Blue Bell Creameries, which distributes frozen desserts to about half of the United States, said that it was voluntarily recalling all of its products after the bacteria listeria was found in two cartons of ice cream.
The United States Centers for Disease Control and Prevention said on Monday that tests indicated Blue Bell products from plants in Texas and Oklahoma were the source of a listeria outbreak that has infected five adults in Kansas, three of whom died, and has sickened another three adults in Texas.
“This is a complex and ongoing, multistate outbreak of listeriosis occurring over an extended period of several years,†the C.D.C. said.
Paul Kruse, Blue Bell’s chief executive and president, apologized in a videotaped message posted on the company’s website.
“We’re committed to doing the 100 percent right thing, and the best way to do that is to take all of our products off the market until we can be confident that they are all safe,†Mr. Kruse said in a news release.
Listeria bacteria, which can be present in raw milk, can cause severe infections in children, the elderly, pregnant women and others with weakened immune systems.
Blue Bell, which is based in Texas, said the recall was triggered after two half-gallon containers of chocolate-chip cookie-dough ice cream, produced on March 17 and March 27, tested positive for the bacteria Listeria monocytogenes.
Five people in Kansas appear to have been sickened from January 2014 through January 2015 while they were hospitalized for unrelated conditions, the C.D.C. said. Of the five, four are known to have had milkshakes at the hospital made with a Blue Bell ice cream called Scoops and two other products made at Blue Bell’s plant in Brenham, Tex.
The Texas patients also developed listeriosis, the condition of being sickened by listeria, after being hospitalized for unrelated reasons from 2011 through 2014. Tests on the genome of the strains with which they were infected “were nearly identical†to strains found at Blue Bell’s plant in Broken Bow, Okla., the C.D.C. said.
Tests are being conducted to see whether three other patients infected with listeriosis between 2010 and 2012 were related to the Blue Bell outbreak, the C.D.C. said.
Blue Bell began removing ice cream products from the market on March 13 after the health authorities reported that they suspected a connection between the Kansas infections and products made by Blue Bell’s Texas plant, according to the United States Food and Drug Administration.
“At this point, we cannot say with certainty how Listeria was introduced to our facilities,†Mr. Kruse said. The company is continuing to investigate the source of the contamination.
On March 23, Blue Bell began a second voluntary recall after listeria strains were found in products made at its Oklahoma plant, the F.D.A. said. The company’s products include ice cream, frozen yogurt, sherbet and frozen snacks.
Blue Bell said it was expanding its cleaning and sanitizing of equipment and increasing swabbing of factory surfaces by 800 percent, with samples sent daily to a lab for testing. The company is also implementing a “test and hold†system, with products only released to the market after tests show they are safe.
The recalled products were distributed to Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Virginia, Wyoming and international locations, the company said. Two distributors of Blue Bell products in the Philippines said they were participating in the voluntary recall.
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