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The number of children with lead poisoning potentially linked to tainted pouches of cinnamon apple puree and cinnamon applesauce has increased to 64, the Food and Drug Administration reported Wednesday. 

The 64 cases, up from 57 last Thursday, all involve children under the age of 6, according to the agency. All were reported to it from Oct. 17 through Dec. 1.

The FDA has homed in on the cinnamon as the most likely source of the lead in the three recalled products — WanaBana apple cinnamon fruit puree, Schnucks apple sauce pouches with cinnamon and Weis cinnamon apple sauce — although the investigation is ongoing.

On Wednesday, the agency said that it conducted an onsite inspection of the facility in Ecuador that made the applesauce pouches, and that ingredient sample collection is underway.

A separate investigation by Ecuadorian authorities found that the cinnamon, which came from the supplier Negasmart, had levels of lead that exceeded what is allowed by the country, the FDA said.

WanaBana did not immediately respond to a request for comment.

Spices, including cinnamon, can become contaminated with lead through multiple routes, including from the environment during cultivation. Dr. Leonardo Trasande, director of environmental pediatrics at NYU Langone Health, said it is possible that the cinnamon contained lead from soil contamination.

Lead exposure can cause serious health problems in children, and the effects are more harmful in children younger than 6, according to the Centers for Disease Control and Prevention. Problems linked to lead exposure include damage to the brain and nervous system; slowed growth and development; and learning and behavior problems. At high levels, it can cause lead poisoning or death.

The FDA said that in the babies and children who consumed the contaminated cinnamon apple pouches, blood lead levels were at or above 3.5 micrograms per deciliter — a level that the CDC considers higher than what’s seen in most children.

As of Wednesday, cases have been reported in 27 states: Alabama, Arkansas, California, Connecticut, Florida, Georgia, Iowa, Illinois, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Missouri, North Carolina, Nebraska, New Hampshire, New Mexico, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington and Wisconsin.

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