The FDA recalled certain apple puree and applesauce products from three brands of fruit pouches: WanaBana apple cinnamon fruit puree pouches, Schnucks brand cinnamon-flavored applesauce pouches and variety pack, Weis brand cinnamon applesauce pouches.
CNN  — 

The US Food and Drug Administration is urging consumers to continue to avoid recalled applesauce pouches amid an ongoing investigation and a growing number of illnesses linked to lead in cinnamon.

There have been at least 57 reports of illnesses linked to apple cinnamon fruit puree pouches sold under the WanaBana, Weis and Schnucks brands, the FDA said Thursday, with cases now identified in more than half of states.

The FDA cautioned that recalled products are still on the shelves of several Dollar Tree stores in multiple states. The pouches were also sold at retailers including Amazon, Sam’s Club, and Schnucks and Weis stores.

“Lead is toxic to humans & affects people of any age or health status. Protecting children from lead exposure is particularly important since kids are more susceptible to lead toxicity,” the agency wrote in a social media post Friday. “These products have a long shelf life. Consumers check your pantry & throw away these products!”

The FDA, the US Centers for Disease Control and Prevention and state and local partners have been investigating reports of high blood lead levels in children who consumed the pouches. In one product sample of a WanaBana Apple Cinnamon Puree from Dollar Tree, the level detected was 2.18 parts per million, the agency said — more than 200 times greater than the action level FDA had proposed in previous draft guidance for products intended for babies and young children.

“FDA’s leading hypothesis is that cinnamon used in these recalled pouches is the likely source of contamination for these products,” the agency said in an update this month.

A distribution company in Ecuador, Negasmart, has been identified as the supplier of the cinnamon that is believed to the source of the elevated lead levels in the recalled products, the FDA said this week in its latest update on the investigation. The findings are based on a “root cause investigation” conducted by the product manufacturer.

However, “there is no method to link lead exposure to a specific source, which can make establishing a causal relationship complicated,” the agency said.

The FDA has confirmed that Negasmart does not import cinnamon directly into the US and does not have reason to believe that the issue extends beyond the products that have already been recalled, the agency said, but the company is working with local authorities in the ongoing investigation.

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Lead is toxic to humans, and there is no safe level. Exposure is not typically apparent right away, but it can cause developmental delays in children. Initial symptoms of lead poisoning may include head, stomach and muscle aches, vomiting, anemia, irritability, fatigue and weight loss.

The FDA has recommended that anyone who may have consumed the recalled products get their blood tested for lead.

Austrofood and Wanabana USA, the manufacturers of the recalled applesauce pouches, are in the process of establishing a program to reimburse some of those health care costs, according to a statement Thursday. The companies are also working on a website to facilitate refunds for the recalled products.

CNN’s Jamie Gumbrecht and Jen Christensen contributed to this report.