Texas ice cream maker Blue Bell Creameries has widely expanded a voluntary recall over Listeria concerns, seeking the return of all of its products currently on the market. Blue Bell products are sold in 23 states.

"We are heartbroken about this situation and apologize to all of our loyal Blue Bell fans and customers," CEO and President Paul Kruse said in a company statement. "We want enjoying our ice cream to be a source of joy and pleasure, never a cause for concern, so we are committed to getting this right."

The recall includes ice cream, frozen yogurt and sherbet. And unlike Blue Bell's other recent recalls, it covers products from all of its manufacturing facilities.

Calling the situation "a complex and ongoing multistate outbreak of listeriosis occurring over an extended period of several years," the Centers for Disease Control and Prevention says it has traced eight related cases of Listeria: five in Kansas and three in Texas. Those cases span a time period from 2011 to 2015.

"All eight case patients are adults, and three deaths have been reported from Kansas," the FDA says.

The bacterium Listeria monocytogenes can cause serious and sometimes fatal infections in young children, the elderly and people with weakened immune systems. It can also cause miscarriages and stillbirths in pregnant women. Symptoms include a fever, muscle aches and a stiff neck.

Unlike many other potential food contaminants, Listeria monocytogenes can keep growing under refrigerated conditions. The incubation period can range from three days to 70 days.

Blue Bell says it is bolstering its sanitizing and training programs and "expects to resume distribution soon on a limited basis once it is confident in the safety of its product."

The company is adopting a new preemptive testing system, in which "all products will be tested first and held for release to the market only after the tests show they are safe."

The full recall comes nearly one month after Blue Bell issued a voluntary recall for ice cream made in its Broken Arrow, Okla., plant. That recall was spurred by a test that came back positive for Listeria monocytogenes in its ice cream at a Kansas hospital.

Earlier this month, Blue Bell and the Food and Drug Administration announced another recall, after a pint of its banana pudding ice cream also tested positive for Listeria monocytogenes. That result prompted the company to idle its Oklahoma facility and recall all products made there.

But other tests also found a risk from products made at Blue Bell's plant in Brenham, Texas. The FDA says it "was notified that the three strains related to the Kansas illness cluster and four other rare strains of Listeria monocytogenes" were detected in two different products in South Carolina that had been made in Brenham.

That finding came from random sampling that was done in February; it was later confirmed by the Texas health agency's testing of three products made at the Brenham plant.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

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