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Division of Foodborne, Bacterial and Mycotic Diseases (DFBMD)
Listeriosis
Clinical Features
Manifestations are host-dependent. In elderly and immunocompromised persons, sepsis and meningitis are the main presentations. Pregnant women may experience a mild, flu-like illness followed by fetal loss or bacteremia and meningitis in their newborns. Immunocompetent persons may experience acute febrile gastroenteritis.
Etiologic Agent
Listeria monocytogenes, a gram-positive rod-shaped bacterium.
Incidence
Last estimated at 2500 cases annually in the United States, based on data through 1997 (but see Trends below).
Sequelae
Last estimated at 500 fatal cases annually in the United States, based on data through 1997 ( but see Trends below).
Transmission
Contaminated food. Rare cases of nosocomial transmission have been reported.
Risk Groups
For invasive disease: immunocompromised individuals, pregnant women and their fetuses and neonates, and the elderly.
Surveillance
Listeriosis was added to the list of nationally notifiable diseases in 2001. To improve surveillance, the Council of State and Territorial Epidemiologists has recommended that all L. monocytogenes isolates be forwarded to state public health laboratories for subtyping through the National Molecular Subtyping Network for Foodborne Disease Surveillance (PulseNet). All states have regulations requiring health care providers to report cases of listeriosis and public health officials try to interview all persons with listeriosis promptly using a standard questionnaire about high risk foods. In addition, FoodNet conducts active laboratory- and population-based surveillance.
The annual incidence of listeriosis decreased by 34% between 1989 and 1993; an analysis of the incidence trend from 1996 to 2006 revealed a 36% decline. However, outbreaks continue to occur. In 2002, an outbreak that resulted in 54 illnesses, 8 deaths, and 3 fetal deaths in 9 states was traced to consumption of contaminated turkey meat.
Challenges
Improve the safety of processed meats through meticulous in-plant sanitation and post-packaging pasteurization; intensify education efforts for high-risk consumers to reduce their risk of listeriosis.
Opportunities
Improve detection of dispersed outbreaks through PulseNet; compare subtypes of L. monocytogenes strains isolated from human cases with those isolated from recalled foods; determine the infectious dose through analysis of foods implicated in outbreaks; look for L. monocytogenes as a cause of outbreaks of febrile gastroenteritis where no other pathogens are identified.
Content Source: National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)
Program Contents
Contact Information
1600 Clifton Road NE
MS-C09
Atlanta, GA 30333
Phone: +1-800-311-1603