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Blue Bell Ice Cream has suspended operations at its Oklahoma plant after health officials linked the deaths of three people to contaminated ice cream.

“We are taking this step out of an abundance of caution to ensure that we are doing everything possible to provide our consumers with safe products and to preserve the trust we have built with them and their families for more than a century,” the company said in a statement on April 3.

Last month, Blue Bell and health officials said a 3-ounce cup of ice cream contaminated with listeriosis was traced to a plant in Broken Arrow, Oklahoma. The now-recalled ice cream product — cups of chocolate, strawberry and vanilla — is not sold in retail locations and is shipped in bulk to “institutional accounts” such as hospitals in 23 states that comprise less than 5% of the company’s sales.

“We recommend that consumers do not eat any Blue Bell brand products made at the company’s Oklahoma facility and that retailers and institutions do not sell or serve them,” the U.S. Centers for Disease Control and Prevention (CDC) said on April 3.Blue Bell Ice Cream Listeria

Ten products recalled earlier in March were from a production line at a plant in Brenham, Texas, the company’s headquarters.

The recall, the first in Blue Bell’s 108-year history, began when five patients at Via Christi St. Francis hospital in Wichita, Kansas, became ill with listeriosis while hospitalized at some point from December 2013 to January 2015. Officials determined at least four drank milkshakes that contained Blue Bell ice cream. Three of the patients later died.

Listeriosis is a life-threatening infection caused by eating food contaminated with bacteria called Listeria monocytogenes, according to the CDC. The disease primarily affects pregnant women, newborns, older adults and people with weakened immune systems.

The CDC also said on April 3 that it has identified six patients with listeriosis between 2010 and 2014 that was indistinguishable from that found in the 3-ounce cup ice cream product traced to the Oklahoma plant.

Four of the six patients were hospitalized in Texas for unrelated problems before developing listeriosis, according to the CDC.

The one patient for whom information is available reported eating ice cream in a Texas hospital before developing listeriosis and the Texas Department of State Health Services reported the hospital had received Blue Bell brand ice cream cups, the CDC said.

The “investigation to determine whether these illnesses are related to exposure to Blue Bell products is ongoing,” the CDC said.

Blue Bell said it will conduct a “careful and complete examination” of its Oklahoma plant “to determine the exact cause of the contamination.”

“Once our investigation is complete and we have made all necessary improvements, it will return to operation,” according to Blue Bell’s statement.

“Our other plants continue to operate and supply our products to retail stores and institutional customers.”

The FDA has been notified of Blue Bell’s decision to voluntarily shut down the plant, the company said.

In addition to the Broken Arrow plant, Blue Bell has two plants in Brenham and one in Sylacauga, Alabama.

The recalled ice cream had been shipped to Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Virginia and Wyoming.

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Some of Blue Bell ice creams have been recalled after three people died in Kansas from a foodborne illness linked to the Texas icon’s product.

This is Blue Bell’s first product recall in its 108-year history.

Five people, in all, developed listeriosis in Kansas after eating products from one production line at the Blue Bell creamery in Brenham, Texas, according to a statement on March 13 from the FDA.

The FDA says listeria bacteria were found in samples of Blue Bell Chocolate Chip Country Cookies, Great Divide Bars, Sour Pop Green Apple Bars, Cotton Candy Bars, Scoops, Vanilla Stick Slices, Almond Bars and No Sugar Added Moo Bars.

Blue Bell says its regular Moo Bars were untainted, as were its half gallons, quarts, pints, cups, three-gallon ice cream and take-home frozen snack novelties.

According to a statement from the CDC on march 13, all five of the people sickened were receiving treatment for unrelated health issues at the same Kansas hospital before developing listeriosis, “a finding that strongly suggests their infections (with listeria bacteria) were acquired in the hospital,” the CDC said.Blue Bell ice cream listeria 2015

Of those five, information was available from four on what foods they had eaten in the month before the infection. All four had consumed milkshakes made with a single-serving Blue Bell ice cream product called “Scoops” while in the hospital, the CDC said.

“Scoops,” as well as the other suspect Blue Bell items, are mostly food service items and not produced for retail, said Paul Kruse, CEO of the Brenham creamery.

The CDC said the listeria isolated from specimens taken from four of the five patients at Via Christi St. Francis hospital in Wichita, Kansas, matched strains from Blue Bell products obtained this year in South Carolina and Texas.

The five patients became ill with listeriosis during their hospitalizations for unrelated causes between December 2013 and January 2015, said hospital spokeswoman Maria Loving.

“Via Christi was not aware of any listeria contamination in the Blue Bell Creameries ice cream products and immediately removed all Blue Bell Creameries products from all Via Christi locations once the potential contamination was discovered,” Maria Loving said in a statement Friday to The Associated Press.

Via Christi has eight hospitals in Kansas and Oklahoma.

Blue Bell handles all of its own distribution and customer service, Paul Kruse said, so it moved to pull suspect products from shelves, as soon as it was alerted to the South Carolina contamination February 13. Paul Kruse did not suspect handling of those products after they left the Central Texas creamery.

“The only time it can be contaminated is at the time of production,” he said. That contamination has been traced to a machine that extrudes the ice cream into forms and onto cookies, and that machine remains off line, he said.

All products now on store and institution shelves are safe, Paul Kruse said.

“Contaminated ice cream products may still be in the freezers of consumers, institutions, and retailers, given that these products can have a shelf life of up to 2 years,” the CDC statement said. CDC recommends that consumers do not eat products that Blue Bell Creameries removed from the market, and institutions and retailers should not serve or sell them.

Listeriosis is a life-threatening infection caused by eating food contaminated with bacteria called Listeria monocytogenes, the CDC said. The disease primarily affects pregnant women and their newborns, older adults, and people with immune systems weakened by cancer, cancer treatments, or other serious conditions.

A person with listeriosis usually has fever and muscle aches, sometimes preceded by diarrhea or other gastrointestinal symptoms. Almost everyone who is diagnosed with listeriosis has invasive infection, meaning the bacteria spread from their intestines to the blood, causing bloodstream infection, or to the central nervous system, causing meningitis. Although people can sometimes develop listeriosis up to two months after eating contaminated food, symptoms usually start within several days. Listeriosis is treated with antibiotics, the CDC said.