Listeriosis

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Preventing Foodborne Illness: Listeriosis

Listeriosis, a serious infection caused by eating food contaminated with the

bacterium Listeria monocytogenes, has recently become an important public

health problem in the United States. The disease affects primarily pregnant

women, newborns, and adults with weakened immune systems. It can be avoided by

following a few simple recommendations.

How great is the risk for listeriosis?

In the United States, an estimated 1,850 persons become seriously ill with

listeriosis each year. Of these, 425 die.

At increased risk are:

Pregnant women They are about 20 times more likely than other healthy adults

to get listeriosis. About one-third of listeriosis cases happen during

pregnancy.

Newborns Newborns rather than the pregnant women themselves suffer the serious

effects of infection in pregnancy.

Persons with weakened immune systems

Persons with cancer, diabetes, or kidney disease

Persons with AIDS. They are almost 300 times more likely to get listeriosis

than people with normal immune systems.

Persons who take glucocorticosteroid medications

The elderly

Healthy adults and children occasionally get infected with Listeria, but they

rarely become seriously ill.

How does Listeria get into food?

Listeria monocytogenes is found in soil and water. Vegetables can become

contaminated from the soil or from manure used as fertilizer. Animals can

carry the bacterium without appearing ill and can contaminate foods of animal

origin such as meats and dairy products. The bacterium has been found in a

variety of raw foods, such as uncooked meats and vegetables, as well as in

processed foods that become contaminated after processing, such as soft

cheeses and cold cuts at the deli counter. Unpasteurized (raw) milk or foods

made from unpasteurized milk may contain the bacterium.

Listeria is killed by pasteurization, and heating procedures used to prepare

ready-to-eat processed meats should be sufficient to kill the bacterium;

however, unless good manufacturing practices are followed, contamination can

occur after processing.

How do you get listeriosis?

You get listeriosis by eating food contaminated with Listeria. Babies can be

born with listeriosis if their mothers eat contaminated food during pregnancy.

Although healthy persons may consume contaminated foods without becoming ill,

those at increased risk for infection can probably get listeriosis after

eating food contaminated with even a few bacteria. Persons at risk can prevent

Listeria infection by avoiding certain high- risk foods and by handling food

properly.

How do you know if you have listeriosis?

A person with listeriosis usually has fever, muscle aches, and sometimes

gastrointestinal symptoms such as nausea or diarrhea. If infection spreads to

the nervous system, symptoms such as headache, stiff neck, confusion, loss of

balance, or convulsions can occur.

Infected pregnant women may experience only a mild, flu-like illness; however,

infection during pregnancy can lead to premature delivery, infection of the

newborn, or even stillbirth.

There is no routine screening test for susceptibility to listeriosis during

pregnancy, as there is for rubella and some other congenital infections. If

you have symptoms such as fever or stiff neck, consult your doctor. A blood or

spinal fluid test (to cultivate the bacteria) will show if you have

listeriosis. During pregnancy, a blood test is the most reliable way to find

out if your symptoms are due to listeriosis.

Can listeriosis be prevented?

The general guidelines recommended for the prevention of listeriosis are

similar to those used to help prevent other foodborne illnesses, such as

salmonellosis.

How can you reduce your risk for listeriosis?

General recommendations:

Cook thoroughly raw food from animal sources, such as beef, pork, or poultry.

Wash raw vegetables thoroughly before eating.

Keep uncooked meats separate from vegetables and from cooked foods and ready-

to-eat foods.

Avoid raw (unpasteurized) milk or foods made from raw milk.

Wash hands, knives, and cutting boards after handling uncooked foods.

Recommendations for persons at high risk, such as pregnant women and persons

with weakened immune systems: In addition to the recommendations listed above,

Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-

style cheese. (Hard cheeses, processed cheeses, cream cheese, cottage cheese,

or yogurt need not be avoided.)

Cook until steaming hot left-over foods or ready-to-eat foods, such as hot

dogs, before eating.

Although the risk of listeriosis associated with foods from deli counters is

relatively low, pregnant women and immunosuppressed persons may choose to

avoid these foods or thoroughly reheat cold cuts before eating.

Can listeriosis be treated?

When infection occurs during pregnancy, antibiotics given promptly to the

pregnant woman can often prevent infection of the fetus or newborn. Babies

with listeriosis receive the same antibiotics as adults, although a

combination of antibiotics is often used until physicians are certain of the

diagnosis. Even with prompt treatment, some infections result in death. This

is particularly likely in the elderly and in persons with other serious

medical problems.

What is being done?

Government agencies and the food industry have taken steps to reduce

contamination of food by the Listeria bacterium. The Food and Drug

Administration and the U. S. Department of Agriculture monitor food regularly.

When a processed food is found to be contaminated, food monitoring and plant

inspection are intensified, and if necessary, the implicated food is recalled.

The National Center for Infectious Diseases (NCID) is studying listeriosis in

several states to help measure the impact of prevention activities and

recognize trends in disease occurrence. NCID also assists local health

departments in investigating outbreaks. Early detection and reporting of

outbreaks of listeriosis to local and state health departments can help

identify sources of infection and prevent more cases of the disease.

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