Published Date: 2000-12-21 23:50:00
Subject: PRO/AH/EDR> Listeriosis, foodborne, turkey products - USA (02)
Archive Number: 20001221.2248
LISTERIOSIS, FOODBORNE, TURKEY PRODUCTS - USA (02)
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See Also
Listeriosis, foodborne, turkey products - USA 20001216.2201Listeria contamination, poultry - USA: Recall 20001215.2198
Date: 21 Dec 2000
From: ProMED-mail <promed@promedmail.org>
Source: MMWR [edited
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4950a1.htm>
Multistate Outbreak of Listeriosis --- United States, 2000
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Since May 2000, 29 illnesses caused by a strain of _Listeria monocytogenes_
(LM) have been identified in 10 states: New York (15 cases); Georgia (3);
Connecticut, Ohio, and Michigan (2 each); and California, Pennsylvania,
Tennessee, Utah, and Wisconsin (one each). Dates of LM isolation ranged
from 17 May through 26 November with 26 (90%) infections occurring since 15
July.
When subtyped, the LM isolates from these cases were indistinguishable by
pulsed-field gel electrophoresis (PulseNet pattern numbers GX6A16.0014 by
Asc1 and GX6A12.0017 by Apa1) and ribotyping (DUP-1053). This report
summarizes the investigation, which linked these cases of listeriosis to
eating deli turkey meat.
Included in the report were 8 perinatal cases and 21 nonperinatal
cases. Among the 21 nonperinatal cases, the median age was 65 years
(range: 29--92 years); 13 (62%) were female. The 29 cases have been
associated with 4 deaths and 3 miscarriages/stillbirths.
A case-control study conducted by 5 state and 2 local health departments
and CDC implicated eating deli turkey meat as the probable source of
infection. It was found that 13 (76%) of 17 case-patients and 5 (21%) of
24 controls ate deli turkey meat during the 30 days before illness onset
(Mantel-Haenszel weighted odds ratio=8.0; 95% confidence
interval=1.2--43.3). State health and agriculture departments investigated
13 stores and delicatessens where 11 patients reported purchasing turkey;
these stores and delicatessens carried turkey meat produced by at least 27
federally-inspected establishments. The investigation linked 2
establishments to 10 of 11 patients; one of these establishments produced
turkey meat for the second establishment.
On 8 Dec, investigators from the Food Safety and Inspection Service, U.S.
Department of Agriculture (USDA) began investigating the implicated
establishments. On 12 Dec, Cargill Turkey Products, Inc. (Waco, Texas)
stopped shipping ready-to-eat foods and, on 14 Dec, voluntarily recalled
processed turkey and chicken deli meat that might have been contaminated.
MMWR Editorial Note:
LM infection causes an estimated 2500 serious illnesses and 500 deaths in
the United States each year. Infected pregnant women may experience only a
mild, influenza-like illness; however, infections during pregnancy can lead
to premature delivery, miscarriage, stillbirth, or serious infection of the
newborn. Other persons at increased risk for infection are those aged >65
years, persons with cancer, diabetes, kidney disease, acquired
immunodeficiency syndrome, or who take immunosuppressive
medications. Manifestations of illness include meningitis and
sepsis. Healthy persons aged <65 years rarely are affected.
The risk for a person developing _Listeria_ infection after eating a
contaminated product is very small. Persons who have eaten a recalled
product but do not have symptoms do not require tests or treatment even if
they are in a high-risk group. However, persons in a high-risk group who
have eaten contaminated product and become ill within 2 months with fever
or signs of serious illness should consult a physician.
Guidelines for preventing listeriosis are similar to those for preventing
other food-borne illnesses. The general recommendations are 1) cook
thoroughly raw food from animal sources (e.g., beef, pork, or poultry); 2)
wash raw vegetables thoroughly before eating; 3) keep uncooked meats
separate from vegetables and from cooked foods and ready-to-eat foods; 4)
avoid raw (unpasteurized) milk or foods made from raw milk; and 5) wash
hands, knives, and cutting boards after each handling of uncooked foods.
Persons at high risk for listeriosis may choose to 1) avoid soft cheeses
(i.e., feta, Brie, Camembert, blue-veined, and Mexican-style cheese such as
queso fresco; hard cheeses, processed cheeses, cream cheese, cottage
cheese, or yogurt need not be avoided); 2) cook leftover foods or
ready-to-eat foods (e.g., hot dogs) until steaming hot; and 3) avoid foods
from deli counters (e.g., prepared salads, meats, and cheeses) or
thoroughly reheat cold cuts before eating.
Cases of listeriosis with onset since 1 Oct 2000 should be reported to
state and local health departments. Information about the recall is
available at:
<http://www.fsis.usda.gov/OA/recalls/rec_actv.htm>*. Consumers who have
recalled meat products, even if they have been stored in freezers, should
discard or return them to the point of purchase. High-risk consumers who
have processed turkey or chicken deli meat but are uncertain of the brand
should call the place of purchase to find out if it might be a recalled
product, or discard it. Answers to meat safety questions are available at
the USDA meat and poultry hotline, (800) 535-4555. Listeriosis information
is available at
<http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_g.htm>.
* References to sites of non-CDC organizations on the World-Wide Web are
provided as a service to MMWR readers and do not constitute or imply
endorsement of these organizations or their programs by CDC or the U.S.
Department of Health and Human Services. CDC is not responsible for the
content of pages found at these sites.
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