Food Borne Illness Listeriosis Nakita Wiley MPH student

Food Borne Illness Listeriosis Nakita Wiley MPH student PUBH-6165 -2 Environmental Health Walden University Instructor: Dr. Rebecca Heick

Objectives p p p p p What is Listeriosis? Food Sources of Listeriosis ? How does Listeria get into food? Who’s at Risk? Symptoms Complications How will your doctor test and diagnose Listeria? What should the food industry do to protect you from Listeria? How to prevent yourself from getting Listeria? Organizations/Stakeholders

What is Listeriosis? Listeriosis is a bacterial infection caused by a grampositive, motile bacterium, Listeria monocytogenes which causes a rare but potentially lethal food-borne infection. Reference: Pirie, J. H. H. 1940. Listeria: change of name for a genus of bacteria. Nature. 145: 264

What is Listeriosis? Listeriosis is one of the most virulent food borne pathogens with 20 to 30 percent of clinical infections resulting in death. Responsible for approximately 2, 500 illnesses and 500 deaths in the United States (U. S. ) annually. Listeriosis is also the leading cause of death among food borne bacterial pathogens with fatality rates exceeding even Salmonella and Clostridium botulinum. Reference: American Meat Institute Fact Sheet. 2008. Listeria monocytogenes. Retrieved January 20, 2010 from http: //www. meatami. com/ht/a/Get. Document. Action/i/1 1478. pdf.

Food Sources of Listeriosis ? L. monocytogenes is primarily a food borne infection. Consumption of contaminated food items has been identified as the source of infection in both sporadic and outbreakassociated cases. Sources: p Cheeses p Hot dogs p Undercooked meats p Lettuce/Cole slaw/Salad items) p Ready-to-eat foods p Raw milk Reference: Engela, Ronald E. , Catherine E. Adamsa and Lester M. Crawforda. 1990. Foodborne listeriosis: risk from meat and poultry. Retrieved January 23, 2010 from http: //www. sciencedirect. com/science? _ob =Article. URL&_udi=B 6 T 6 S-49 N 8 SPD 1 V&_user=10&_cover. Date=01%2 F 31%2 F 1990&_rdoc=1&_fmt=high&_orig=se arch&_sort=d&_docanchor=&view=c&_search. Str. Id=1178273829&_rerun. Origin =google&_acct=C 000050221&_version=1&_url. Version=0&_userid=10&md 5=b 4 ce 6 f 6 cd 78498 b 7610 b 4 a 14 dec 389 ff

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. Reference: CDC. 2008. Listeriosis. Retrieved January 22, 2010 from http: //www. cdc. gov/nczved/dfbmd/disease_listing/listeriosis_gi. html

Who’s at Risk? p p p Pregnant women (about 20 times more likely than other healthy adults to get listeriosis) Newborns People over the age of 65 years People who have weakened immune systems, such as those who are undergoing chemotherapy or taking glucocorticosteroid medications Persons with AIDS (almost 300 times more likely to get listeriosis than people with normal immune systems) Persons with cancer, diabetes, or kidney disease Reference: CDC. 2008. Listeriosis. Retrieved January 21, 2010 from http: //www. cdc. gov/nczved/dfbmd/disease_listing/listeriosis_gi. html #

Risk? What makes it hard to pinpoint the food source of Listeria? INCUBATION PERIOD (UP TO 70 DAYS) The incubation period (time between ingestion and the onset of symptoms) for Listeria ranges from three to 70 days and averages 21 days. Reference: CDC. 2008. Listeriosis. Retrieved January 22, 2010 from http: //www. cdc. gov/nczved/dfbmd/disease_listing/listeriosis_gi. html

Symptoms An adult with Listeriosis (Listeria infection) exhibits: -“flu like symptoms” -fever -muscle aches -gastrointestinal symptoms (nausea or diarrhea). Reference: Clark, Marler. 2010. About Listeria. Retrieved January 23, 2010 from http: //www. aboutlisteria. com/listeria_symptoms_risks

Symptoms Newborns with a Listeriosis infection may experience symptoms that include: p Lethargy p Loss of Appetite p Vomiting p Breathing Difficulty p Skin Rash p Yellowing of the Skin and Whites of the Eyes Reference: Clark, Marler. 2010. About Listeria. Retrieved January 23, 2010 from http: //www. aboutlisteria. com/listeria_symptoms_risks

Symptoms (con’t) If infection spreads to the nervous system, symptoms such as: -headache -stiff neck -confusion -loss of balance or -convulsions Infected pregnant women may experience only a mild, flu-like illness; however, infections during pregnancy can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. In immune-deficient individuals, Listeria can invade the central nervous system, causing meningitis and/or encephalitis (brain infection). Reference: Medic 8. com. 2010. Listeria. Retrieved January 23, 2010 from http: //www. medic 8. com/healthguide/articles/listeria. html

Complications A Listeria infection can lead to life-threatening complications — including: p A generalized blood infection (septicemia) p Inflammation of the membranes and fluid surrounding the brain (meningitis) Infants who survive a Listeria infection may experience long-term neurological damage and delayed development. Reference: Medic 8. com. 2010. Listeria. Retrieved January 23, 2010 from http: //www. medic 8. com/healthguide/articles/listeria. html

How will your doctor test and diagnose Listeria? A blood test is often the most effective way to determine whether you have a Listeria infection. In some cases, samples of spinal fluid, urine or the fluid that surrounds and protects a baby before birth (amniotic fluid) may be tested as well. Reference: Wrong Diagnosis. 2010. Prevention of Listeriosis. Retrieved January 20, 2010 from http: //www. wrongdiagnosis. com/l/listeriosis/prevent. htm

What should the food industry do to protect you from Listeria? It is important to check a restaurant’s rating for: p p p Thoroughly cook 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 unpasteurized (raw) milk or foods made from unpasteurized milk. Wash hands, knives, and cutting boards after handling uncooked foods. Consume perishable and ready-to-eat foods as soon as possible. Reference: Wrong Diagnosis. 2010. Prevention of Listeriosis. Retrieved January 20, 2010 from http: //www. wrongdiagnosis. com/l/listeriosis/prevent. htm

How to prevent yourself from Listeria? p p p Keep raw meats separated from vegetables, fruit, foods that have been cooked, and ready-to-eat foods. Avoid unpasteurized milk or foods made from unpasteurized milk. Wash hands, knives, cutting boards, and counter tops after handling uncooked foods. Thoroughly cook raw foods from animals, such as beef, pork, and poultry. Wash raw vegetables thoroughly before consumption, especially those that have been grown using manure as a fertilizer. Use perishable and ready-to-eat foods as soon as possible. Reference: Wrong Diagnosis. 2010. Prevention of Listeriosis. Retrieved January 20, 2010 from http: //www. wrongdiagnosis. com/l/listeriosis/prevent. htm

How to prevent yourself from Listeria? (con’t) p p p Do not eat hot dogs, luncheon meats, or deli-meats, unless they have been reheated and are steaming hot. Avoid getting the fluid from hot dog packages on other foods, utensils, and food preparation surfaces. Wash your hands after handling hot dogs, luncheon meats, and deli meats. Do not eat soft cheeses unless they have labels that clearly state they are made from pasteurized milk. Do not eat refrigerated meat spreads. Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish (such as a casserole). Canned or shelved smoked seafood is safe. Reference: Wrong Diagnosis. 2010. Prevention of Listeriosis. Retrieved January 20, 2010 from http: //www. wrongdiagnosis. com/l/listeriosis/prevent. htm

Stakeholders p Dept. of Agriculture, Food Safety and Inspection Service http: //www. fsis. usda. gov/ p Food and Drug Administration http: //www. fda. gov/ p United States Department of Agriculture http: //www. usda. gov/wps/portal/usdahome p National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Division of Foodborne, Bacterial and Mycotic Diseases (Centers for Disease Control and Prevention) http: //www. cdc. gov/nczved/divisions/dfbmd/ p National Institute of Allergy and Infectious Diseases http: //www 3. niaid. nih. gov/

Sources for further reading… Listeria Infection (Listeriosis) (Mayo Foundation for Medical Education and Research) http: //www. mayoclinic. com/print/listeriainfection/DS 00963/DSECTION=all&METHOD=print Special Handling for Ready-to-Eat, Refrigerated Foods: Reducing the Risks of Food borne Listeria (Food and Drug Administration) http: //www. fda. gov/Food/Resources. For. You/Consumers/ucm 079667. htm Food Safety for Moms to Be: While You're Pregnant – Listeria (Food and Drug Administration) http: //www. fda. gov/Food/Resources. For. You/Consumers/ucm 083320. htm Protect Your Baby and Yourself from Listeriosis (Dept. of Agriculture, Food Safety and Inspection Service) http: //www. fsis. usda. gov/Fact_Sheets/Protect_Your_Baby/index. asp CDC (MMWR). 2008. Outbreak of Listeria monocytogenes Infections Associated with Pasteurized Milk from a Local Dairy --- Massachusetts, 2007. MMWR October 10, 2008 / 57(40); 1097 -1100. http: //www. cdc. gov/mmwr/preview/mmwrhtml/mm 5740 a 1. htm Weinstein K, Ortiz J. Listeria Monocytogenes 2008. Available online at: http: //emedicine. medscape. com/article/220684 -print Zach T. Listeria infection. e. Medicine. com 2007. Available online at: http: //emedicine. medscape. com/article/965841 -print

References p American Meat Institute Fact Sheet. 2008. Listeria monocytogenes. Retrieved January 20, 2010 from http: //www. meatami. com/ht/a/Get. Document. Action/i/11478. pdf p The Centers for Disease Control and Prevention (CDC). 2005. Food Borne Illness. Retrieved January 20, 2010 from http: //www. cdc. gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g. htm p CDC. 2008. Listeriosis. Retrieved January 22, 2010 from http: //www. cdc. gov/nczved/dfbmd/disease_listing/listeriosis_gi. html p Clark, Marler. 2010. About Listeria. Retrieved January 23, 2010 from http: //www. aboutlisteria. com/listeria_symptoms_risks p Engela, Ronald E. , Catherine E. Adamsa and Lester M. Crawforda. 1990. Foodborne listeriosis: risk from meat and poultry. Retrieved January 23, 2010 from http: //www. sciencedirect. com/science? _ob=Article. URL&_udi=B 6 T 6 S-49 N 8 SPD 1 V&_user=10&_cover. Date=01%2 F 31%2 F 1990&_rdoc=1&_fmt=high&_orig=search&_sort=d&_doc anchor=&view=c&_search. Str. Id=1178273829&_rerun. Origin=google&_acct=C 000050221&_version =1&_url. Version=0&_userid=10&md 5=b 4 ce 6 f 6 cd 78498 b 7610 b 4 a 14 dec 389 ff p Pirie, J. H. H. 1940. Listeria: change of name for a genus of bacteria. Nature. 145: 264 p Medic 8. com. 2010. Listeria. Retrieved January 23, 2010 from http: //www. medic 8. com/healthguide/articles/listeria. html p Wrong Diagnosis. 2010. Prevention of Listeriosis. Retrieved January 20, 2010 from http: //www. wrongdiagnosis. com/l/listeriosis/prevent. htm

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