back as march 2013. the outbreak led to 3 deaths in kansas. blue bell was the nation's third most popular ice cream brand. the items came from the company's production facility in broken arrow, oklahoma . the cdc stated that all five of the sickened individuals, including the three older people who died, were receiving treatment at the same kansas hospital before developing the listeriosis, suggesting their infections with the listeria bacteria were nosocomial (acquired, while eating the products, in the hospital). their pre-existing weakened conditions might help to explain the higher mortality rate in these cases (60%, versus the more normal 20–30%). on april 20, 2015, blue bell issued a voluntary recall of all its products, citing further internal testing that found listeria monocytogenes in an additional half gallon of ice cream from the brenham facility. 2015–18 european listeriosis outbreak on 5 july 2018 the manchester evening news reported that at least four major supermarket retailers had issued major product recalls as a result of a large supplier confirming possible contamination of frozen vegetables sourced from hungary. the supplier, greenyard frozen uk, reported to the uk's food standards agency that the factory in which the food was processed had been shut down by the hungarian food chain safety office, after which the european food safety authority and the european centre for disease prevention and control issued updates stating that at least five eu member states (uk, austria, denmark, finland and sweden) were affected. between june 2015 and july 2018, 9 people had reportedly died as a result of listeriosis, of a total of 47 confirmed cases. in an update on the efsa website, it was stated that the contamination had supposedly been present since at least 2015, and as a result the hungarian food chain safety office had prohibited the marketing of all affected frozen vegetables and frozen vegetable packs produced by the plant in baja between august 2016 and june 2018. this followed a previous study that found the majority of l. monocytogenes isolates had been found in a 2017 sample of various frozen vegetables, with a minority found in a 2016 sample and a small number found in a 2018 sample. the study suggested that the strain identified (l. monocytogenes serogroup ivb, multi-locus sequence type 6 (st6)) was likely persisting through standard cleaning operations and disinfection procedures, and that since common production lines were in operation, cross-contamination was an additional concern. 2017–18 south african listeriosis outbreak main article: 2017–18 south african listeriosis outbreak in early december 2017 an outbreak of listeriosis was reported by the south african department of health. as of 4 march 2018, with 967 people infected and 180 deaths, this was the largest listeriosis outbreak in history. the source was traced to processed meat products produced at a tiger brands enterprise plant in polokwane. 2018 australia listeriosis outbreaks main article: 2018 australian rockmelon listeriosis outbreak on 2 march 2018 the new south wales food authority confirmed that investigations into a listeriosis outbreak in rockmelons (cantaloupes) began in january. the cantaloupes had infected people from victoria, queensland, new south wales and tasmania, after being grown on a farm in the riverina region of nsw. as of 2 march 2018, 13 of 15 cases had been confirmed as originating from listeria infected cantaloupes, and of the 15 people infected, 3 had died. later victims included a fourth person on 7 march and a victorian man in his 80s on 16 march. a miscarriage was also linked to listeriosis. seventeen cases had been confirmed as of 7 march. in july 2018, a number of countries, including australia, issued recalls of frozen vegetables due to listeria. 2019 spain listeriosis outbreak in august 2019, an outbreak was declared in several provinces in andalusia, southern spain, as a result of consumption of a contaminated batch of processed-meat products. as of 19 august 2019, 80 people had been diagnosed and 56 were hospitalized (43 of them in the province of seville), as of 20 august, 114 people were diagnosed, and 18 pregnant woman in hospital, and the first confirmed death (a 90-year-old woman); although the total figure of hospitalised reduced to 53. in addition, eight miscarriages have been related to the outbreak. spanish minister of health maría luisa carcedo declared that the outbreak had expanded out of the andalusian autonomous community, with one confirmed case in extremadura and five suspected cases in extremadura and madrid. the minister specified that, although new cases could appear as a consequence of the long incubation period, the contaminated product had been withdrawn. as of 21 august 2019, 132 people were diagnosed and 23 pregnant woman in hospital. on 22 august an international alert was declared. 2022 united states listeriosis outbreak on november 9, 2022 the cdc announced that listeria in deli meats and cheeses had been linked to at least 16 cases of listeriosis, including 13 hospitalizations and 1 death. cases were known from maryland, new york, illinois, massachusetts, new jersey and california.