1
|
HEIMAN KE, GARALDE VB, GRONOSTAJ M, JACKSON KA, BEAM S, JOSEPH L, SAUPE A, RICOTTA E, WAECHTER H, WELLMAN A, ADAMS-CAMERON M, RAY G, FIELDS A, CHEN Y, DATTA A, BURALL L, SABOL A, KUCEROVA Z, TREES E, METZ M, LEBLANC P, LANCE S, GRIFFIN PM, TAUXE RV, SILK BJ. Multistate outbreak of listeriosis caused by imported cheese and evidence of cross-contamination of other cheeses, USA, 2012. Epidemiol Infect 2016; 144:2698-708. [PMID: 26122394 PMCID: PMC6527316 DOI: 10.1017/s095026881500117x] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/07/2015] [Accepted: 05/11/2015] [Indexed: 11/06/2022] Open
Abstract
Listeria monocytogenes is a foodborne pathogen that can cause bacteraemia, meningitis, and complications during pregnancy. In July 2012, molecular subtyping identified indistinguishable L. monocytogenes isolates from six patients and two samples of different cut and repackaged cheeses. A multistate outbreak investigation was initiated. Initial analyses identified an association between eating soft cheese and outbreak-related illness (odds ratio 17·3, 95% confidence interval 2·0-825·7) but no common brand. Cheese inventory data from locations where patients bought cheese and an additional location where repackaged cheese yielded the outbreak strain were compared to identify cheeses for microbiological sampling. Intact packages of imported ricotta salata yielded the outbreak strain. Fourteen jurisdictions reported 22 cases from March-October 2012, including four deaths and a fetal loss. Six patients ultimately reported eating ricotta salata; another reported eating cheese likely cut with equipment also used for contaminated ricotta salata, and nine more reported eating other cheeses that might also have been cross-contaminated. An FDA import alert and US and international recalls followed. Epidemiology-directed microbiological testing of suspect cheeses helped identify the outbreak source. Cross-contamination of cheese highlights the importance of using validated disinfectant protocols and routine cleaning and sanitizing after cutting each block or wheel.
Collapse
Affiliation(s)
- K. E. HEIMAN
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - V. B. GARALDE
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - M. GRONOSTAJ
- Allegheny County Health Department, Pittsburgh, PA, USA
| | - K. A. JACKSON
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S. BEAM
- California Department of Food and Agriculture, Sacramento, CA, USA
| | - L. JOSEPH
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A. SAUPE
- Minnesota Department of Health, St Paul, MN, USA
| | - E. RICOTTA
- Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA
| | - H. WAECHTER
- New York City Department of Health and Hygiene, NY, New York, USA
| | - A. WELLMAN
- Virginia Department of Health, Richmond, VA, USA
| | | | - G. RAY
- District of Columbia Department of Health, Washington, DC, USA
| | - A. FIELDS
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Y. CHEN
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - A. DATTA
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - L. BURALL
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - A. SABOL
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Z. KUCEROVA
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - E. TREES
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M. METZ
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - P. LEBLANC
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - S. LANCE
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - P. M. GRIFFIN
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - R. V. TAUXE
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - B. J. SILK
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|