At least seven children across five states have suffered acute lead poisoning linked to at least three brands of apple cinnamon fruit puree pouches marketed to children and sold nationwide, the Food and Drug Administration announced in an updated safety alert Friday.
The brands include WanaBana apple cinnamon fruit puree pouches, Schnucks brand cinnamon-flavored applesauce pouches, and Weis brand cinnamon applesauce pouches. All three have been recalled. Consumers should not buy, sell, serve, or eat any of these products. Any pouches that have already been purchased should be thrown away. Parents or guardians of any children who may have eaten the purees should talk with health care providers about blood lead tests.
In an October 28 alert, the FDA said it was working with authorities in the state of North Carolina who had identified four children with elevated blood lead levels in the western part of the state. North Carolina considers a child to have elevated blood lead levels if they have two consecutive blood lead test results greater than or equal to 5 micrograms per deciliter (µg/dl)—at which point the child becomes eligible for an investigation into the lead source. The Centers for Disease Control and Prevention meanwhile has a threshold of 3.5 µg/dl to consider a blood lead level high, which corresponds to the 97.5th percentile of blood levels in a survey of US children.
North Carolina officials investigating the four cases in the western part of the state identified the WanaBana apple cinnamon pouches as a potential source. The North Carolina Department of Health and Human Services (NCDHHS) then tested "multiple lots" of the pouches, and the testing revealed "extremely high concentrations of lead." The FDA reviewed the results and concluded with the NCDHHS that "this level could result in acute toxicity."
The FDA noted that such acute toxicity might manifest as headache, abdominal pain or colic, vomiting, and anemia. Long-term exposures can lead to irritability, lethargy, fatigue, muscle aches or muscle prickling/burning, occasional abdominal discomfort, constipation, difficulty concentrating, muscular exhaustibility, tremor, or weight loss. Lead is a potent neurotoxic metal that is particularly dangerous to children. Even low-dose exposures are linked to developmental delays, difficulty learning, and behavioral issues, the CDC notes.
On November 3, the FDA identified two additional contaminated puree products, Schnucks and Weis, and reported additional cases.
According to complaints received by the FDA's reporting system, there are at least seven cases in five states: Arizona (1), Louisiana (1), Maryland (1), Missouri (1), North Carolina (2), and a remaining case in an unidentified state. The FDA reported that it has received additional reports of illnesses and is evaluating them.
Recalled WanaBana pouches were sold nationwide and were available through online retailers, including Amazon and Dollar Tree. The other recalled brands were found at select grocery stores.
The FDA said it is working to identify additional cases and other products that may also be contaminated, and to understand the source of the lead. In its recall notice, Schnucks reported its supplier, Purcell International, notified it of "elevated levels of lead found in the cinnamon raw material used by Austrofood SAS, the manufacturer of the applesauce cinnamon pouches."