CDC reports tainted cheese linked to death and illness

Robin Wulffson MD's picture
listeriosis, Listeria monocytogenes, outbreak, death, illness, ricotta cheese
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Listeria monocytogenes is a virulent pathogen that can cause serious illness or death. On September 11, the Centers for Disease Control and Prevention (CDC) reported that as of that date, a total of 14 individuals have been infected with the bacterium.

Cases have been reported from 11 states and the District of Columbia. At least one death is due to the infection.

The listeriosis infections have been traced to one voluntarily recalled one lot of Frescolina brand ricotta salata cheese. On September 10, the distributor of the cheese, Forever Cheese, Inc., voluntarily recalled the entire lot. The number of ill individuals identified in each state is as follows: California, 1; Colorado, 1; District of Columbia, 1; Maryland, 3; Minnesota, 1; Nebraska, 1; New Jersey, 1; New Mexico, 1; New York, 1; Ohio, 1; Pennsylvania, 1; and Virginia, 1. All 14 infected persons have been hospitalized. Three deaths have been reported. Listeriosis contributed to at least one of these deaths.

Between June 20, 2012 and August 9, 2012, the cheese was sold to distributors for retailers and restaurants in California, Colorado, District of Columbia, Florida, Georgia, Illinois, Indiana, Maine, Maryland, Massachusetts, Montana, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Virginia, and Washington.

The CDC notes that the ricotta can have up to a four-month shelf life; thus, some consumers may still have it in their homes. Consumers who purchased recalled Frescolina brand ricotta salata cheese are advised not to eat it and to discard any remaining cheese. This is especially important for pregnant women, individuals with weakened immune systems, and seniors. The CDC advises: when in doubt, throw it out. The CDC notes that it will update the public on the progress of this investigation as information becomes available.

According to the CDC, listeriosis is an important public health problem in the United States. Listeria monocytogenes is commonly found in wild animals, domesticated animals, and in soil and water. The bacteria make many animals sick and commonly lead to miscarriage and stillbirth in domestic animals. Vegetables, meats, and other foods you eat can get infected with the bacteria if they come in contact with contaminated soil or manure. Raw milk or products made from raw milk may carry these bacteria.

If you eat the contaminated products, you may get sick. The bacteria most often cause a gastrointestinal illness. In some cases, you can develop a blood infection (septicemia) or inflammation of the covering of the brain (meningitis). Infection in early pregnancy generally leads to miscarriage. The bacteria may cross the placenta and infect the developing fetus. Infections in late pregnancy may lead to stillbirth or death of the infant within a few hours of birth. About half of infants infected at or near term will die.

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Symptoms:

  • In infants, symptoms of listeriosis may be seen in the first few days of life and may include:
  • Loss of appetite
  • Lethargy
  • Jaundice
  • Vomiting
  • Respiratory distress (usually pneumonia)
  • Shock
  • Skin rash
  • Increased pressure inside the skull (due to meningitis) possibly causing suture separation

Late-appearing infection in the infant (symptoms appear age 5 days or older) and infection in children is often seen as meningitis.

In adults, the disease may take many forms depending on what organ or organ systems are infected. It may occur as meningitis, pneumonia, septicemia, and endocarditis, or in milder form as abscesses, skin lesion, and conjunctivitis.

If a pregnant woman becomes infected, it can lead to:

  • Stillbirth
  • Death of a newborn within a few hours of birth

Signs and tests:
Laboratory tests may be done to detect the bacteria in amniotic fluid, blood, feces, and urine. A cerebrospinal fluid (CSF) culture may be performed. There is no way, without testing, to know if meningitis is due to listeria or another cause.

Treatment
Antibiotics are prescribed to kill the bacteria that are causing the infection.

Precautions for pregnant women:

  • Pregnant women should avoid contact with wild and domestic animals. Listeria is well controlled in American food products, but food-associated outbreaks have occurred.
  • Pregnant women should avoid consumption of soft cheeses, deli meats, and cold salads from salad bars. Foreign food products such as nonpasteurized soft cheeses have also been implicated in outbreaks of listeriosis. Food should always be adequately cooked.

Reference: CDC

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