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Press Release

Update: Listeriosis Outbreak Investigation

October 9, 2002
Contact: CDC, Media Relations
(404) 639−3286

CDC, several state and local health departments, and the United States Department of Agriculture (USDA) are investigating an outbreak of listeriosis, primarily affecting persons in the northeastern United States. Thus far, 44 ill persons with the outbreak strain of Listeria have been detected; most were hospitalized, 7 died, and 3 pregnant women had miscarriages or stillbirths. The data to date indicate that precooked turkey deli meat, the kind that is sliced at the deli counter of a grocery or restaurant, is the most likely cause of this outbreak. Health and regulatory officials are continuing to investigate to determine the brand(s) and origin of the product involved.

Listeriosis is a very serious foodborne disease that can be life-threatening to certain individuals, including the elderly or those with weakened immune systems. It can also cause miscarriages and stillbirths in pregnant women. Persons in these risk groups who reside in the affected states may reduce their risk of infection by not eating sliced turkey deli meats or by thoroughly heating them until steaming hot.

Today USDA's Food Safety and Inspection Service (FSIS) announced a recall of turkey deli meat from a production plant in Pennsylvania because Listeria was detected in a turkey product package. The Listeria strain detected in this product is different from the strain that is causing the outbreak.

The affected patients live in 8 states: Pennsylvania (14 cases), New York (11 cases in New York City, 6 in other locations), New Jersey (4 cases), Delaware (4 cases), Maryland (2 cases), Connecticut (1 case), Michigan (1 case), and Massachusetts (1 case). Twenty-six patients were male and 18 were female. Fourteen patients were age 65 or above, 14 patients were age 1 to 64 years and had an immunocompromising medical condition, 7 others were pregnant, and 3 were neonates; 6 patients were age 1 to 64 years and were not pregnant or immunocompromised. Of the seven patients who died, six had immunocompromising conditions (3 of these patients were also age 65 or older), and one was a neonate. The most recent patient became ill on September 30.

In addition to the patients whose illnesses have been confirmed as part of the outbreak, CDC and state and local health departments have learned about other cases of Listeria infection in the same region. DNA subtyping has shown that strains from over 50 patients in these same states are different from the outbreak strain and 16 of these patients have died; these illnesses are part of the "background" of sporadic Listeria infections and are likely due to a variety of different foods. In addition, testing of strains from several additional persons is ongoing, some of these may be identified as the outbreak strain.

Because pregnant women, older adults, and people with weakened immune systems are at higher risk for listeriosis, we recommend the following measures for those persons:

  • Do not eat hot dogs and luncheon meats, unless they are reheated until steaming hot.

  • Avoid cross-contaminating other foods, utensils, and food preparation surfaces with fluid from hot dog packages, and wash hands after handling hot dogs.

  • Do not eat soft cheeses such as Feta, Brie and Camembert cheeses, blue-veined cheeses, and Mexican-style cheeses such as "queso blanco fresco." Cheeses that may be eaten include hard cheeses; semi-soft cheeses such as mozzarella; pasteurized processed cheeses such as slices and spreads; cream cheese; and cottage cheese.

  • Do not eat refrigerated pβtιs or meat spreads. Canned or shelf-stable pβtιs and meat spreads may be eaten.

  • Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.

  • Do not drink raw (unpasteurized) milk or eat foods that contain unpasteurized milk.

About 2500 cases of listeriosis occur each year in the United States. The initial symptoms are often fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea or diarrhea. The illness may be mild and ill persons sometimes describe their illness as flu-like. If infection spreads to the nervous system, symptoms such as headache, stiff neck, confusion, loss of balance, or convulsions can occur. Most cases of listeriosis and most deaths occur in adults with weakened immune systems, the elderly, pregnant women, and newborns. However, infections can occur occasionally in otherwise healthy persons. Infections during pregnancy can lead to miscarriages, stillbirths, and infection of newborn infants. Previous outbreaks of listeriosis have been linked to a variety of foods especially processed meats (such as hot dogs, deli meats, and patι) and dairy products made from unpasteurized milk.

If you have questions about Listeria, you can call your local or state health department, your physician, or visit the CDC web site at http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_g.htm or visit the USDA web site at http://www.usda.gov/news/releases/2001/01/0020.htm.

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