Wednesday, September 14, 2011

Listeria and Cantaloupes

This is the first case of Listeria that has been reported to be related to Cantaloupes.   Cantaloupes have been related to other foodborne illness outbreaks, with Salmonella most often being the agent.  Much of this is due to the fact that cantaloupes are grown on the soil surface and they have a rough exterior surface that can retain organisms such as Salmonella.  The interesting thing about this case is that unlike an infection due to Salmonella, the infectious dose of Listeria is higher.  This would seem to indicate that either there was a high level of listeria on the product to start, or the cantaloupe was held at room temperature for a long time in order for this bacterium to grow.  Makes one question the transport vehicle or the use of manure as fertilizer.



Cantaloupes should be washed before slices by scrubbing the exterior surface with a brush under clean running water.  After cutting with a clean knife, it is important to store the cantaloupe at refrigeration temperatures.



To date, there have been at least 15 cases in CO, TX, NE, and OK.

FDA STATEMENT

For Immediate Release: September 13, 2011
Media Inquiries: Siobhan DeLancey, 202-510-4177, siobhan.delancey@fda.hhs.gov
Consumer Inquiries: 1-888-INFO-FDA


FDA investigates multistate outbreak of listeriosis

The U.S. Food and Drug Administration is working closely with the Centers for Disease Control and Prevention and state health agencies to investigate a multi-state outbreak of listeriosis.

At least 15 people infected with the outbreak strain of Listeria monocytogenes have been reported in Colorado, Nebraska, Oklahoma and Texas.

State and local public health officials have interviewed most of the patients and discovered that the majority of them consumed whole cantaloupes, most likely marketed from the Rocky Ford growing region of Colorado.

FDA investigators along with state health officials are working quickly to determine where in the supply chain the contamination most likely occurred and where potentially contaminated product may have been distributed.

Both FDA and state public health officials have collected product and environmental samples. Laboratory testing is underway.

Listeriosis is a rare and serious illness caused by eating food contaminated with bacteria called Listeria. People who think they might have become ill should consult their doctor.

A person with listeriosis usually has fever and muscle aches. Almost everyone who is diagnosed with listeriosis has "invasive" infection, in which the bacteria spread beyond the gastrointestinal tract.

Listeriosis can be fatal, especially in certain high-risk groups. These groups include older adults, people with compromised immune systems and certain chronic medical conditions (such as cancer). In pregnant women, listeriosis can cause miscarriage, stillbirth, and serious illness or death in newborn babies, though the mother herself rarely becomes seriously ill.

As FDA’s investigation continues, the agency will provide updates as warranted.

CDC: Deadly Listeria outbreak linked to cantaloupe


DENVER–Health officials have issued a warning for cantaloupes from a revered melon-producing area of Colorado amid a bacteria outbreak blamed for four deaths in the state and New Mexico, troubling farmers who depend on sales of the fruit.

  • The warning from the Centers for Disease Control and Prevention came after 15 cases of a strain of Listeria were reported from four states, including 11 from Colorado, two from Texas, and one each from Nebraska and Oklahoma. Suspected cases were being investigated in other states.

The agency said it was the first Listeria outbreak linked to cantaloupe in the United States.

Rocky Ford cantaloupes are famous throughout the country, drawing travelers to roadside stands. Piles of the coveted melons are featured on postcards. W.C. Fields reportedly said bald guys have "a head shaped like a Rocky Ford cantaloupe," and Lucile Ball had the melons delivered to her dressing room.

"This is really silly. You can get Listeria any place. I eat those melons every day," said Kent Lusk, a fifth-generation cantaloupe farmer from Rocky Ford.

Colorado Agriculture Commissioner John Salazar said it might not be the cantaloupes, but a contaminated truck or other source. He said no recalls have been issued, but several Colorado grocery chains pulled their supplies as a precaution.

Listeriosis is a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes. The disease primarily affects older adults, pregnant women, newborns and adults with weakened immune systems.

Colorado health director Chris Urbina said people who are at high risk included people 60 and older, those with weakened immune systems from transplants and people with chronic diseases. Symptoms can include fever, muscle aches, diarrhea, headache, stiff neck, confusion and convulsions. Listeriosis can cause miscarriages and stillbirths.

Urbina said the department was expecting more test results this week that might help identify the specific source of the cantaloupe sickening people.

Lusk said this year's growing season was almost over and that he doesn't believe the outbreak will have a lasting impact.

"I think there were just a few bad ones," said Adela Licano, a Chamber of Commerce board member who added that about a dozen roadside stands were still open.

"This is a major industry. We hope there is no permanent impact. We're going to get to the bottom of this," Salazar said.

In New Mexico, the fatal cases included a 93-year-old man from Bernalillo County, a 61-year-old woman from Curry County and a 63-year-old man from Bernalillo County. State Environmental Health Bureau inspectors were collecting cantaloupe samples from grocery stores and distributors across New Mexico for laboratory analysis.

Mark Salley, spokesman for the Colorado Department of Public Health and Environment, said the person who died in Colorado was not being identified.

"We extend our sympathy to the families and friends of those who have died from this infection," said Colorado Health Secretary Dr. Catherine Torres. "At this time, based on the preliminary findings in Colorado, we are cautioning people who are at high risk for Listeria infection to avoid eating cantaloupe."











Investigation Announcement: Multistate Outbreak of Listeriosis Linked to Rocky Ford Cantaloupes


CDC

September 12, 2011



Introduction

CDC is collaborating with public health officials in several states, including Colorado, and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of listeriosis. Listeriosis is a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes. Investigators are using DNA analysis of Listeria isolated from patients to identify cases of illness that may be part of this outbreak. The Listeria bacteria are obtained from diagnostic testing; pulsed-field gel electrophoresis (PFGE) is used to determine DNA fingerprint patterns. Investigators are using data from PulseNet, the national subtyping network made up of state and local public health laboratories and federal food regulatory laboratories that performs molecular surveillance of foodborne infections.

A total of 15 persons infected with the outbreak strain of Listeria monocytogenes have been reported from 4 states. All illnesses started on or after August 15, 2011. The number of infected persons identified in each state is as follows: Colorado (11), Nebraska (1), Oklahoma (1), and Texas (2). Listeriosis illnesses in several other states are currently being investigated by state and local health departments to determine if these illnesses are part of this outbreak.

Among persons for whom information is available, illnesses began on or after August 15, 2011. Ages range from 38 to 96 years, with a median age of 84 years old. Most ill persons are over 60 years old or have health conditions that weaken the immune system. Seventy-three percent of ill persons are female. All 15 (100%) patients were hospitalized, and one death has been reported.

The outbreak can be visually described with a chart showing the number of persons who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after August 26, 2011, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. Please see the description of the steps in a foodborne outbreak investigation for more details.

About 800 cases of Listeria infection are diagnosed each year in the United States, along with 3 or 4 outbreaks of Listeria-associated foodborne illness. The typical foods that cause these outbreaks have been deli meats, hot dogs, and Mexican-style soft cheeses made with unpasteurized milk. Produce is not often identified as a source, but sprouts caused an outbreak in 2009, and celery caused an outbreak in 2010.

Investigation of the Outbreak

Ongoing collaborative investigations by local, state, and federal public health and regulatory agencies indicate the likely source of the outbreak is a type of cantaloupe, called Rocky Ford cantaloupes, which are grown in the Rocky Ford region of southeastern Colorado. These cantaloupes were harvested in August and September, distributed widely in the United States, and are currently available in grocery stores. Ill persons were interviewed about exposures during the month before becoming ill; investigators compared their responses to persons with listeriosis reported through the CDC Listeria Initiative, whose illnesses were not part of this outbreak. Preliminary results strongly suggest that illnesses are linked to consumption of cantaloupes. Several ill persons who remembered the type of cantaloupe said they were Rocky Ford cantaloupes. Product traceback information indicated these cantaloupes were marketed as cantaloupes harvested in the Rocky Ford region.

Laboratory testing by the Colorado Department of Public Health and Environment identified Listeria monocytogenes bacteria on cantaloupe collected from grocery stores and from an ill person’s home. Product traceback information from Colorado State officials indicated these cantaloupes were harvested in the Rocky Ford region. FDA is working closely with CDC, the firms involved, and public health authorities in states where illnesses occurred to determine the exact source of contamination.

On September 9, the Colorado Department of Public Health and Environment [PDF - 2 pages] advised persons in Colorado at high risk for severe listeriosis to avoid eating cantaloupes. CDC now advises persons throughout the mainland United States and at high risk for listeriosis, including older adults, persons with weakened immune systems, and pregnant women, to not eat cantaloupes marketed as coming from the Rocky Ford region of Colorado.


Clinical Features/Signs and Symptoms

Listeriosis is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes. The disease primarily affects older adults, persons with weakened immune systems, pregnant women and newborns. Rarely, persons without these risk factors can also be affected.

A person with listeriosis usually has fever and muscle aches, often preceded by diarrhea or other gastrointestinal symptoms. Almost everyone who is diagnosed with listeriosis has "invasive" infection, in which the bacteria spread from the intestines to the blood stream or other body sites.

The symptoms vary with the infected person:

·        Persons other than pregnant women: Symptoms, in addition to fever and muscle aches, can include headache, stiff neck, confusion, loss of balance, and convulsions.

·        Pregnant women: Pregnant women typically experience only a mild, flu-like illness. However, infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.

More general information about Listeriosis can be found at the CDC's Listeriosis webpage

Advice to Consumers

Contaminated cantaloupes may still be in grocery stores and in consumers' homes.

·        CDC recommends that persons at high risk for listeriosis, including older adults, persons with weakened immune systems, and pregnant women, do not eat cantaloupes marketed as coming from the Rocky Ford region of Colorado.

·        Consumers who have cantaloupes in their homes can check the label or inquire at the store where they purchased it to determine if the fruit was marketed as coming from the Rocky Ford region of Colorado.

·        Listeriosis primarily affects older adults, persons with weakened immune systems, pregnant women, and newborns. Persons who think they might have become ill from eating possibly contaminated cantaloupes should consult their doctor immediately.

·        Cantaloupes marketed as coming from the Rocky Ford region should be disposed of in a closed plastic bag placed in a sealed trash can. This will prevent people or animals from eating them.

Food items other than cantaloupes can also carry Listeria bacteria. People at high risk for listeriosis and those who prepare their meals can take steps to lower the risk.

·        Rinse raw produce, such as fruits and vegetables, thoroughly under running tap water before eating. Dry the produce with a clean cloth or paper towel before cutting them up.

·        Thoroughly cook raw meat and poultry.

·        Heat hot dogs, deli meats, and cold cuts until they are steaming hot just before serving.

·        Do not drink raw (unpasteurized) milk and do not eat fresh soft cheeses that have unpasteurized milk in them, especially Mexican style cheeses like queso fresco.

·        Be sure that your refrigerator is at or below 40 degrees F, and your freezer at or below 0 degrees F by using a refrigerator thermometer.

·        Follow general food safety guidelines for preparing food, such as those at FoodSafety.gov .

General Melon Safety Advice:

·        Consumers and food preparers should wash their hands before and after handling any whole melon, such as cantaloupe, watermelon, or honeydew.

·        Wash the melons and dry them with a clean cloth or paper towel before cutting.

·        Cut melon should be promptly consumed or refrigerated at or less than 40 degrees F (32-34 degrees F is optimal for storage of cut melon).

·        Cut melons left at room temperature for more than 4 hours should be discarded.

More information about Listeriosis and recommendations to reduce risk of getting Listeriosis from food can be found at the CDC's Listeriosis webpage.


No comments:

Post a Comment