Safety as important as ever following formula recalls
On Feb. 17, Abbott, a manufacturer of infant formula, initiated a recall of Similac, Alimentum and EleCare infant formulas manufactured in their Sturgis, Mich., facility, due to likely contamination with the bacteria Cronobacter sakazakii, or Salmonella Newport. According to the Centers for Disease Control and Prevention, from Sept. 16, 2021, to Jan. 5, 2022, the agency received three reports of Cronobacter cases in infants that were later linked to the U.S. Food and Drug Administration’s ongoing investigation of such cases from formula manufactured at the Michigan facility.
As of Feb. 28, a total of four infants became ill and were hospitalized after consuming Similac Sensitive, Similac Pro-total Comfort, Similac Advance, and Similac PM 60/40 infant formulas. All four patients were hospitalized and it is believed that Cronobacter infection may have contributed to two infant deaths in Ohio. The CDC has received additional reports of Cronobacter illnesses in infants and is currently investigating any possible linkages to the recalled formula products. Additionally, the FDA received one complaint of a Salmonella Newport infection in an infant who consumed the recalled formula.The investigation into possible Salmonella contamination of the formula is ongoing.
Cronobacter is found in the environment and can contaminate dried foods such as infant formula, dried teas, milk powders and starches. Cronobacter infections in infants often result in sepsis or severe meningitis, with a mortality rate around 40%. Additionally, infection in infants can result in seizures, brain abscesses, fluid in the brain and other serious complications that can result in long-term neurological problems. Although Cronobacter infections are thought to be rare, a national FoodNet survey in 2002 estimated annual invasive Cronobacter infections at 1-8.7 infections per 100,000 infants aged less than 1 year. Moreover, data suggests that infections in adults are much more common but cause less severe illness.
Salmonella has generally been associated with birds and reptiles, but can often contaminate food products including dried milk powders and infant formula. Salmonella contamination of infant formula has been linked to multiple outbreaks worldwide. Children younger than 5 are extremely susceptible to Salmonella infection, and are at risk of severe disease due to their underdeveloped immune system. Severe disease can result in sepsis, meningitis, bone infections and reactive arthritis, which can last for months or years, and be difficult to treat. Moreover, Salmonella is becoming a leading public health threat because 16% of Salmonella strains are resistant to at least one essential antibiotic used to treat severe infection, while 2% of strains are resistant to three or more essential antibiotics.
Similac, Alimentum, or EleCare powdered infant formulas included in the recall should not be consumed. A list of recalled products can be found on the FDA’s website at bit.ly/3HFHWnS. Often, recalls can be expanded so you should refer back to the FDA’s website regularly for updates. The FDA recommends contacting your child’s healthcare provider for infant formula recommendations if the regularly used formula is not available. Infant formula should never be purchased through online sources as there is an increased risk of receiving counterfeit products which may be dangerous. If you receive infant formula through WIC you should return the formula to the store for a refund or exchange.
It is important to remember that infant formulas are not sterile, thus proper handling of formula is important to help prevent outgrowth of bacteria. Always wash your hands with soap and warm water for 20 seconds prior to handling formula. Both the bottles and workspaces should be cleaned and sanitized prior to mixing formula. Always use water from a safe source for mixing formula. Always follow the label instructions for mixing formula as diluting the formula may result in severe nutritional deficiencies. Prepared infant formula needs to be used within two hours of preparation or one hour from when feeding begins. If prepared formula is not going to be used immediately, it may be stored in the refrigerator for up to 24 hours. Any formula left in a bottle after feeding needs to be discarded.
For more information on the recall, visit the FDA’s website at bit.ly/3tj7RfP or the CDC’s website at bit.ly/3tsq5f4. For more information on safe preparation and handling of infant formula, visit bit.ly/3Htfzc9.
Smith is an assistant professor and statewide consumer food specialist for Washington State University. She can be reached at food.safety@wsu.edu. If you have a food safety question you would like to see in this column, send your question to us at food.safety@wsu.edu.
