In the days and months leading up to the Food and Drug Administration’s nationwide recall of WanaBana applesauce and cinnamon in late October, several families found themselves frantically searching their homes. sources of lead, desperately trying to understand how their children had been exposed to this heavy metal.
“This was a mystery to us,” one parent wrote in an adverse event report received by the FDA on November 6. The document was one of several provided to NBC News in response to a Freedom of Information Act request. The agency redacted all personal data in the reports, which are issued in relation to specific products regulated by the FDA.
A routine checkup on October 11 found that the children’s blood lead levels, which had been within normal range the previous year, had risen to 5.1 micrograms per deciliter, a level considered higher than that seen in most minors, according to the Centers for Disease Control and Prevention (CDC).
“We have a new house and all the toys are new,” one parent wrote. “We keep our home clean and there is nothing in our hobbies that could bring lead into our home.”
Later that month, WanaBana announced it was recalling its Apple Cinnamon Fruit Puree pouches from the market due to elevated lead levels. The child, the same father wrote, had consumed three bags of the puree the week before taking the test.
Parental confusion, frustration and alarm were common in reports received by the FDA of lead poisoning in children who had allegedly consumed one of the three recalled products: WanaBana cinnamon applesauce, Cinnamon Apple Schnucks and Weis Cinnamon Apple Jelly. Schnucks and Weis products are also manufactured by WanaBana USA.
The FDA said last month that parents should not buy the products while it investigates cases of lead poisoning in children, reports the agency said it began receiving in mid-October.
The regulatory authority revealed this Monday that samples of cinnamon contaminated with lead were found in the puree bags that are manufactured in a plant in Ecuador, called Austrofoods. FDA investigators took samples of cinnamon at those facilities, which came from Negasmart, another supplier in that country.
The FDA said its tests showed that the cinnamon samples contained “extremely high levels of lead.” One of them contained lead levels of 5,110 parts per million, about 2,000 times higher than the international safety standards proposed by the United Nations Food and Agriculture Organization of 2.5 parts per million for spices that include cinnamon.
As of Tuesday, the agency had received at least 65 reports of lead poisoning in children potentially related to the recalled products. All reported cases – which have not necessarily been verified or confirmed by the FDA – correspond to children under 6 years of age.
Mariah Piazza, 27, of Buffalo, New York, told NBC News she was one of the parents who submitted a report to the FDA in November.
Her one-year-old son Caiden had been eating cinnamon applesauce packets almost every day for a month.
In March, a blood test revealed that Caiden had a blood lead level of 13 micrograms per deciliter. A New York State Department of Health home search found nothing in the family’s home that could have caused the lead poisoning, she added. (The CDC recommends home screening for children with blood lead levels above 3.5 micrograms per deciliter to identify possible sources.)
“It was a total surprise,” said Piazza, who added that investigators who attended her home told her she might never know where her lead exposure came from.
Out of an abundance of caution, the woman eliminated all processed foods from Caiden’s diet, including WanaBana pouches. She didn’t find out about the withdrawal until early November. She felt relieved.
When Caiden stopped eating the pouches, “his levels went down very quickly,” he explained. “Most people, when their child is lead poisoned and gets tested, it takes almost a year for her levels to be undetectable.”
No immediate symptoms
There is no known safe blood lead level for children, according to the CDC. The agency uses a level of 3.5 micrograms per deciliter to identify children with higher blood levels than most.
Long-term exposure to lead, a neurotoxin, can damage the nervous system and brain, according to Dr. Adam Keating, a primary care pediatrician at the Cleveland Clinic. It can also cause ongoing learning and behavior problems, as well as hearing and speech problems.
However, what constitutes prolonged exposure remains unclear.
How long and how much lead exposure it takes for a child to develop these problems remains an unknown, according to Dr. Cree Kachelski, a pediatric emergency physician at the Mayo Clinic in Rochester, Minnesota.
Lead poisoning can be difficult to detect. Kachelski says most children who have been exposed to lead are asymptomatic or have no obvious immediate symptoms.
“For this reason, routine tests are carried out during check-up visits for healthy children, because a large part of the minors are asymptomatic,” he explains.
In a report submitted to the FDA, a parent whose child had blood lead levels of 13 micrograms per deciliter said the child had no symptoms, noting that the child appeared “healthy at this time.”
In another report, a family wrote that their one-year-old daughter had been eating the WanaBana apple and cinnamon fruit puree packets for nine months.
On June 1, a blood test at a primary care office revealed that his lead levels were above average. In a subsequent home search, the health department found no obvious signs of lead in the family’s home, they said.
“After a month of trying to get the health department to come back, the FDA announced that Wanabana puree pouches had been removed from the market due to their high lead content and that our daughter had been consuming them for the last 9 months for an average of 4 -6 a week,” they wrote.
Some acute illnesses
Some of the reports described symptoms prior to blood tests.
One parent indicated in an adverse event report that she had purchased WanaBana Cinnamon Applesauce for her one-year-old son at Dollar Tree on Tuesday, October 24.
The next day, a babysitter reported that the boy had lost his appetite and, at 5 a.m. Thursday, began vomiting. The parents immediately called the pediatrician, who advised them to monitor the child over the weekend in case he showed signs of dehydration. The little boy suffered episodes of vomiting and diarrhea during those days and the following Monday he was diagnosed with stomach flu.
The father, who was unsure of the cause of the child’s illness, researched the Internet and discovered that the FDA had recalled WanaBana apple-cinnamon packets from the market. Alarmed, he took his son to the hospital for lead testing and discovered his levels were “above range.”
“I am concerned that your flu-like symptoms were due to exposure to lead from this recalled product,” the father wrote.
Another parent stated in an adverse event report that her one-year-old son had “severe anemia” during an annual check-up in early October.
The boy, who had been consuming the cinnamon apple packets two or three times a day and “loved” the brand, had also had loose stools.
“The loose stools (which were initially thought to be caused by breast milk) turned into explosive diarrhea that smelled like death,” the father specified.
Kachelski noted that gastrointestinal symptoms or stomach problems can be an early sign of acute lead exposure in children.
“For example, vomiting, or they just don’t feel well because it upsets their gastrointestinal tract,” he said.
Doctors often see more constipation than diarrhea in these cases, he says. It’s also possible for lead poisoning to look like a stomach virus.
