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Foodborne Febrile Gastroenteritis? Could Be Listeria

Listeria monocytogenes (listeria) has only recently been recognized as a cause of foodborne febrile gastroenteritis in immunocompetent people. This report highlights the potential for widespread disease caused by a single listeria-contaminated food product.

Following May 1997 reports of an outbreak of febrile gastroenteritisin northern Italy, investigators interviewed 2189 students and staff at2 primary schools. All had eaten food prepared by the same caterer; 1566 (72%) had symptomatic infection, most experiencing headache, abdominal pain, and fever. Vomiting and fever were common in children; diarrhea and musculo-articular pain were frequent in adults. Overall, 292 (19%) required hospitalization; none died. Median time between eating and symptom onset was 24 hours. Listeria was recovered from 123 of 141 patient stool samples (87%), 1 of 40 blood cultures, 1 of 12 stools from food handlers, and 3 of 45 environmental specimens from the catering plant. Epidemiological evidence linked a cold corn-and-tuna salad to the outbreak, and listeria was recovered from the salad. All listeria isolates belonged to serogroup type 4b and had identical DNA profiles. Experimentally inoculated sterile corn kernels supported listeria growth, but inoculated tuna samples did not.

Comment: Add listeria to the list of foodborne gastrointestinal pathogens that affect immunocompetent people. Fever is usually present, and the severity of illness often requires hospitalization. Fortunately, this outbreak did not spread to people who didn't eat the contaminated salad. The U.S. government is establishing regulations for monitoring foods for listeria.

— N Blacklow

Published in Journal Watch Infectious Diseases June 1, 2000

Citation(s):

Aureli P et al. An outbreak of febrile gastroenteritis associated with corn contaminated by Listeria monocytogenes. N Engl J Med 2000 Apr 27 342 1236-1241.

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Osterholm MT. Emerging infections -- Another warning. N Engl J Med 2000 Apr 27 342 1280-1281.

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• Medline abstract (Free)