Four people have recently died after eating prepackaged caramel apples contaminated with the bacterium listeria, health officials said. While at least 28 people in 10 states have fallen sick, 26 of them have been hospitalized.  

The listeria-tainted caramel apples outbreak affected four adults, between the ages of 59 and 90, in Minnesota during the period of late October and November, Minnesota Department of Health spokesman Doug Schultz said on Friday. The victims became ill after consuming caramel apples contaminated with the bacteria, Food Safety News reported.

"Anytime we have two cases or more that match by pathogen and by time and space, that to us indicates there may be an outbreak," Schultz said.

Supervalu Inc's Cub Foods, Kwik Trip, and Mike's Discount Foods were identified as the stores which carried Carnival brand and Kitchen Cravings brand apples, Reuters reported. The four victims had reportedly purchased caramel apples from those stores before falling sick, health officials said, adding that these two brands are no longer available for purchase at retail locations.

Consumers, who may have purchased any pre-packaged, commercially-produced caramel apples from those two brands, have been warned by the Minnesota Departments of Health and Agriculture to wait for more available information before deciding to eat them, which include caramel apples topped with nuts, chocolate and sprinkles.

On Thursday, Minnesota officials said that they were working with the Centers for Disease Control and Prevention and the Food and Drug Administration to determine the scope of products impacted on a multi-state listeriosis outbreak, according to the department's press release.

So far, the 10 states with Listeria cases are: Arizona, California, Minnesota, Missouri, New Mexico, North Carolina, Texas, Utah, Washington and Wisconsin.  

Texas health officials said four people have contracted a food poisoning linked to prepackaged caramel apples, according to The Associated Press

Listeriosis, a serious infection caused by eating food contaminated with listeria, is known to primarily affect older adults, pregnant women, newborns and adults with weakened immune systems, according to CDC. Symptoms include fever, muscle aches, headache, confusion and convulsions.

Meanwhile, CDC officials were not immediately available for comment on Friday.