Listeria

Disease

List of foodborne illness outbreaks in the United States

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2011 United States listeriosis outbreak from cantaloupes from Colorado in July, August and September. 29 people have died.^[3] It is the second deadliest recorded U.S. outbreak in terms of the number of deaths since the Centers for Disease Control and Prevention began tracking outbreaks in the 1970s.^[4]^[2]
2011 United States salmonellosis outbreak in Del Monte cantaloupe infected with Salmonella Panama from Guatemala.^[5]
Andrew Williamson Fresh Produce is voluntarily recalling one lot of organic grape tomatoes sold under the Limited Edition and Fresh & Easy labels due to a possible health risk from Salmonella.
Emporia, Kansas based Tyson Fresh Meats (Tyson Foods) announces it is recalling 131,300 pounds of ground beef products due to possible E. coli O157:H7 contamination.
Publix Super Markets is issuing a voluntary recall for spinach dip because it may be adulterated with Listeria monocytogenes.
Roundy's Super Markets Inc., a Milwaukee, Wisconsin-based company with an establishment in Kenosha, Wisconsin, is recalling 360 pounds of breaded chicken breast products, that should have been fully cooked, because they may have been undercooked.

E. coli in strawberry from Newberg, Oregon killed one person on August 8, 2011.^[5] The Oregon Health Authority announced^[6] that they had linked at least 10 E. coli infections to a strawberry farm in Newberg, Oregon. Four patients had been hospitalized and an elderly woman died from kidney failure associated with her E coli illness. The strawberries were sold to buyers, who resold them at roadside stands and farmer's markets. ^[7]

One dead in California from Samonella and 76 more people sickened in 26 states. On August 3, 2011, Cargill recalled 36,000,000 pounds of fresh and frozen ground turkey products produced at the company's Springdale, Arkansas, facility from February 20, 2011, through August 2, 2011, due to possible contamination from Salmonella Heidelberg.^[8]^[5]^[9]

In March and April 2011, Jennie-O recalled almost 55,000 pounds of turkey burgers because drug-resistant salmonella was found in its products.^[10]

In June 2011, Nearly 3,000 cases of Dole Food Company salad bags are being recalled after a random test found the bacteria listeria in a bag of the salad. Dole is voluntarily recalling bags of its Italian blend salad and Kroger Fresh Selections Italian Style Blend, both with the use-by date of June 19, 2011. The salads were distributed in Illinois, Indiana, Kentucky, Maine, Michigan, Mississippi, New Jersey, New York, Ohio, Pennsylvania, Tennessee and Wisconsin, as well as parts of Canada. Dole says if you still have the salad bags in your fridge, you should throw them away. So far, no illnesses have been reported. ^[11]

Contaminated papaya appears to be the cause of an outbreak of Salmonella food poisoning (salmonellosis) in 23 states, the Food and Drug Administration (FDA) is warning consumers. The FDA says papayas imported from Mexico and distributed by Agromod Produce Inc. of McAllen, Texas, is likely the source of 97 cases of Salmonella Agona. To date, 10 people have been hospitalized but there have been no reported deaths. As a result, all papayas sold before Saturday, July 23, 2011, have been voluntarily recalled by Agromod. The cases were reported between January 1 and July 18 in Arkansas, Arizona, California, Colorado, Georgia, Illinois, Louisiana, Massachusetts, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, Ohio. Oklahoma, Pennsylvania, Tennessee, Texas, Virginia, Washington and Wisconsin. While ages ranged from 1 year to 91 years old, the average age of those stricken is 20. More than half of the cases are women. Texas had the most cases with 25 people falling ill. According to the Centers for Disease Control and Prevention (CDC), Salmonella agona is one of about 2,000 strains of salmonella. Symptoms usually show up 12 to 72 hours after infection and can last up to seven days. Approximately 40,000 cases of salmonellosis, taking into account all cases from all pathologic strains, are reported each year in the U.S. The FDA is telling consumers to check for the Agromod brand stickers on fresh papayas before buying the fruit. Consumers and retailers who already have Agromod brand papayas should throw them out in a sealed container so that even animals can't eat them. Investigators say anyone who believes they got sick from eating papaya should see their doctor. The papayas could have been distributed nationwide in the U.S. and Canada. The FDA and CDC are working together with public health officials at the state level to identify additional cases. In a press release the agency said "the FDA is taking regulatory action to prevent potentially contaminated papaya from entering the United States, including increasing its sampling of imported papaya."

Disease

Recent outbreaks of Listeria

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According to the Centers for Disease Control and Prevention (CDC) there are about 1,600 cases of listeriosis annually in the United States. Compared to 1996-1998, the incidence of listeriosis had declined by about 38% by 2003. However, illnesses and deaths continue to occur. On average from 1998-2008, 2.4 outbreaks per year were reported to the CDC. A large outbreak occurred in 2002, when 54 illnesses, 8 deaths, and 3 fetal deaths in 9 states were found to be associated with consumption of contaminated turkey deli meat.^[13]
The 2008 Canadian listeriosis outbreak, a widespread outbreak of listeriosis in Canada linked to a Maple Leaf Foods plant in Toronto, Ontario killed 23 people and there were 57 total confirmed cases.^[14]
On September 14, 2011, the U.S. Food and Drug Administration warned consumers not to eat cantaloupes shipped by Jensen Farms from Granada, Colorado due to a potential link to a multi-state outbreak of listeriosis. At that time Jensen Farms voluntarily recalled cantaloupes shipped from July 29 through September 10, and distributed to at least 17 states with possible further distribution. The CDC reported that at least 22 people in seven states had been infected as of September 14.^[15] On September 26, the Centers for Disease Control and Prevention reported that a total of 72 persons had been infected with the four outbreak-associated strains of Listeria monocytogenes which had been reported to the CDC from 18 states. All illnesses started on or after July 31, 2011 and by September 26, thirteen deaths had been reported: 2 in Colorado, 1 in Kansas, 1 in Maryland, 1 in Missouri, 1 in Nebraska, 4 in New Mexico, 1 in Oklahoma, and 2 in Texas.^[16]^[17] On September 30, 2011, a random sample of romaine lettuce taken by the U.S. Food and Drug Administration tested positive for listeria on lettuce shipped on September 12 and 13 by an Oregon distributor to at least two other states -- Washington and Idaho.^[18]
By October 18, the CDC reported that 12 states are now linked to listeria in cantaloupe and that 123 people have been sickened and a total of 25 have died. While the tainted cantaloupes should be off store shelves by now, the number of illnesses may still continue to grow. The CDC confirmed a sixth death in Colorado and a second in New York; Indiana, Kansas, Louisiana, Maryland, Missouri, Nebraska, New Mexico, Oklahoma, Texas and Wyoming have also reported deaths.

Disease

Epidemiology of Listeriosis

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Incidence in 2004–2005 was 2.5–3 cases per million population a year in the United States, where pregnant women accounted for 30% of all cases.^[10] Of all nonperinatal infections, 70% occur in immunocompromised patients. Incidence in the U.S. has been falling since the 1990s, in contrast to Europe where changes in eating habits have led to an increase during the same time. In Sweden, it has stabilized at around 5 cases per annum per million population, with pregnant women typically accounting for 1–2 of some 40 total yearly cases.^[11]
There are four distinct clinical syndromes:

Infection in pregnancy: Listeria can proliferate asymptomatically in the vagina and uterus. If the mother becomes symptomatic, it is usually in the third trimester. Symptoms include fever, myalgias, arthralgias and headache. Miscarriage, stillbirth and preterm labor are complications of this infection. Symptoms last 7–10 days.
Neonatal infection (granulomatosis infantisepticum): There are two forms. One, an early-onset sepsis, with Listeria acquired in utero, results in premature birth. Listeria can be isolated in the placenta, blood, meconium, nose, ears, and throat. Another, late-onset meningitis is acquired through vaginal transmission, although it also has been reported with caesarean deliveries.
Central nervous system (CNS) infection: Listeria has a predilection for the brain parenchyma, especially the brain stem, and the meninges. It can cause cranial nerve palsies, encephalitis, meningitis, meningoencephalitis and abscesses. Mental status changes are common. Seizures occur in at least 25% of patients.
Gastroenteritis: L. monocytogenes can produce food-borne diarrheal disease, which typically is noninvasive. The median incubation period is 21 days, with diarrhea lasting anywhere from 1–3 days. Patients present with fever, muscle aches, gastrointestinal nausea or diarrhea, headache, stiff neck, confusion, loss of balance, or convulsions.

Particular strains of Listeria monocytogenes are able to invade the heart, leading to serious and difficult-to-treat heart infections. About 10 percent of serious listeria infections involve cardiac infections that are difficult to treat, with more than one-third proving fatal. A strain of listeria had been isolated from a patient with endocarditis (infection of the heart). Usually with endocarditis, there is bacterial growth on heart valves, but in this case the infection had invaded the cardiac muscle. When mice were infected with either the cardiac isolate or a lab strain, 10 times as much bacteria were found in the hearts of mice infected with the cardiac strain. In the spleen and liver, organs that are commonly targeted by listeria, the levels of bacteria were equal in both groups of mice. While the lab-strain-infected group often had no heart infection at all, 90 percent of the mice infected with the cardiac strain had heart infections. Only one other strain of listeria out of 10 acquired seemed to also target the heart. The results suggest that these two cardiac-associated strains display modified proteins on their surface that enable the bacteria to more easily enter cardiac cells, targeting the heart and leading to bacterial infection