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Multistate outbreak of listeriosis linked to turkey deli meat and
subsequent changes in US regulatory policy.
Clin Infect Dis. 2006; 42(1):29-36.
Gottlieb SL, Newbern EC, Griffin PM, Graves LM, Hoekstra RM, Baker NL,
Hunter SB, Holt KG, Ramsey F, Head M, Levine P, Johnson G, Schoonmaker-Bopp
D, Reddy V, Kornstein L, Gerwel M, Nsubuga J, Edwards L, Stonecipher S, Hurd
S, Austin D, Jefferson MA, Young SD, Hise K, Chernak ED, Sobel J; Listeriosis
Outbreak Working Group.
Abstract
BACKGROUND: Listeriosis, a life-threatening foodborne illness caused by Listeria
monocytogenes, affects approximately 2500 Americans annually. Between July
and October 2002, an uncommon strain of L. monocytogenes caused an outbreak
of listeriosis in 9 states. METHODS: We conducted case finding, a case-control
study, and traceback and microbiological investigations to determine the
extent and source of the outbreak and to propose control measures. Case patients
were infected with the outbreak strain of L. monocytogenes between July and
November 2002 in 9 states, and control patients were infected with different
L. monocytogenes strains. Outcome measures included food exposure associated
with outbreak strain infection and source of the implicated food. RESULTS:
Fifty-four case patients were identified; 8 died, and 3 pregnant women had
fetal deaths. The case-control study included 38 case patients and 53 control
patients. Case patients consumed turkey deli meat much more frequently than
did control patients (P = .008, by Wilcoxon rank-sum test). In the 4 weeks
before illness, 55% of case patients had eaten deli turkey breast more than
1-2 times, compared with 28% of control patients (odds ratio, 4.5; 95% confidence
interval, 1.3-17.1). Investigation of turkey deli meat eaten by case patients
led to several turkey processing plants. The outbreak strain was found in
the environment of 1 processing plant and in turkey products from a second.
Together, the processing plants recalled > 30 million pounds of products.
Following the outbreak, the US Department of Agriculture's Food Safety and
Inspection Service issued new regulations outlining a L. monocytogenes control
and testing program for ready-to-eat meat and poultry processing plants.
CONCLUSIONS: Turkey deli meat was the source of a large multistate outbreak
of listeriosis. Investigation of this outbreak helped guide policy changes
designed to prevent future L. monocytogenes contamination of ready-to-eat
meat and poultry products.