Listeria food poisoning - Listeria infection
The first outbreak of the confirmation of an indirect transmission from animals to humans until 1983, although L. monocytogenes has been recognized as an animal pathogen over 80 years ago, reported in the maritime provinces of Canada. Manure were stored in this outbreak, cabbage, in the cold during the winter by contact with infected sheep contaminated with listeria. A subsequent outbreak in California in 1985 confirmed the role of food in the dissemination of listeriosis. Has since been brought Listeria in many outbreaks of foodborne disease associated most often caused by exposure to contaminated dairy products and meat products, including Turkey and sausages, pies, hot dogs and seafood. [4]Given the wide dissemination in the environment and the food supply, taking Listeria has been described as "very common." [18]The incidence of Listeria infectionsListeria bacteria in the environment far found in soil, decaying vegetation, including in water and can be part of the fecal flora of a variety of mammals, including healthy human adults. [4, 18] According to the FDA, "Studies show that 1-10% of the people can be intestinal carriers of Listeria." [14] Another authority states that the "organism from stool of about 5% of healthy adults isolated." [18] A total seasonal trends show a remarkable peak total Listeria cases and related-deaths of July to October. [3]Is taken by mouth, Listeria is to virulent pathogens, with up to 20% of clinical infections resulting in death. [3] These bacteria especially serious illness and death in individuals with immature or compromised immune systems. [13, 18] Therefore, most healthy adults may Listeria with little to no risk of infection and disease to be suspended. [4, 11]A study published in 1995 projected Listeria Infection rates to the US population, suggesting that an estimated 1,965 cases and 481 deaths in 1989, compared with an estimated 1092 cases and 248 deaths in 1993, 44% and 48% reduction in disease and death, respectively. [25] In comparison, a USDA study published in 1996 estimated that there was in 1993 from 1.795 to 1,860 Listeria-related cases and 445 to 510 deaths, with 85-95% of these on the consumption of contaminated food. [28] The listeriosis related mortality decreased annually by 10.7% from 1990 to 1996 and by 4.3% from 1996 to 2005 [3]Among adults aged 50 years and older, infection rates were decreased by an estimated 16.2 per 1 million in 1989 to 10.2 million in 1993. [25] The perinatal diseases declined from 17.4 cases per 100,000 live births in 1989 to 8.6 cases per 100,000 births in 1993 [25], neonatal infections are often more severe, with a mortality rate of 25-50%. [4]According to the CDC National Center for Zoonotic, Vector-Borne, and intestinal disorders:
Listeriosis was recorded in 2001 in the list of nationally notifiable diseases to improve monitoring, the Council of State and Territorial Epidemiologists has recommended that all passed by L. monocytogenes isolates to public health laboratories for subtyping by the National Molecular subtyping network for foodborne disease surveillance state are (PulseNet). All states have regulations require health care providers to try to report cases of listeriosis and public health officials to interview all individuals with listeriosis immediately using a standard questionnaire to high risk foods. In addition, results FoodNet active laboratory and population-based survey. [7]In 2006, public health officials from 48 States reported 1,270 foodborne disease outbreaks, with a confirmed or suspected source of outbreaks in 884 (70%). [8] Only one of the outbreaks with a confirmed source was attributed to Listeria, with this outbreak with eleven hospitalizations and one death. [8] In the next year of 17,883 laboratory-confirmed cases of the CDC attributed 122 Listeria. [9] In 2009, there were 158 confirmed Listeria infections, representing an incidence rate of 0.34 cases per 100,000 persons in the United States. [10] These data showed an incidence rate of 0.27 cases per 100,000 people, representing a decrease of 42% from 1996 to 1998. [10] But according to Technical Information Website CDC, it is estimated that there are 1,600 cases of listeria infection per year in the United States on the basis of data on 2008 [7]The 2009 figures represents a reported 30% decrease in the number of infections in comparison to the 1996-1998 rates of infection. [10] Although the type and degree of under-reporting is subject to dispute, all agree that the confirmed cases represent only the tip of the iceberg. [6, 13] In fact, in one study estimated the annual incidence rate for Listeria to 1.795 to 1.860 cases per 100,000 person be with 445-510 cases end with death. [28]Finally, in a study FoodNet laboratory-confirmed cases of invasive-wo-infection detected in the blood, cerebrospinal fluid, amniotic fluid, placenta or products of conception-the number of listeriosis cases decreased by 24% from 1996 to 2003 [33] During this same period, pregnancy-associated diseases have fallen by 37%, while the cases of the 50 years and over 23% reduced. [33]Listeria bacteria are widely distributed in nature.Listeria is a common occurrence in nature, in countries such as water, soil, infected animals, human and animal feces, raw and treated wastewater, leafy vegetables, wastewater from poultry and meat processing plants, decaying corn and soybeans, improperly fermented silage found far and raw (unpasteurized) milk. [18, 23, 27]Foods were generally identified as sources of Listeria infection, are not properly pasteurized fluid milk, cheeses (particularly soft-ripened varieties such as traditional Mexican cheese, camembert and ricotta), ice cream, raw vegetables, fermented raw-meat sausages, raw and cooked poultry, and cooked meats-often referred to ready-to-eat (RTE) as a "sausage". [18, 21, 23, 28] One study found that over a period of five years of testing, several processing plants, Listeria monocytogenes was isolated smoked by 14% of 1080 samples of smoked fish and shellfish. [16]Ready-to-eat foods have proven to be a remarkable and constant source of Listeria. [14, 21] For example, a forschungs study of Listeria Study Group conducted found that Listeria monocytogenes grew by at least one food sample in the fridges of 64% of those with a confirmed Listeria infection (79 of 123 patients) and in 11% of more than 2,000 food samples collected in the investigation. [21] In addition, 33% of the food refrigerators (26 79) contained, which grew as expected by chance the same tribe with which had been infected individual, a frequency is much higher. [21] A frequently cited USDA study that tests summarized the available literature that:
In samples of raw meat and poultry from seven countries were detectable up to 70 percent of Listeria quantities [13]. Schuchat [23] found that 32 percent of 165 culture-confirmed listeriosis cases could eat deli counter or soft cheese due bought in a store. In Pinner [21] obtained microbiological survey of chilled food samples from households with listeriosis patients, 36 percent of beef samples and 31 percent of the poultry samples were contaminated with listeria.The prevalence of Listeria in ready-to-eat meat did not prove difficult to explain. [26, 29] As an expert in another oft-cited article was found:
The central production of prepared ready-to-eat foods ... increases the risk of higher contamination because it requires that foods be stored for extended periods at refrigeration temperatures that favor the growth of Listeria. During the manufacture, transport and storage of prepared foods, the organism can be multiplied to reach cause a required threshold value, infections. [4]The risk, due to the risk of Listeria in ready-to-eat meat, the USDA provided prompt to explain the bacterium a clobbering in this type of meat products and, as a consequence, to a zero-tolerance policy this for the present take deadly pathogen. [7, 29]A USDA Baseline Data Collection Program in 1994 performed Listeria contamination documented in 15.0% of the broiler chicken carcasses [30]. Not to test subsequent USDA data collection for the prevalence of Listeria in chicken or turkey. [31, 32]Transmission and infection with ListeriaWith the exception of transmission from mother to the fetus is human-to-human transmission of Listeria is not known. [18] The infection is almost exclusively caused by eating food contaminated by the uptake of the bacteria most often. [18, 21, 23] The most widely accepted estimate of food transfer of 85 to 95% of all cases of Listeria. [23, 28The infection dose, that is, the amount of bacteria was added to cause disease is unknown. [4, 18, 26] In an otherwise healthy person, an extremely large number of Listeria bacteria must be included to disease estimated somewhere 10-100 million live bacteria cause (or colony-forming units "CFU") in healthy individuals and only 0.1 to 10,000,000 CFU in people at high risk of infection. [4, 18, 26] Even with such a dose, a healthy individual is only a fever, diarrhea, and related gastrointestinal symptoms suffer. [4, 18].The time period from infection to onset of symptoms typically used as the incubation time can vary referred to a considerable extent. The symptoms of Listeria infection can develop at any time from 2 to 70 days after eating contaminated food. [4, 5] According to an authoritative text:
The incubation period for invasive disease is not well established, but evidence of a few cases on certain points related Ingestion of 11 to 70 days with a mean of 31 days. In a report, two pregnant women whose only shared commitment was to attend a party developed Listeria bacteremia with the same enzyme unusual way; Incubation periods for diseases were 19 and 23 days. [18]Adults may be contaminated by eating foods with listeria listeria, but babies can be born with listeriosis if their mothers eat contaminated food during pregnancy. [4, 24] The mode of transmission of Listeria to the fetus either transplacental via the maternal circulation or ascending from a colonized genital tract. [24] infections during pregnancy can premature birth, miscarriage, stillbirth, or serious health problems for the newborn lead. [18, 24]Occurrence of Listeria in HIV-positive individuals is higher than in the general population. [17, 18] One study found that:
The estimated incidence of listeriosis in HIV-infected patients in Atlanta metropolitan regions was 52 cases per 100,000 patients per year, and in patients with AIDS, it was 115 cases per 100,000 patients per year, rates 65-145 times higher than the general population. HIV-associated cases occurred in adults who were 29-62 years old and in the postnatal infants who were 2 and 6 months old. [17]Pregnant women make up about 30% of all cases of infection, while 60% of the cases in which the 10- to 40-year-olds. [18]Who is most at risk for becoming ill with Listeria?The elderly, pregnant women and immunocompromised person is most at risk for Listeria contract.Several parts of the population are at increased risk and should be informed so that proper precautions can be taken. [19,20, 27] The body's defense against Listeria is called a "cell-mediated immunity" because of the success of the defense against infections depends on our cells (unlike our antibodies), especially lymphocytes called "T-cells." [12] Therefore, people whose cell-mediated immunity is suppressed more vulnerable to the devastating effects of listeriosis, most notably HIV-infected persons who have been found to have a Listeria mortality of 29%. [12, 17, 18]Pregnant naturally have a depressed cell-mediated immune system. [18, 24] In addition, the immune systems of fetuses and newborns are very immature and are extremely vulnerable to these types of infections. [24] Other adults, especially transplant recipients and lymphoma patients are necessary, given therapies with the specific intent of depression of T-cells, and these individuals become particularly vulnerable, Listeria and. [7, 18, 27]According to the CDC and other public health organizations, individuals at increased risk that infected and always difficult to Listeria include the following groups:
Pregnant women: They are about 20 times more likely than other healthy adults to get listeriosis to. About one-third of listeriosis cases happen during pregnancy.
Newborn: newborn and not pregnant even suffer from the serious consequences of the infection in pregnancy.
People with a weakened immune system
People with cancer, diabetes or kidney disease
People with AIDS: They are almost 300 times more likely to get listeriosis than people with normal immune systems.
Those glucocorticosteroid drugs (such as cortisone)
The elderly [11, 20, 21]What are the symptoms of Listeria infection?When a person is infected and developed symptoms of Listeria infection, the resulting disease called listeriosis. [4, 11, 18] Only a small percentage of people who do become ill or are taking any Listeria symptoms. [18] For those who do develop symptoms as a result of their infection, the resulting disease is either minor or relatively heavy, in what is sometimes called a "bimodal distribution of severity". [13, 28]At the mild end of the spectrum, listeriosis usually a sudden onset of fever, chills, severe headache, vomiting and other flu-like symptoms. [18, 28] Along these same lines, the CDC that infected persons may include fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea or diarrhea. [11] If present, the diarrhea usually lasts 1-4 days (42 hours is as average), with 12 bowel movements per day at its worst. [18]
Most healthy adults and children who consume contaminated food experience only mild to moderate symptoms. The infection is self-limited in general, since in healthy hosts Listeria action stimulates the production of tumor necrosis factor and other cytokines to activate monocytes and macrophages in order to eliminate the organism. Who continue Few people with normal immune function, severe, life-threatening forms of listeriosis, characterized by septic shock, meningitis and encephalitis. [4]As already mentioned, in pregnancy, women have a slightly compromised immune systems that makes them susceptible to Listeria infection. [19] When infected, the disease called acute fever, muscle aches, back pain and headache is. [18, 24], illness occurs usually in the third trimester, which is the smallest in immunity. [18] An infection during pregnancy can lead to premature birth, miscarriage, infection of the newborn, or even stillbirth. [24, 28] Twenty-two percent of these infections result in stillbirth or neonatal death. [18]Newborns may present clinically with early onset (less than 7 days) or late-onset forms of infection (7 or more days). [3] The often with an early start to form in the first 24 hours of life with sepsis (infection in the blood) diagnosed. [3, 18] Early-onset listeriosis is most commonly acquired through trans-placental transmission. [18, 24] Delayed neonatal listeriosis less common than the early-onset form. [4, 18, 24] The clinical symptoms may be subtle and include irritability, fever and poor nutrition. [24] The nature of the acquisition of late-onset listeriosis is not well known. [18, 24]Complications of listeria infectionBlood infection and meningitis are both complications of Listeria infection. The death is the most serious consequence of listeriosis.For people who suffer from a Listeria infection that will not solve itself, the complications can (or consequential) of many. [4, 28] The most common is septicemia (bacterial pathogens in the blood, also known as bacteremia), with meningitis as the second most common. [4, 18] Other complications can include inflammation of the brain and brain stem (brain inflammation), brain abscess, inflammation of the heart membrane (endocarditis) and localized infection, either internally or to the skin. [18]The death is the most serious consequence of listeriosis, and it is tragic usual. [3] For example, based on 2009 FoodNet surveillance data, 89.2% of patients Listeria ended up in hospital, the highest hospitalization rate for pathogenic bacterial infection. [10] Persons 50 years and older, there was a 17.5% death rate is also the highest compared to other pathogens. [10, 18]How is Listeria infection diagnosed?Listeria infection is diagnosed by blood or stool cultures. Spinal fluid can also be tested for Listeria.Since there are only a few symptoms that are unique to listeriosis need doctors can cause a variety of possible causes of infections, including viral infections (such as flu) and other bacterial infections such as sepsis or meningitis look at. [4, 18, 19]
Early diagnosis and treatment of listeriosis in high-risk patients is critical, as the result of untreated infection can be devastating. This is especially true for pregnant women because of the increased risk of miscarriage and premature birth. Depending on the risk group, death rates of listeriosis range from 10% to 50%, with the highest rate in neonates in the first week of life. [4]Method typically used to disrupt identify in stool cultures diarrhea-causing bacteria or to limit the growth of Listeria, so that it is less likely identified and isolated for further testing. [18] On the other hand, routine methods are effective for the isolation of Listeria from spinal fluid, blood and synovial fluid. [4, 18] magnetic resonance imaging (MRI) is used to confirm or rule out brain or brainstem involvement. [18]Treatment of Listeria infectionListeria infections usually without treatment, but antibiotics may be necessary to treat some cases.Listeriosis is usually a self-limited disease which means that a majority of infected individuals without the need for medical care improve. [4, 11, 14, 18], but for those patients with high fever, a stool culture and antibiotic treatment may be justified in otherwise healthy individuals. [4, 18] Although there are no studies to determine which drugs or duration of treatment is best, ampicillin is commonly referred to as the "preferred agent." [18] There is no consensus on the best approach for patients who are allergic to penicillin [18].Invasive infections with Listeria can be treated with antibiotics. [18] When infection occurs during pregnancy, antibiotics given promptly to the pregnant woman can often prevent infection of the fetus or newborn. [18, 24] Babies with listeriosis receive the same antibiotics as adults, although a combination of antibiotics is often used to physicians, certain diagnosis.Antibiotic resistance in bacteria
Antimicrobial resistance is to be in food poisoning pathogens.Antibiotic resistance in bacteria is an emerging and growing threat to human health. [1, 4] The doctors are increasingly aware that the increase antibiotic resistance in pathogens and are prescribed as a result, patients who received antibiotics, are at increased risk for acquiring antimicrobial resistant foodborne infections. [1] In fact, "increased frequency of treatment failure in acute diseases and increased severity of infection may manifest with longer duration of illness, increased frequency of bloodstream infections, increased hospitalization or increased mortality." [3]The use of antimicrobial agents in the feed of food animals is by the FDA estimated 100 million pounds per year. [4] It is estimated that 36% to 70% of the produced in the United States antibiotics used in food or animal feed in a prophylactic treatment to animal diseases. [3, 4, 18] In 2002, the Minnesota Medical Association published an article by David Wallinga, MD, MPH wrote:
According to the [Union of Concerned Scientists], 70 percent of all in the United States for all purposes, or about £ 24,600,000 per year, are poultry, pigs and cattle for non-therapeutic purposes fed antimicrobials used, in the absence of disease. More than half are "medically important" antimicrobial agents; is identical or closely related to human use in the context that resistance to the animal drug may confer resistance to the human-like drug. Penicillin, tetracycline, macrolides, streptogramins, and sulfonamides are well known examples. [33]The use of antibiotics in feed for livestock, animal prophylactically to prevent disease and the use of antibiotics in humans must be reduced unnecessarily. [1, 25] European countries have reduced the use of antibiotics in animal feed and seen a corresponding reduction in antibiotic-resistant diseases in
The economic impact of Listeria infections
The total cost estimates for Listeria infections in the United States from $ 61.7 to $ 64.8 million per year to run.
The USDA Economic Research Service (ERS) its first comprehensive cost estimates for sixteen foodborne bacterial pathogens in 1989 [22] Five years later, it was estimated that in 1993 there were 1795-1860 Listeria infections that require hospitalization, with 295 -360 of these cases of pregnant women. [28] On the basis of these estimates were the medical expenses that Listeria infection had caused every year, allegedly by $ 61.7 to $ 64.8 million, including those individuals who ultimately died as a result of the infection. [28]For these same acute cases productivity costs were estimated lead of $ 125.8 154.4 million dollars per year. [28] The costs associated with the productivity was associated Listeria-related chronic diseases estimated that an additional $ 38 million a year. [28] In sum, "[e] of the total costs for the 1795-1860 cases of listeriosis stimates range from $ 232,700,000 to $ 264,400,000 a year." [28]
Campylobacter, Salmonella, E. coli O157: H7 and Listeria monocytogenes 2000 USDA for four excitation updated cost estimates. [28] Estimates of 2000, the CDC then newly released estimates of the annual foodborne illnesses based, and put the total cost in the United States for these four pathogens at 6.5 billion dollars per year. [28] For Listeria said, it was estimated that the cost amounted to 2.3 billion dollars per year, based on 2493 cases, which involved 2,298 hospitalizations and 499 deaths. [28] More recently, in 2007, it was estimated that the global cost of all foodborne disease was $ 1.4 trillion per year. [6Real Life Effects of Listeria infection
Listeria infection often to death among elderly population and stillbirth, miscarriage or premature delivery in pregnant women.
Because Listeria infection is the most severe in the elderly, pregnant women and newborns, symptoms of infection are very different.
In older adults or immunocompromised individuals, septicemia (Listeria bacteria in the bloodstream) and meningitis are the most common indicators of the disease.
In pregnant women, a mild, flu-like disease caused by miscarriage, premature birth or stillbirth observed.
In newborns, bacteremia (Listeria bacteria in the bloodstream) and meningitis are the most common indicators of Listeria infection.
Several families changed their lives when they lost to Listeria infection a loved one have shared their stories here. All were victims of the 2012 outbreak of Listeria contaminated Jensen Farms attributed melons.
Herbert Stevens and Charles "Chuck" Palmer both survived Listeria infections in 2011, but their struggles with this pathogen they had greatly weakened. Marie Jones and William beach both died as a result of their Listeria infections. The stories of these victims of cantaloupe Listeria outbreak 4 Here are shared.
Dr. Michael Hauser died after a devastating Listeria infection he contracted from Jensen Farms cantaloupe.Prevent infection by Listeria
Important food safety measures should be taken to prevent Listeria infection - especially among the elderly and pregnant women.
Given the wide dissemination in the environment, and the fact that the vast majority of Listeria infections are the result of consuming contaminated food or water to prevent disease and death necessarily (and understandably) a food safety problem.
Listeria monocytogenes is of particular concern in relation to the handling of food because they grow at refrigerator temperatures (4 ° C to 10 ° C) temperatures, which are commonly used to control pathogens in food. Freezing also has little adverse effect on the microbe. Although pasteurization sufficient to kill Listeria, failure to reach the desired temperature in big packages it can survive the organism. Food may be contaminated, even after the processing by the introduction of non-pasteurized material since happens during the production of certain cheese. Listeria can also be spread by contact with contaminated hands, equipment and work surfaces. [4]
To reduce the use of irradiation on Listeria to safe levels in foods has many proponents. [26] As of excellent CDC researchers, Robert V. Tauxe mentioned,
Ready-to-eat meats such as hot dogs, have already been to a pathogen-killing step if the meat is cooked been subjected in the factory so that contamination is usually the result of internal contamination after this step. Improved hygiene in many plants has reduced the incidence of infection by half since 1986, but there is a risk, as of a great hot dog-associated outbreak that occurred in 1999, additional heat treatment or irradiation of meat after it was packed Listeria shown eliminate that might be present at this point. [26]
The CDC provides a comprehensive list of recommendations and precautions to prevent Listeria infected as follows:
Thoroughly cook raw food from animal sources such as beef, pork, poultry or to a safe internal temperature. A list of recommended temperatures for meat and poultry, visit the website of USDA.
Rinse raw vegetables thoroughly under running water before eating.
Keep raw meat and poultry separate from vegetables and from cooked foods and ready-to-eat foods.
Do not drink raw (unpasteurized) milk and no food to eat unpasteurized milk in them.
Wash after handling uncooked food preparation and hands, knives, countertops and cutting boards.
Consume perishable and ready-to-eat foods as soon as possible.
Recommendations for persons at high risk, such as pregnant women and people with weakened immune systems, in addition to the above recommendations are:
Meat
Do not eat hot dogs, luncheon meats, sausage, other sausages (eg Bologna) or fermented dry sausage or if they are to an internal temperature of 165 ° C or until steaming hot before serving.
Prevent liquid from hot dogs and lunch meat packages on other foods, utensils and food preparation surfaces and wash your hands after handling hot dogs, luncheon meats and sausages.
Do not eat in the refrigerator or meat pie spreads from a deli or meat counter or from the refrigerated section of the store. Foods that require no refrigeration, such as cans or shelf stable meat pies and spreads are safe to eat. Refrigerate after opening.
Cheese
Do not eat soft cheeses such as feta, cream cheese, queso fresco, Brie, Camembert, blue or panela (queso panela), if they are not labeled as pasteurized milk. Make sure the label says "Made with pasteurized milk."
Seafood
Do not eat in the refrigerator smoked fish when it is in a hot food, how to give a casserole, or unless it is being canned or shelf-stable product. Cooling smoked fish, such as salmon, trout, whitefish, cod, tuna and mackerel, is most commonly known as "nova-style," "lox letters", "kippered," "smoked" or "jerk." These fish are typically found in the refrigerator or sold seafood and counters of grocery stores and delicatessens. Canned and shelf-stable tuna, salmon and other fish products are safe to eat.
Help keep you safe recommendations for food:
Note that Listeria monocytogenes to grow in foods in the refrigerator. Use a device, thermometer, such as a refrigerator thermometer to check the temperature inside the refrigerator. Does the refrigerator 40 ° F or lower and the freezer 0 ° F or lower.
Eliminate the spilled material in your fridge-especially juices from hot dog and lunch meat packaging, raw meat and raw poultry.
Clean the inside walls and shelves of your refrigerator with hot water and soap, then rinse.
Share promote residues in shallow containers fast, uniform cooling. Lid with airtight lid or put in plastic wrap or aluminum foil. Use leftovers within 3 to 4 days.
Use precooked or ready-to-eat food as fast as you can. The product must not refrigerate after the expiry date; follow USDA guidelines refrigerator storage time:
Hot Dogs - shop opened packages no longer than 1 week and unopened package no longer than 2 weeks in the refrigerator.
Lunch and Deli Meat - packed opening the factory sealed, undamaged no more than 2 weeks. Store opened packages and meat sliced in a deli no more than 3 to 5 days in the refrigerator. [11]
Additional preventive steps and precautions can be found on the websites of most state departments of health, including to be found, for example, the Minnesota Department of Health. [20] There is some good information at the Extension Service website of the Institute of Food and Agricultural Sciences at the University of Florida found. [27]
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