The Centers for Disease Control and Prevention warned health care providers to watch out for children who might be sick due to lead exposure after three companies recalled cinnamon applesauce pouches this month due to high levels of lead.

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In a health advisory issued Monday, officials said 22 cases of high blood lead levels have been reported in toddlers in at least 14 states. The states were identified as Alabama, Arkansas, Louisiana, Maryland, Missouri, New Mexico, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Washington.

The affected children, who are between the ages of 1 and 3, experienced headache, nausea, vomiting, diarrhea, anemia and other symptoms, according to the CDC.

The Food and Drug Administration earlier launched an investigation after testing found “extremely high concentrations of lead” in cinnamon applesauce pouches sold under the WanaBana, Weis and Schnucks labels. The pouches were sold nationwide and online through retailers including Dollar Tree and Amazon.

Anyone who bought the recalled applesauce pouches was urged not to eat the fruit puree and to instead return them for a full refund.

On Monday, health officials advised doctors to recommend that children not eat the recalled applesauce pouches and that they consider lead exposure when dealing with patients with symptoms associated with lead poisoning. The symptoms were identified as:

• Constitutional symptoms such as generalized weakness, fatigue, malaise, arthralgias, myalgias, irritability, anorexia, insomnia and weight loss.
• Abdominal pain (“lead colic”), constipation, nausea and other gastrointestinal symptoms.
• Anemia.
• Central nervous system effects, such as headache, impaired visual-motor coordination, tremor, and, in severe cases, seizure, encephalopathy and coma.
• Stunted growth, hearing problems, impaired neurobehavioral development, decreased intelligence and failure to meet expected developmental milestones.
• Impaired kidney function, such as acute tubular dysfunction.

The CDC added that some people may have high blood lead levels without any symptoms.