Outbreaks, Recalls, and Investigations in Wisconsin

The Centers for Disease Control and Prevention (CDC), public health officials in several states, the California Department of Public Health Infant Botulism Treatment and Prevention Program, and the U.S. Food and Drug Administration, are investigating a multistate outbreak of infant botulism linked to infant formula.

According to the CDC as of November 19, 2025, this outbreak includes 31 infants with suspected or confirmed botulism in 15 states. All 31 infants were hospitalized, and no deaths have been reported.

The Wisconsin Department of Health Services has identified and is investigating a suspect case of infant botulism related to this outbreak. The infant is currently hospitalized and receiving medical care.

Recalled infant formula

The recall includes all lot numbers, sizes of cans and single serve sticks of ByHeart Whole Nutrition infant formula. Parents and caregivers should stop using all ByHeart Whole Nutrition infant formula immediately.

Advice to consumers

• Do not use any ByHeart Nutrition infant formula.
  • If anyone has leftover ByHeart powdered formula that was fed to their infant, they should record the lot number and best by date, and keep it stored for at least a month. If an infant fed ByHeart powdered formula develops symptoms of infant botulism, Bureau of Communicable Disease (BCD) staff may want to collect it for testing.
• Wash items and surfaces that may have touched the recalled formula using hot soapy water or a dishwasher.

When to see a health care provider

Parents should take their infant to see a health care provider when both of the following apply:

• Your infant has consumed ByHeart Whole Nutrition infant formula.
• Your infant has symptoms of infant botulism. Symptoms of infant botulism can take weeks to develop and include:
  • Poor feeding.
  • Loss of head control.
  • Difficulty swallowing.
  • Decreased facial expression.

Public hotline for questions related to infant botulism

The California Department of Public Health has a hotline for parents and caregivers to get answers to questions they have about infant botulism. The hotline is open seven days a week from 9 a.m. to 1 a.m Central Daylight Time. You can reach the hotline at 833-398-2022.

Frequently asked questions for parents

If my infant has consumed the recalled formula, can I test my baby to know if they have botulism?

There is no test to determine if an infant without symptoms has been exposed to the bacteria. Only infants that have symptoms of botulism and are hospitalized can be tested. The special test is done through a stool sample.

If my infant has consumed ByHeart Whole Nutrition infant formula, will they get botulism?

Not all infants who consumed the recalled formula will develop botulism. The presence of the bacteria alone doesn't cause botulism. Once the bacteria have started growing in the gut, they produce a toxin that affects the nervous system. The toxin is what causes symptoms of botulism. Younger babies are more likely to have less mature gut microbiomes and are more susceptible to getting sick with botulism.

What symptoms should I watch for?

The first symptom is usually constipation followed by droopy eyelids, poor sucking, pooling of milk in mouth, a weak or gargled cry, and “floppy” neck. Having a fever is not a symptom of botulism.

How is botulism treated?

To prevent worsening symptoms, babies suspected of having botulism are often given an antitoxin called BabyBIG. Infants with botulism need to be hospitalized. Supportive treatment will take several weeks and a feeding tube and ventilation may be required. Physical and occupational therapies are needed for full recovery. Most babies that receive supportive care will survive and recover.

Advice to businesses

• Do not sell or use recalled ByHeart Whole Nutrition infant formula.
• Sanitize surfaces that may have come in contact with recalled formula.

Advice to clinicians

• Initial diagnosis of infant botulism is based on clinical symptoms that can't be explained by another disease.
• Consult with the Infant Botulism Treatment and Prevention Program (IBTPP) for suspected cases by phone immediately at 510-231-7600.
• Request and administer BabyBIG antitoxins as soon as possible if clinical consultation supports infant botulism. Do not wait for laboratory confirmation.
• Providers should report all suspected cases of infant botulism to BCD immediately at 608-267-9003, or after hours at 800-943-0003 (option 4).
• More information for clinicians is available on the CDC Clinical Overview of Infant Botulism webpage.

Frequently asked questions for health care providers

When to test for infant botulism?

• Testing for infant botulism is only done if an IBTPP consult determines the infant meets clinical case criteria and will receive BabyBIG.
• There are no screening tests to determine if an infant without symptoms has been exposed to botulinum neurotoxin (BoNT).
• Testing for BoNT requires approval from BCD and the referral testing laboratory.
• Administration of BabyBIG is not dependent on BoNT test results, so testing is not the first priority.
• A stool specimen is collected from symptomatic infants for BoNT testing and Clostridium culture. Instructions for specimen collection and handling are provided at time of BCD approval.
• The gold standard confirmatory test for BoNT is the mouse bioassay which can take up to two weeks to finalize results.

When to suspect a patient has botulism?

• Suspect botulism in infants who develop clinically-compatible signs and symptoms of botulism and have consumed ByHeart Whole Nutrition infant formula within the past month.
• Consult with the IBTPP for an infant suspected of having botulism. Consult is usually initiated by the attending pediatrician after initial medical assessment.
• Suspected cases of botulism should be reported to BCD immediately at 608-267-9003, or after hours at 800-943-0003 (option 4). BCD can arrange consult with IBTPP and facilitates testing of clinical specimens and environmental samples.

Resources

Visit the FDA and CDC webpages for more information on this outbreak, and to stay up to date on other foodborne outbreaks and recalls:
CDC: Infant Botulism Outbreak Linked to Infant Formula, November 2025
CDC: About Botulism
DHS: Botulism
FDA: Outbreak Investigation of Infant Botulism-Infant Formula

California Department of Public Health Infant Botulism Hotline

The Wisconsin Department of Health Services (DHS) is working with local, state, and federal partners to investigate three multistate outbreaks of Salmonella linked to pet geckos.

According to the Centers for Disease Control and Prevention (CDC), 101 people in 33 states have gotten sick with one of the outbreak strains of Salmonella. Twenty-seven people have been hospitalized, and no deaths have occurred. Wisconsin has two laboratory-confirmed cases linked to these outbreaks.

Reptiles like geckos can carry germs like Salmonella in their droppings. These germs spread to their bodies and the area where they live. People can get sick with Salmonella from touching a gecko and then touching their mouth or food.

If you have a pet gecko

Make sure to always take these steps to keep you and others healthy around it:

• Wash your hands with soap and water handling your gecko, feeding it, cleaning its cage or equipment, and before eating and drinking.
• Children under 5 years old should not handle or touch reptiles, amphibians. They are at higher risk of a serious illness from Salmonella infection.
• Keep your gecko and supplies away from your food and anywhere food is prepared, stored, served, or eaten.
• Clean your gecko supplies outside the house. If you must clean them indoors, use a laundry sink or bathtub and clean and disinfect the area right after.

Advice for businesses

• Educate ( PDF) customers about how to stay healthy around geckos.
• Learn industry-specific tips on how to prevent diseases with non-traditional pets.
• Keep different reptile species separate in your facility.

Symptoms of Salmonella

• Diarrhea, fever, and stomach cramps are the most common symptoms of Salmonella.
  • Symptoms usually start six hours to six days after swallowing the germ.
  • Most people recover in four to seven days, without treatment.
• Some groups, like children younger than 5 years, adults 65 years and older, and people with weakened immune systems, may experience more severe illnesses and that require medical treatment and hospitalization.

Resources

Visit the CDC webpages for more information on this investigation and to stay up to date on other foodborne outbreaks and recalls:

CDC: Salmonella Outbreaks Linked to Geckos
CDC: About Salmonella

The Wisconsin Department of Health Services (DHS) is working with local, state, and federal partners to investigate a multistate outbreak of Salmonella linked to certain home delivery meals made by Metabolic Meals.

According to the CDC (Centers for Disease Control and Prevention), 16 people in 10 states were infected with the outbreak strain of Salmonella. Seven people have been hospitalized, and zero deaths have been reported.

Wisconsin has one laboratory-confirmed cases linked to this outbreak.

Product and recall information

The products in this recall were select meals delivered by Metabolic Meals during the week of July 28, 2025. Those meals include:

• Four Cheese Tortellini with Pesto Sauce and Grilled Chicken
  • Lot Code: 25199
  • Best By: 08/07/2025
• Low Carb Chicken Teriyaki and Vegetables
  • Lot Code: 25202
  • Best By: 08/05/2025
• Black Garlic & Ranch Chicken Tenders with Roasted Vegetables
  • Lot Code: 25205
  • Best By: 08/08/2025
• Sliced Top Sirloin with Roasted Peanut Sauce and Summer Vegetables
  • Lot Code: 25203
  • Best By: 08/06/2025
• Additional meal lot codes include: 25199, 25202, 25203, 25204, 25205

DHS and CDC continue to urge people to take the following steps:

• Check your fridge for the recalled products. Throw them away and do not eat them.
• Wash surfaces and containers that may have touched these products using hot soapy water or a dishwasher.
• Call your health care provider if you have any of these severe Salmonella symptoms:
  • Diarrhea and a fever higher than 102 F
  • Diarrhea for more than three days that is not improving
  • Bloody diarrhea
  • So much vomiting that you cannot keep liquids down
  • Signs of dehydration, such as:
    • Not peeing much
    • Dry mouth and throat
    • Feeling dizzy when standing up

Symptoms of Salmonella

• Diarrhea, fever, and stomach cramps are the most common symptoms of Salmonella.
  • Symptoms usually start six hours to six days after swallowing the germ.
  • Most people recover in four to seven days, without treatment.
• Some groups, like children younger than 5 years, adults 65 years and older, and people with weakened immune systems, may experience more severe illnesses and that require medical treatment and hospitalization.

Resources

See the CDC webpages for more information on this investigation, and to stay up to date on other foodborne outbreaks and recalls:

• CDC: Salmonella Outbreak Linked to Home Delivery Meals
• CDC: About Salmonella