Multistate outbreak of listeriosis associated with cantaloupe
- PMID:24004121
- DOI: 10.1056/NEJMoa1215837
Multistate outbreak of listeriosis associated with cantaloupe
Abstract
Background: Although new pathogen-vehicle combinations are increasingly being identified in produce-related disease outbreaks, fresh produce is a rarely recognized vehicle for listeriosis. We investigated a nationwide listeriosis outbreak that occurred in the United States during 2011.
Methods: We defined an outbreak-related case as a laboratory-confirmed infection with any of five outbreak-related subtypes of Listeria monocytogenes isolated during the period from August 1 through October 31, 2011. Multistate epidemiologic, trace-back, and environmental investigations were conducted, and outbreak-related cases were compared with sporadic cases reported previously to the Listeria Initiative, an enhanced surveillance system that routinely collects detailed information about U.S. cases of listeriosis.
Results: We identified 147 outbreak-related cases in 28 states. The majority of patients (127 of 147, 86%) were 60 years of age or older. Seven infections among pregnant women and newborns and one related miscarriage were reported. Of 145 patients for whom information about hospitalization was available, 143 (99%) were hospitalized. Thirty-three of the 147 patients (22%) died. Patients with outbreak-related illness were significantly more likely to have eaten cantaloupe than were patients 60 years of age or older with sporadic illness (odds ratio, 8.5; 95% confidence interval, 1.3 to ∞). Cantaloupe and environmental samples collected during the investigation yielded isolates matching all five outbreak-related subtypes, confirming that whole cantaloupe produced by a single Colorado farm was the outbreak source. Unsanitary conditions identified in the processing facility operated by the farm probably resulted in contamination of cantaloupes with L. monocytogenes.
Conclusions: Raw produce, including cantaloupe, can serve as a vehicle for listeriosis. This outbreak highlights the importance of preventing produce contamination within farm and processing environments.
Similar articles
- Multistate outbreak of listeriosis associated with Jensen Farms cantaloupe--United States, August-September 2011.Centers for Disease Control and Prevention.Centers for Disease Control and Prevention.MMWR Morb Mortal Wkly Rep. 2011 Oct 7;60(39):1357-8.MMWR Morb Mortal Wkly Rep. 2011.PMID:21976119
- Multistate outbreak of Listeriosis linked to turkey deli meat and subsequent changes in US regulatory policy.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.Gottlieb SL, et al.Clin Infect Dis. 2006 Jan 1;42(1):29-36. doi: 10.1086/498113. Epub 2005 Nov 23.Clin Infect Dis. 2006.PMID:16323088
- Listeria monocytogenes infection from foods prepared in a commercial establishment: a case-control study of potential sources of sporadic illness in the United States.Varma JK, Samuel MC, Marcus R, Hoekstra RM, Medus C, Segler S, Anderson BJ, Jones TF, Shiferaw B, Haubert N, Megginson M, McCarthy PV, Graves L, Gilder TV, Angulo FJ.Varma JK, et al.Clin Infect Dis. 2007 Feb 15;44(4):521-8. doi: 10.1086/509920. Epub 2007 Jan 8.Clin Infect Dis. 2007.PMID:17243054
- Challenges in listeriosis cluster and outbreak investigations, Province of Quebec, 1997-2011.Gaulin C, Gravel G, Bekal S, Currie A, Ramsay D, Roy S.Gaulin C, et al.Foodborne Pathog Dis. 2014 Jan;11(1):1-7. doi: 10.1089/fpd.2013.1574. Epub 2013 Oct 17.Foodborne Pathog Dis. 2014.PMID:24134667Review.
- Fresh Produce-Associated Listeriosis Outbreaks, Sources of Concern, Teachable Moments, and Insights.Garner D, Kathariou S.Garner D, et al.J Food Prot. 2016 Feb;79(2):337-44. doi: 10.4315/0362-028X.JFP-15-387.J Food Prot. 2016.PMID:26818997Review.
Cited by
- Identification of a peptide-pheromone that enhances Listeria monocytogenes escape from host cell vacuoles.Xayarath B, Alonzo F 3rd, Freitag NE.Xayarath B, et al.PLoS Pathog. 2015 Mar 30;11(3):e1004707. doi: 10.1371/journal.ppat.1004707. eCollection 2015 Mar.PLoS Pathog. 2015.PMID:25822753Free PMC article.
- Control selection methods in recent case-control studies conducted as part of infectious disease outbreaks.Waldram A, McKerr C, Gobin M, Adak G, Stuart JM, Cleary P.Waldram A, et al.Eur J Epidemiol. 2015 Jun;30(6):465-71. doi: 10.1007/s10654-015-0005-x. Epub 2015 Mar 12.Eur J Epidemiol. 2015.PMID:25762171Review.
- Nutrition and listeriosis during pregnancy: a systematic review.Moran LJ, Verwiel Y, Bahri Khomami M, Roseboom TJ, Painter RC.Moran LJ, et al.J Nutr Sci. 2018 Sep 24;7:e25. doi: 10.1017/jns.2018.16. eCollection 2018.J Nutr Sci. 2018.PMID:30275948Free PMC article.Review.
- The Listeria monocytogenes Key Virulence Determinants hly and prfA are involved in Biofilm Formation and Aggregation but not Colonization of Fresh Produce.Price R, Jayeola V, Niedermeyer J, Parsons C, Kathariou S.Price R, et al.Pathogens. 2018 Feb 1;7(1):18. doi: 10.3390/pathogens7010018.Pathogens. 2018.PMID:29389865Free PMC article.
- Efficacy of Ozonated Water, Chlorine, Chlorine Dioxide, Quaternary Ammonium Compounds and Peroxyacetic Acid AgainstListeria monocytogenes Biofilm on Polystyrene Surfaces.Korany AM, Hua Z, Green T, Hanrahan I, El-Shinawy SH, El-Kholy A, Hassan G, Zhu MJ.Korany AM, et al.Front Microbiol. 2018 Oct 12;9:2296. doi: 10.3389/fmicb.2018.02296. eCollection 2018.Front Microbiol. 2018.PMID:30369909Free PMC article.
MeSH terms
Related information
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical