(WASHINGTON) — The death of a 10-day-old Missouri infant from what early tests indicate was a bacterial infection has prompted Walmart to pull cans of infant formula from 3,000 of its stores nationwide.
The company pulled 12.5 ounce cans of Enfamil Premium Newborn formula, lot number ZP1K7G, after it learned that infant Avery Cornett had consumed the formula before he became sick. Preliminary tests show he developed a rare infection from Cronobacter sakazakii, a bacteria that has previously been found in powdered infant formula.
“This is not a formal government recall. We just did this out of an abundance of caution, and we’re currently holding the product until the investigation is complete. The product could possibly be returned to shelves at a later date,” a Walmart spokesperson told ABC News Radio.
Customers who purchased the formula should discard it or return it to the store.
The Missouri Department of Health and Senior Services said in a statement samples of the formula were sent to the Centers of Disease Control and Prevention and the Food and Drug Administration for testing.
The FDA said so far, they “don’t have anything that indicates this is linked to Enfamil.” However, the agency is testing samples from the open packet of formula fed to the infant, an unopened packet of the formula and the water used to mix the formula. They expect results by the middle of next week.
Avery is the second infant to develop a Cronobacter sakazakii-related infection in a Missouri hospital in the past month, the department said on its web site. The second infant recovered.
A spokesman for Mead Johnson Nutrition, the manufacturer of Enfamil formulas, said the company routinely tests its formula for Cronobacter.
The spokesman also said officials investigating the infant’s death would also be testing other sources to determine where the bacteria came from, including the water used to prepare the formula.
Cronobacter sakazakii, once known as Enterobacter sakazakii, is a bacteria found in powdered infant formula as well as in plant material and the environment, according to the CDC.
The World Health Organization says there have been about 120 documented cases of Cronobacter sakazakii infection worldwide. In 50 to 80 percent of cases, powdered infant formula is the source of Cronobacter illness. There have been several outbreaks of disease in neonatal intensive care units around the world.
Newborns are at highest risk for serious illness from the bacteria, which can cause meningitis and bloodstream infections. The fatality rate in infants is very high.
“It’s introduced somehow during the manufacturing process, but they haven’t quite figured out how that happens,” said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University Medical Center. “Infant formula has all kinds of nutrients, so it’s a particularly appropriate environment for these bugs to grow [in].”
According to WHO, the bacteria could be introduced in three ways: through the raw ingredients before production, through contamination after pasteurization and through contamination during preparation of the formula by caregivers.
Referring to published case studies, Schaffner said many of the infants became ill because the formula wasn’t prepared properly. Powdered infant formula is not sterile and must be handled carefully to avoid contamination.
“Caregivers sometimes haven’t followed the instructions very meticulously,” he said.
He said in order to minimize the risk of infection, caregivers should take careful precautions.
“Sterilize bottles, spoons and nipples in boiling water. Infant formula should be freely prepared for each feeding, and remaining milk should be discarded. Water should be boiled and allowed to cool before preparing the formula,” Schaffner explained.
In addition to meningitis and bloodstream infections, Cronobacter sakazakii can cause necrotizing enterocolitis, a condition in which the intestinal lining dies off.
Symptoms of necrotizing enterocolitis include bloody stool, diarrhea, vomiting, lethargy and intolerance to feeding.
Symptoms of meningitis in infants include high fever, neck and body stiffness, constant crying and seizures.
Copyright 2011 ABC News Radio
Jen Christensen, CNN
Michael H. O'Donnell, Idaho State Journal