How can parents help prevent Cronobacter infections now and in the future?
Do not use the recalled powdered infant formula.
The CDC has warned that powdered formulas are not sterile. Prepare and store powdered infant formula safely. Make sure your formula is not expired or recalled and that the container is in good condition. Keep powdered formula lids and spoons clean and close formula containers as soon as possible. Prepare the formula with hot water (at least 158°F/70°C) to protect against Cronobacter.
Breast-feed. Very few cases of Cronobacter infections have been reported in infants fed only breast milk. However, you must clean, sanitize, and store feeding items, pump parts, and bottles safely.
Consider using a liquid formula when possible. If your baby is getting formula, consider using formula that is sold in liquid form rather than powdered form. This is especially important when your baby is less than 3 months old or was born prematurely or has a weakened immune system. Liquid infant formulas are designed to be sterile (germ-free) and should not transmit Cronobacter infection when handled with care.
Keep hands clean. Always wash your hands thoroughly with soap and water at key times:
- Before preparing and giving bottles or foods to your baby.
- Before touching your baby’s mouth.
- Before touching pacifiers or other objects that go into your baby’s mouth.
- After going to the bathroom or changing diapers.
What is Cronobacter?
The CDC reports that Cronobacter infections are rare, but can be fatal in newborns. Infections in infants usually occur during the first days or weeks of life. About two to four cases are reported to the CDC each year, but this figure may not reflect the true number of illnesses because most hospitals and laboratories are not required to report Cronobacter infections to health departments.
Cronobacter germs can cause a dangerous blood infection (sepsis) or cause the walls around the brain and spinal cord to swell (meningitis). Infants 2 months and younger are most likely to develop meningitis if they get sick from Cronobacter. Other infants more likely to get sick are those born prematurely and those who are less able to fight off germs and illness due to illness or medical treatment, such as infants receiving chemotherapy for cancer.
The first symptom of Cronobacter infection in infants is usually a fever, accompanied by poor feeding, crying, or very low energy. You should take a child with these symptoms to the doctor.
The epidemic to date.
The CDC and FDA report that from September 16, 2021 through January 5, 2022, the CDC received reports of three cases of Cronobacter in infants that were later found to be linked to the FDA’s ongoing investigation. Since then, the CDC has identified one additional case of Cronobacter infection in an infant who consumed formula produced at this facility.
- Four infants with Cronobacter infections in Minnesota (1), Ohio (2) and Texas (1) consumed formula produced at the Sturgis, Michigan facility before falling ill.
- Cronobacter infections may have contributed to the deaths of two infants in Ohio.
Previously, the FDA and CDC identified Salmonella Newport illness in an infant likely linked to the same infant formula. This link has been removed.
What was recalled.
According to the FDA. On February 28, 2022, Abbott Nutrition recalled Similac PM 60/40 Powder Formula (Lot # 27032K80 (box) / Lot # 27032K800 (box). Similac PM 60/40 recall joins other batches of Similac, Alimentum and EleCare Powder Formulas that were recalled on February 17, 2022 for possible Cronobacter contamination.
Similac, Alimentum or EleCare powdered formula recalled on February 17 bear the following three statements:
- The first two digits range from 22 to 37, AND
- The code on the container contains “K8”, “SH” or “Z2”, AND
- Expiry date is 4-1-2022 (April 2022) or later
The recall affects Alimentum, EleCare and Human Milk Fortifier for markets outside of the United States. No other Abbott Nutrition products distributed outside of the United States are affected by this recall. According to the company, the recalled products were distributed in the following countries/locations: Australia, Bahrain, Barbados, Bermuda, Canada, Chile, China, Colombia, Costa Rica, Dominican Republic, Ecuador, Egypt, Guam, Guatemala, Hong Kong , India, Indonesia, Israel, Jordan, Kuwait, Lebanon, Malaysia, Mexico, New Zealand, Oman, Peru, Puerto Rico, Qatar, Saudi Arabia, Singapore, South Africa, Sudan, Taiwan, Thailand, United Arab Emirates, Kingdom United and Vietnam ANI South.
Full List of Recalled Brands
Examples of medical and specialty products
 Minnesota is the only state that requires Cronobacter cases to be reported. This lack of nationwide reporting may be a cause of the seemingly slow public health response to this tragic outbreak.