.5 oz. tray packages; Best by 06/19/25 or prior)

The recalled products were sold in Kroger and Walmart retail locations nationwide.

In March 2025, the FSIS recovered the outbreak strain of Listeria monocytogenes from a routine sample of chicken fettuccine alfredo collected at one of the FreshRealm establishments. The contaminated batch was held during sampling, destroyed, and never entered commerce, and subsequent investigations were unable to determine the source of the contamination.

Testing of FDA-regulated ingredients for the recalled products has been completed, and the outbreak strain was not found in any of those ingredient samples.

What consumers need to know (per CDC and FSIS)

Do not eat recalled chicken fettuccine alfredo meals from FreshRealm.
Clean your refrigerator, containers, and surfaces that may have touched the chicken fettuccine alfredo meals. Listeria can survive in the refrigerator and can easily spread to other foods and surfaces.
FSIS advises all consumers to safely prepare their meat products, including fresh and frozen, and to only consume premade meals like chicken fettuccine alfredo that has been cooked to a temperature of 165º F. The only way to confirm that premade meals are cooked to a temperature high enough to kill harmful bacteria is to use a food thermometer that measures internal temperature, https://www.fsis.usda.gov/safetempchart.

Listeria is especially harmful to pregnant women and people who are 65 or older or who have weakened immune systems. This is because Listeria is more likely to spread beyond their gut to other parts of their body, resulting in a severe condition known as invasive listeriosis.

Call a healthcare provider right away if you have these symptoms after eating the chicken fettuccine alfredo:
- Pregnant women: Fever, muscle aches, and tiredness. Your illness may be mild, but Listeria can cause pregnancy loss or premature birth. It can also cause serious illness or death in newborns.
- Other people may have: Headache, stiff neck, confusion, loss of balance, and convulsions, in addition to fever, muscle aches, and tiredness.
- For women who are pregnant, Listeria can cause pregnancy loss, premature birth, or a life-threatening infection in newborns.
- For people who are 65 years or older or who have a weakened immune system, Listeria often results in hospitalization and sometimes death.
Symptoms usually start within 2 weeks after eating food contaminated with Listeria but may start as early as the same day or as late as 10 weeks after.
- Pregnant women: Fever, muscle aches, and tiredness. Your illness may be mild, but Listeria can cause pregnancy loss or premature birth. It can also cause serious illness or death in newborns.
- Other people may have: Headache, stiff neck, confusion, loss of balance, and convulsions, in addition to fever, muscle aches, and tiredness.