An outbreak of febrile gastroenteritis associated with jellied pork contaminated with Listeria monocytogenes

Abstract

In September 2008, the Austrian Agency for Health and Food Safety (AGES) learned of an outbreak of diarrheal illness that included a 71-year-old patient hospitalized for gastroenteritis with a blood culture positive for Listeria monocytogenes. Three stool specimens provided by seven of 19 persons attending a day trip to a foreign city, including a final break at an Austrian tavern, yielded L. monocytogenes. All isolates were of serovar 4b and had fingerprints indistinguishable from each other. A cohort study revealed that the outbreak of gastroenteritis occurred among 16 persons who had eaten dinner at the wine tavern on September 6. Of the 15 persons who ate from platters of mixed cold-cuts, 12 (80%) developed symptoms of febrile gastroenteritis within 24-48 h. The median age of those who became ill was 62 years. A 72-year-old patient recovered from gastroenteritis but was hospitalized with bacterial meningitis on day 19 after the dinner. The epidemiological investigation identified the consumption of mixed cold-cuts (including jellied pork) at the wine tavern as the most likely vehicle of the foodborne outbreak (P = 0.0015). This hypothesis was confirmed by microbiological investigation of jellied pork produced by the tavern owner on September 3. L. monocytogenes was isolated from leftover food in numbers of 3 x 10(3)-3 x 10(4) colony forming units/g and was indistinguishable from the clinical outbreak isolates. Symptoms reported by the 12 patients included unspecified fever (12x), diarrhea (9x), headache (5x), vomiting (4x), body aches (2x) and sore throat (1x). Active case finding identified one case of rhombencephalitis (female, age 48) among another group of four guests, among whom only the patient and her asymptomatic husband had eaten jellied pork on September 6. This is the first outbreak of L. monocytogenes-associated gastroenteritis reported in Austria. The occurrence of a secondary case of meningitis (diagnosed on day 19 after consumption of jellied pork) indicates a significant risk of systemic listeriosis among elderly patients with febrile gastroenteritis caused by L. monocytogenes; antibiotic therapy should therefore be considered in such cases of documented listerial gastroenteritis.

Processing-Dependent and Clonal Contamination Patterns of Listeria monocytogenes in the Cured Ham Food Chain Revealed by Genetic Analysis

“…In particular, susceptible individuals, like pregnant women, newborns, immunocompromised patients, and the elderly, are at risk of developing invasive listeriosis that can arise with septicemia or meningitis and is often complicated by encephalitis, abortion, and perinatal infections (5). A gastrointestinal form of the disease is also reported and referred to as noninvasive listeriosis (6)(7)(8). L. monocytogenes is widely diffused in the environment and, like other species of the genus Listeria, its natural habitat is soil, preferably in the presence of decaying vegetation; these bacteria can also be harbored in the intestinal tracts of humans (9), various domestic animals, like ruminants, pigs, and poultry, and wild species (10).…”

Listeriosis: The Dark Side of Refrigeration and Ensiling

“…Foodborne transmission of L. monocytogenes can also cause a self-limiting acute gastroenteritis (in immunocompetent persons). From the data available in normal hosts in Italy, Illinois (USA) and Austria, it appears that febrile gastroenteritis in normal hosts requires the ingestion of a high dose of several million bacteria (Aureli et al 2000;Dalton et al 1977;Pichler et al 2009). Grif et al studied the incidence of fecal carriage of L. monocytogenes in healthy volunteers (Grif et al 2003).…”

The challenges of foodborne pathogens and antimicrobial chemotherapy: A global perspective

“…Different food sources particularly poultry, red meat and meat products have been associated with outbreaks as well as sporadic cases (Billie et al, 2006;Pichler et al, 2009;El-Malek et al, 2010). Other studies reported vegetable products especially cabbage as a source of contamination and retrospective study, revealed that sheep manure from a flock diagnosed earlier with listeriosis was used to fertilize the crop (Schlech et al, 1983;Rocourt et al, 2001).…”