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CDC Investigates Listeria Outbreak Linked To Queso Fresco, Cotija Cheese; 1 Death Reported In Texas

SAN ANTONIO – The Centers for Disease Control and Prevention is investigating a listeria outbreak linked to queso fresco, cotija cheese and other dairy products.

As of Tuesday morning, 26 people have been infected in seven states. Two deaths have been reported, including one in Texas and one in California. At least one other person in Texas was infected, but the true number of illnesses is likely higher than the number reported.

The CDC said the outbreak's source is unknown, but epidemiologic evidence leads to products from Rizo-López Foods.

On Monday, Rizo-López Foods recalled all cheeses and other dairy products made in their facility.

Products from Rizo-López Foods were distributed nationwide and sold at deli counters including El Super, Cardenas Market, Northgate Gonzalez, Superior Groceries, El Rancho, Vallarta, Food City, La Michoacana, and Numero Uno Markets.

The products include queso fresco, Cotija, Oaxaca, ricotta, sour cream and yogurt.

Some of the recalled cheeses from Rizo-López Foods. (CDC)

They were sold under the brand names Tio Francisco, Don Francisco, Rizo Bros, Rio Grande, Food City, El Huache, La Ordena, San Carlos, Campesino, Santa Maria, Dos Ranchitos, Casa Cardenas, and 365 Whole Foods Market.

Click here for a list of all recalled products.

CDC investigated this outbreak in 2017 and 2021 and reopened the investigation in January 2024 due to new reported illnesses. This outbreak includes cases dating back to 2014.

"There was not enough data to identify a source until this most recent investigation," a news release from the CDC states. "Interviews with sick people and recent Listeria findings in cheese and a production facility show that queso fresco and cotija made by Rizo-López Foods are making people in this outbreak sick."

People who have a recalled product in their refrigerator should throw it away or return it to the place of purchase. They should also clean their refrigerator, as listeria can survive in the refrigerator and spread to other foods and surfaces.

Symptoms include fever, muscle aches, and tiredness, a headache, stiff neck, confusion, loss of balance, or seizures.

Symptoms usually start within two weeks after eating contaminated food but may start as early as the same day or as late as 10 weeks after.

Listeria is especially harmful to people who are pregnant, aged 65 or older, or with weakened immune systems, according to the CDC.

Candida Auris: What To Know About The Fungal Infection Spreading Across The U.S.

Recent reports of outbreaks of the multidrug-resistant yeast Candida auris (C. Auris) are worrying health officials and experts across the U.S.

As of January 26, four patients in Washington with links to the same Seattle hospital tested positive for C. Auris in the state's first known outbreak. Nationally, cases are higher than they've ever been.

Adding to concern is the risk that this microscopic fungus poses to already-sick patients, along with its unusual staying power on surfaces, and surveillance that relies on known cases.

What Is C. Auris and How Does It Spread?

C. Auris is a highly transmissible yeast that can lead to infections, particularly in patients who already have serious medical conditions. Some infections may be mild, while blood infections are the most dangerous -- even deadly.

Those with invasive medical devices like breathing tubes, feeding tubes, or catheters may be at higher risk for infection with C. Auris, along with patients who have long stays in a hospital or care facility, as well as those who have been treated with antibiotics or antifungals in the past.

According to the CDC, "healthy people without these risk factors, including healthcare workers and family members, have a low risk for getting infected with C. Auris."

Anthony Harris, MD, MPH, an infectious diseases physician at the University of Maryland School of Medicine in Baltimore, told MedPage Today that "most resistant bacteria, including C. Auris, [occur] in people who have a lot of exposures to different types of healthcare facilities. It's people who've gotten a lot of antibiotics, and it's people who have comorbid conditions that predispose them," like immunosuppression.

However, the yeast can spread by attaching to the skin and other body sites, and can "colonize," meaning people may not become infected or ill but can still spread the disease through physical contact. It can also be spread through contact with contaminated surfaces or equipment.

How Widespread Is C. Auris?

The yeast was first detected in Japan in 2009, and wasn't identified in the U.S. Until 2016. Many of the early C. Auris cases were imported, but recent cases, including the first in Washington in July, have been locally transmitted.

Documented C. Auris cases have risen steadily in recent years, from 330 cases reported nationally in 2018 to 1,471 in 2021, which was a 95% jump from 2020. It has now been found in more than half of U.S. States. In the past 12 months, clinical cases reported by the CDC have been highest in and near some of the most populous states: Florida, New York, and California.

Tracking C. Auris can be a challenge for local health authorities, however, because it can be difficult to identify without specialized laboratory testing, and screening for C. Auris is not routinely conducted in many healthcare facilities, Harris said.

In an email, Meghan Lyman, MD, of the CDC's National Center for Emerging and Zoonotic Infectious Diseases, told MedPage Today that "all states do voluntarily report cases to the CDC. However, detection of colonization cases depends on screening practices, which [are] not uniform across the U.S."

Generally, screening for C. Auris is recommended when patients or healthcare workers shared space or came into contact with a known case, or if a patient with multidrug-resistant bacteria recently received medical care outside the U.S.

In the Washington cases, the hospital had recently put in place a "proactive screening program" that swabbed all patients upon admittance for testing by the state health department's public health lab, which led to the early identification.

Why Are Public Health Authorities Concerned About C. Auris?

In addition to its surveillance challenges, C. Auris is resistant to medicines normally used to treat other fungal infections. According to the CDC, a class of antifungals known as echinocandins can be used to treat the infection, but some C. Auris strains are resistant to all antifungals.

The yeast can colonize human skin effectively, often in the armpits and groin, but also in the nostrils, fingertips, and palms, which makes it efficient in spreading over high-touch areas and even via contaminated gloves. Though methods like bathing patients with chlorhexidine gluconate solution, or using healthcare-grade disinfectants for surfaces, are commonly used, they are not completely effective. According to the CDC, no specific intervention "is known to reduce or eliminate C. Auris colonization."

C. Auris can also linger on surfaces in healthcare facilities for long stretches of time -- on floors, bed rails, bed sheets, door handles, oxygen masks, and sinks. In dry environments, it can survive on plastic for multiple weeks, and according to one review, "devices in contact with skin may be particularly prone to contamination by C. Auris biofilms."

It can also be difficult to tell how much, or if, the fungal infection contributed to death in patients with ongoing medical problems and C. Auris.

The best way to prevent outbreaks, Harris said, is to use proper hand hygiene and contact precautions including gowns, gloves, and hospital-grade disinfectants. He also noted that funding programs like the CDC's Prevention Epicenters allows institutions to do the kind of research that can identify new antifungals and prevention strategies. "It just seems amazing that post-COVID pandemic, that instead of investing more money in the CDC, we're investing less," Harris said.

Lyman noted that the "CDC encourages being proactive instead of reactive, since it is better to identify C. Auris cases before there is spread."

"This may mean providing healthcare worker education, conducting screening, and assessing infection control compliance before a case is detected instead of waiting for a positive clinical specimen to prompt a response and finding that there has already been spread," she said.

Sophie Putka is an enterprise and investigative writer for MedPage Today. Her work has appeared in the Wall Street Journal, Discover, Business Insider, Inverse, Cannabis Wire, and more. She joined MedPage Today in August of 2021. Follow

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CDC Issues Food Safety Alert After Multi-state Outbreak Of Listeria Linked To Dairy Products

JACKSONVILLE, Fla. – Twenty-six people from 11 states, including two people in Florida and Georgia, have been infected with the outbreak strain of Listeria, according to the Centers for Disease Control and Prevention (CDC).

The outbreak is linked to a large recall of queso fresco, cotija cheese and other Rizo-Lopez Foods dairy products. Rico-Lopez Foods recalled all cheeses and dairy products on Monday.

The first initial cases were reported from 2014 through 2023.

Out of the 26 reported illnesses there have been two reported deaths.

Listeria is typically more prone to affect pregnant women, people aged 65 or older, or those with weakened immune systems. Experts say symptoms usually start within two weeks after eating food contaminated with Listeria but may start as early as the same day.

To help combat future Listeria outbreaks the CDC said to clean out refrigerators, containers and surfaces that may've been touched by the recalled dairy products.

For more information about Listeria, see the Listeria questions and answers page.

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