Listeria concerns on the rise for pregnant women?

Listeria has always been a concern, but according to a NBC news affiliate, it’s new.

amy.pregnant.listeriaAnd people wonder why mainstream journalism is dying.

“While normally this is a bacteria our bodies can fight off, for expecting women, it becomes more difficult because of a lowered immune system. Additionally, there is concern that the bacteria could be passed on to the fetus.”

Duh.

Diet alert for mums-to-be

Whenever I get a chance to expound, I always put a plug in for Listeria, and the havoc it can wreck in pregnant mothers.

amy.pregnant.cat Last year in New Zealand, five women between 23 and 36 weeks pregnant were struck down with listeriosis, and three of their babies died. From 2010 to 2012 there were 12 cases of perinatal listeriosis, with six baby deaths.

Listeria is one of several food-borne illnesses, including toxoplasma, methylmercury and salmonella, which can cause severe complications in pregnancy, when the immune system is lowered.

The Ministry for Primary Industries principal health advisor, Dr Craig Thornley, said while such cases were rare, it was important pregnant women followed food safety recommendations to avoid any risk.

Listeria bacteria can be found in refrigerated, ready-to-eat foods such as meat, poultry and seafood, or food made with unpasteurised milk.

Avoiding raw milk and eggs, unpasteurised cheese, processed and undercooked meats, some seafood, and even sushi and hummus would cut down the chance of becoming ill.

New Zealand College of Midwives midwifery advisor Lesley Dixon said women should focus on what they can eat.

“I think we get hooked up on ‘we can’t eat this and we can’t eat that’ and what we forget is what we can eat and what we should be eating,” she said. “Yes we can’t eat brie and camembert anymore but actually we can still eat cheese.”

When Amanda Ashman was pregnant with her son Jake in 1997 she wasn’t warned not to eat certain foods.

So when she fell pregnant again in 2012 with her daughter Mackenzie, the barrage of food safety advice came as a big shock.

“I was constantly saying ‘I was never told any of this when I was pregnant with Jake’.”

The 34-year-old West Auckland mum said as a pregnant 17-year-old she knew not to drink or smoke but doesn’t recall anyone advising her not to eat food that could cause her to become ill such as unpasteurised cheese, pre-cooked ham, and raw eggs.

She ate whatever she wanted and did not have any problems.

She said it was concerning to find out later pregnant women were warned off some food.

“I thought it was strange that I wasn’t warned about it when I was carrying Jake.”

Fifteen years later, when pregnant with Mackenzie, it was a different story.

She was made aware of the guidelines by her midwife and kept to them but thinks they might be a bit over the top.

Rob Mancini: Moms, Listeria, and stealth sprouts

Rob Mancini, a MS graduate of Kansas State University and a health inspector with the Manitoba Department of Health writes:

amy.pregnant.listeriaMy wife and I are trying for baby number 2 and food safety is always on my mind. Listeria monocytogenes presents a significant risk to pregnant women and as such there are certain foods expected moms should avoid, like deli meats, hot dogs that have not undergone a cooking process, soft cheeses, meat spreads, raw milk, and others.

Many medical doctors are not completely aware of all the foods that must be avoided during pregnancy, for instance, avoiding the consumption of raw sprouts. The Internet doesn’t help either. I did a random interview of 40 expectant women in the grocery store to determine if they would consume raw sprouts during their pregnancy. Ninety per cent of the interviewed women said that they would consume raw sprouts due to their nutritional value. This was disturbing. Public health types, including myself, have to do a better job in communicating the risks and more importantly that the message is factual and consistent. 

KETV reports that the family of a baby, hospitalized at Children’s Hospital & Medical Center, wants to warn other expecting mothers and new parents about the illness that made their son extremely sick.

Ezra Armstrong entered the world at a whopping 9-plus pounds, and the ‘big guy’ is still adding to that.“He’s drinking four ounces every two hours,” said his mother, Lucinda.  “Gaining weight like a pro.”

Lucinda, also mom to 2-year-old Lena, knows the difference between ‘I’m hungry’ cries and when something is wrong.  She was on high alert in May, when Ezra was just two weeks old.“He was red all day, he pretty much cried his eyes out all day and then when we took his temperature at night time it was bad,” said Armstrong.  “That was when we decided to go to the hospital.”Ezra had a fever of 101.6, dangerously high for a newborn.  The Armstrongs rushed their baby to Mercy Hospital in Council Bluffs.  Doctors performed several tests, and a spinal tap revealed Ezra had meningitis, an infection of the coverings of the brain. Ezra was immediately transported to Children’s Hospital and Medical Center in Omaha.  Doctors, including Division Chief of Pediatric Infectious Diseases Dr. Kari Simonsen, determined Ezra had listeria meningitis.

listeria“Listeria is a particular type of bacteria that’s known to cause meningitis, particularly in susceptible patients; infants are one of the most susceptible,” said Dr. Simonsen.  “Most babies get it around the time of delivery from their mother, who’s acquired it usually from a food.”

Dr. Simonsen said refrigerated meats and cheeses and deli products usually served cold host the listeria bacteria, which can live at the refrigerated temperature. 

“Often times, the mom won’t become clinically ill because of her normal immune system,” said Dr. Simonsen.  Babies’ immature immune systems cannot fight off the bacteria.  Dr. Simonsen says it is important to note listeria meningitis is not contagious; you cannot spread the infection person to person.

Doctors are now helping Ezra’s tiny body battle the infection.

“They said he was in pretty bad shape,” said Armstrong.  “They said we probably would’ve lost him if this would’ve gone untreated.”

Ezra is improving every day; doctors will watch him closely but Dr. Simonsen says many patients have normal outcomes.

“I think the main takeaway for moms would be to listen to your obstetrician’s advice,” said Dr. Simonsen.  “In this case, those foods that might be dangerous for moms to consume while pregnant.”

Lucinda Armstrong also has a message for parents.

“I’d tell them to go with their gut,” said Lucinda.  “If they feel something’s wrong, it’s much better going to the hospital and figuring out nothing is wrong rather than not going, then to figure out something bad happened.”

It’s not clear how long Ezra will have to stay in the hospital.  Lucinda and her husband, Greg, plan to stay with their baby until they can take him home.

“[I was] sitting here thinking about it and I just broke down in tears because I think of how bad it could’ve been if it would’ve gone untreated,” said Lucinda.  “If we wouldn’t have thought anything of it at the time, we could’ve lost him.

(That’s pregnant Amy, not pregnant Rob’s partner)

Seven ill and one dead after consuming Listeria-contaminated cheese

Health authorities from US Center for Disease Control and Prevention (CDC) announced today the investigation into an outbreak of listeriosis linked to Hispanic cheeses. The outbreak has lead to a death and seven other illnesses in Maryland and California. CDC reports that five of the illnesses (2 mother-newborn pairs and a newborn) were related to pregnancy and all patients are of Hispanic ethnicity.

Among persons for whom information is available, dates that illness was diagnosed range from August 1, 2013 to November 27, 2013. Seven of the eight ill persons were hospitalized. Five of the illnesses were related to a pregnancy; two of these were diagnosed in two mother–newborn pairs, and one in only the newborn. The three other illnesses occurred among adults.   Eveling raking the curds

In interviews, ill persons answered questions about foods consumed and other exposures in the month before becoming ill. All patients in Maryland reported consuming soft or semi-soft Hispanic-style cheese and all shopped at different locations of same food store chain (Chain A). Testing of cheese products collected from Chain A (VDACS reports it as Mega Mart -ben) stores was performed in Maryland and Virginia. 

Virginia’s Division of Consolidated Laboratory Services (DCLS) identified the outbreak strain of Listeria monocytogenes in a sample of Caujada en Terron (fresh cheese curd) collected by the Virginia Department of Agriculture and Consumer Services (VDACS) from a Chain A store. This cheese was likely produced by Roos Foods of Kenton, Delaware and was later repackaged in the Chain A store.  VDACS issued a press release on February 15, 2014 instructing persons who purchased this product not to consume the cheese and to discard any remaining product.

logoFrom the VDACS press release,

On February 10, 2014, Listeria monocytogenes, a bacterium that can cause human illness, was isolated from a sample of Cuajada en Terron (Fresh Cheese Curd) collected by food safety inspectors from Virginia Department of Agriculture and Consumer Services.  The sample was collected at Mega Mart, a retail store located at 8328 Shopper’s Square, Manassas, VA 20111. The product was sold in clear, unlabeled plastic bags held in the retail cheese display cooler within the facility.

Listeria affects the elderly and pregnant women disproportionately more than healthy adults and is fatal 25-30 per cent of the time. Hispanic style fresh cheese is regularly linked to Listeria cases. In January, Oregon public health officials issued a warning for illegally imported cheese from Mexico that is believed responsible for giving an unborn baby Listeria. In 2010, Two Oregon mothers have were sickened by Listeria after eating tainted Mexican-style cheese made in Yakima, causing their babies to be born with a serious illness

294 sick; Firefly Salmonella creates complications, hard choices for pregnant Las Vegan

In late April, a couple of days after Konstantino and “Myla,” Lyudmyla Kouris walked over from their All Real Estate investment company office to have lunch with their friend Nikk Zorbas at the Firefly restaurant next door, Myla, got sick.

Paul Harasim of the Las Vegas Review-Journal writes that ahough doctors first saw the symptoms as a commonplace indication of pregnancy, stool Lyudmyla Radchenkosamples taken after her condition worsened showed –– and continue to show –– she suffers from salmonella, food poisoning that caused the Southern Nevada Health District to shutter the Paradise Road Firefly on April 26.

To their horror, the couple learned that what was generally causing others a few days of distress –– nearly 300 people have now reported food poisoning symptoms –– could lead to severe pregnancy complications.

Radchenko, expecting her child in early June, was too ill to take part in initial interviews with the Review-Journal last week in which Kouris and Zorbas first outlined her situation. Zorbas spent four days in the hospital fighting salmonella symptoms, while Kouris recently stopped taking antibiotics for his bout with salmonella.

“Our lives have been nothing but stress since we found out what Myla had –– nothing is really positive any more,” Kouris, 50, said as the couple sat in their office on Monday. “All we talk about now, all we think about, is what salmonella could do to our baby.”

With stool samples this week showing the salmonella still strong in her system, Radchenko nodded at the talk of stress as she repeatedly caressed her stomach.

“So much stress,” she said in an accent that reflects her Ukrainian homeland. “It is so scary. I’m afraid for our little boy.”

Pregnant woman diagnosed with listeriosis: illness linked to Jersey business El Ranchero del Sur, LLC’s cheese

Listeria is scary stuff, especially for pregnant women. Pregnant women make up nearly one-third of all cases of listeriosis, due to natural hormonal changes of pregnancy that weaken the immune system. While the mother normally survives an infection during pregnancy, the perinatal/neonatal mortality rate is greater than 80%.

According to an alert sent from the New Jersey Department of Health and Senior Services to a couple of barfblog readers, El Ranchero del Sur, LLC of South River, NJ has a listeria problem in their cheese products. Consumption of their products have been linked to listeriosis in a pregnant woman and investigators have confirmed the presence of the pathogen. In queso fresco, again (here, here, etc).

The New Jersey Department of Health and Senior Services (NJDHSS) Food and Drug Safety Program (FDSP) is warning the public not to consume any cheese products produced by El Ranchero del Sur, LLC of South River, NJ. On March 2, 2012, a 38-week pregnant woman was diagnosed with Listeria monocytogenes infection at a New Brunswick hospital. Subsequent investigation by the Middlesex County Health Department and product analysis by NJDHSS Public Health Environmental and Agricultural Laboratories confirmed the presence of L. monocytogenes in a sample of Los Corrales Queso Fresco Fresh Cheese and Banana Leaf code dated 03/16/12.

Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

FDSP, with assistance from the U.S. Food and Drug Administration (FDA), has obtained a voluntary closure by the firm’s owner while the products and facility are investigated for the presence of L. monocytogenes. All products and ingredients at the facility have been placed under embargo pending the outcome of laboratory testing for L. monocytogenes.

El Ranchero del Sur, LLC has pledged to conduct a voluntary recall through the FDA and is contacting its customers to arrange for the retrieval of all of their cheese products. El Ranchero del Sur cheese products can be found primarily in Mexican and Latin American grocery stores, restaurants, and other hispanic food establishments under the name brands El Ranchero, Los Corrales, and Carnes Don Beto with the plant number 34-0013669 marked on the label. All products are 14 ounces in weight except for the Queso Hebra Oaxaca String Cheese ball in 10 pound packages.
FDSP is requesting local health departments to investigate retail food establishments, in their respective jurisdictions, which are likely to sell or use these products in food service, and take actions to remove from sale or service all of the products described above, of all types and code dates.

If you have any questions, please contact Alan Talarsky, Dairy Project Coordinator, FDSP at (609) 826-4935. Thank you for your assistance in this matter.

Pregnancy, protein and listeria: are mums-to-be ‘too cautious’ on risk foods?

"How long have you been pregnant,” I asked the thirty-something as we filled our plates during the catered lunch at a meeting in 2000 in Ottawa.

“About six weeks.”??

The American media had been filled with coverage of listeria after the 1998-1999 Sara Lee Bil Mar hot dog outbreak in which 80 were sickened, 15 killed and at least six pregnant women had miscarriages. Risk assessments had been conducted, people were talking about warning labels, and especially, the risks to pregnant women. ??There was no such public discussion in Canada.?? So as I watched the pregnant PhD load up on smoked salmon, cold cuts and soft cheese for lunch, I wondered, do I say something?

One of the biggest risks in pregnancy is protein deficiency. What if smoked salmon, cold cuts and soft cheeses were this woman’s biggest source of protein? (Turns out they were.)?? Another risk factor is stress. I didn’t want to freak her out. Besides, who the hell am I to say anything? ??We sat together during lunch and chatted about babies, her aspirations and how she was feeling. Eventually I introduced the subject of listeria by talking about a risk assessment that had recently been published by the U.S. Food and Drug Administration, and that maybe she would be interested in looking at the results. I felt sorta goofy.
Professor Clare Collins of the University of Newcastle studied the eating habits of 7000 Australian women to see if they were missing out on important nutrients as a result of avoiding "risky" foods that potentially carried listeria.

9News reports some pregnant women are being overly cautious about avoiding what are traditionally considered "no-no" foods, such as soft cheese, pate and sashimi, a researcher says. Oysters, smoked fish, delicatessen meats, salad bar salads and pre-cut fruit are also considered high risk for carrying the Listeria monocytogenes.

Reporting her findings in the journal Public Health Nutrition, Prof Clare said her study found that women who ate the most listeria foods reported more frequent miscarriages, but had high levels of the nutrients needed to have a healthy baby.

Conversely, those who ate moderate or low amounts of listeria foods had less miscarriages but also lower levels of nutrients like calcium, folate and Omega 3 acids.

"In those with moderate and low exposure there was no excess risk of miscarriage but the problem was their nutrient intakes were then worse," Prof Clare said.

"We’re saying pregnant women need to be given more advice on how to eat healthy. If all they hear is risky foods, and they drop out all the potential listeria foods, their micro nutrient intake is going to be really bad.”

She said the existing listeria guidelines for pregnant women were entirely legitimate but needed to be rewritten to provide more information about what could be eaten, as well as what should be avoided.

There were 65 cases of listeriosis in Australia in 2008, 12 during pregnancy and one that was fatal.

Is toxoplasmosis underestimated in the food supply?

When toxoplasma in pork ranked second in last year’s top 10 riskiest combinations of foods and disease-causing microorganisms at $1.2 billion a year, some wondered, what?

Now the Brits have chirped in, saying much more needs to be known about Toxoplasma gondii in the country’s food and especially the impact on pregnant women.

The UK Food Standards Agency’s (FSA) Advisory Committee of the Microbiological Safety of Food (ACMSF) is seeking stakeholder views on its draft report relating to toxoplasma in the food chain (available at http://www.food.gov.uk/multimedia/pdfs/consultation/criskprotoxoplasmafoodchain.pdf).

According to the UK National Health Service (NHS), food sources include undercooked or raw meat, raw cured meat (including Parma ham, salami) and unpasteurised goat’s milk, and the infection can pass between humans from a pregnant woman to an unborn baby.

Although toxoplasmosis usually only causes mild flu-like symptoms in adults, the ACMSF said it can be fatal to babies, and has been linked with associated jaundice, eye infections and seizures.

The FSA’s scientific advisory committee was asked to consider whether current evidence indicates a food safety issue that needs to be addressed, what food sources could present a significant risk and identify further work needed on UK prevalence and foodborne sources of toxoplasmosis.

38 sick, many pregnant in 2008 listeria in pasteurized cheese outbreak in Quebec; cross-contamination affected hundreds of retailers

Fall 2008 was a crappy time in Canada. While the Maple Leaf listeria-in-deli-meats outbreak would kill 23 and sicken 56, a listeria-in-cheese outbreak plagued Quebec (that’s in Canada, according to some), sickening lots, especially expectant mothers.

Amy was pregnant, heightening sensitivities.

At the time, public attention and concern in Quebec was far more focused on the plight of cheesemongers than the sick and several dead. Regulators took some tough steps to limit the outbreak but in a culture that values tradition, the Quebec Minister of Agriculture was forced to capitulate and change his tune from, "The province is not there to compensate. We aren’t an insurance company," to offering a three-year, $8.4-million aid package, along with $11.3-million in interest-free loans to Quebec’s small cheese producers and retailers less than three weeks later.

Government health-types in Quebec have now offered their version of events in the current issue of the Journal of Food Protection.

Although numbers of sick people were all over the place at the time, the researchers conclude there were 38 confirmed sick with the same strain of Listeria monocytogenes (LM P93) across Quebec from June through Dec. 2008, including 14 pregnant women and two babies born to asymptomatic mothers. There were two elderly deaths and three neonatal deaths.

The traceback of many brands of cheese that tested positive for LM P93 collected from retailers identified two cheese plants contaminated by L. monocytogenes strains on 3 and 4 September. PFGE profiles became available for both plants on 8 September, and confirmed that a single plant was associated with the outbreak. Products from these two plants were distributed to more than 300 retailers in the province, leading to extensive cross-contamination of retail stock.

So where is that local cheesemonger you know, trust and can look in the eye, getting their cheese from?

The abstract is below:

Widespread Listeriosis outbreak attributable to pasteurized cheese, which led to extensive cross-contamination affecting cheese retailers, Quebec, Canada, 2008
01.jan.12
Journal of Food Protection®, Volume 75, Number 1, January 2012 , pp. 71-78(8)
Gaulin, Colette; Ramsay, Danielle; Bekal, Sadjia
http://www.ingentaconnect.com/content/iafp/jfp/2012/00000075/00000001/art00011
Abstract:
A major Listeria monocytogenes outbreak occurred in the province of Quebec, Canada, in 2008, involving a strain of L. monocytogenes (LM P93) characterized by pulsed-field gel electrophoresis (PFGE) and associated with the consumption of pasteurized milk cheese. This report describes the results of the ensuing investigation. All individuals affected with LM P93 across the province were interviewed with a standardized questionnaire. Microbiological and environmental investigations were conducted by the Quebec’s Food Inspection Branch of Ministère de l’Agriculture, des Pêcheries et de l’Alimentation du Québec among retailers and cheese plants involved in the outbreak. Between 8 June and 31 December 2008, 38 confirmed cases of LM P93 were reported to public health authorities, including 16 maternal-neonatal cases (14 pregnant women, and two babies born to asymptomatic mothers). The traceback of many brands of cheese that tested positive for LM P93 collected from retailers identified two cheese plants contaminated by L. monocytogenes strains on 3 and 4 September. PFGE profiles became available for both plants on 8 September, and confirmed that a single plant was associated with the outbreak. Products from these two plants were distributed to more than 300 retailers in the province, leading to extensive cross-contamination of retail stock. L. monocytogenes is ubiquitous, and contamination can occur subsequent to heat treatment, which usually precedes cheese production. Contaminated soft-textured cheese is particularly prone to bacterial growth. Ongoing regulatory and industry efforts are needed to decrease the presence of Listeria in foods, including pasteurized products. Retailers should be instructed about the risk of cross-contamination, even with soft pasteurized cheese and apply methods to avoid it.

Leukemia patients, pregnant women at greatest risk of listeriosis

People with certain conditions, including leukemia, other cancers and pregnancy, are at the greatest risk of getting sick from the foodborne bacterium Listeria, French researchers report in a new study.

Doctors and public health officials have known that these conditions make people more vulnerable to listeriosis, but this study is the first to rank the size of the risk for people with each condition.

The results "will help focus risk communication for the medical community," said Ramon Guevara, an epidemiologist for the County of Los Angeles Department of Public Health, who was not involved in the study.

The study looked at nearly 2,000 cases of listeriosis in France — affecting 39 out of every 10 million people — from 2001 to 2008.

Despite its rarity, listeriosis is still considered an important public health concern because it’s relatively deadly compared to other food-borne illnesses, lead author Dr. Véronique Goulet at the Institut de Veille Sanitaire in Saint-Maurice wrote in an email to Reuters Health.

More than 400 of the 2,000 people who developed listeriosis died.

None of the cases involved an outbreak.

About one in six of the listeriosis cases in France affected pregnant women.

Incidence of Listeriosis and related mortality among groups at risk of acquiring Listeriosis
23.dec.11
Clinical Infectious Diseases
Véronique Goulet, Marjolaine Hebert, Craig Hedberg, Edith Laurent, Véronique Vaillant, Henriette De Valk, and Jean-Claude Desenclos
http://cid.oxfordjournals.org/content/early/2011/12/12/cid.cir902
Abstract
Background. Listeriosis is a foodborne disease of significant public health concern that primarily affects persons with recognized underlying conditions or diseases that impair cell-mediated immunity. The degree of risk posed by the different underlying conditions is crucial to prioritize prevention programs that target the highest risk populations.

Methods. We reviewed cases of listeriosis reported in France from 2001 to 2008. Numbers of cases and deaths were tabulated by age and underlying condition. Measures of the impact of specific underlying conditions on the occurrence of listeriosis were calculated. For estimating the total number of persons living with specific diseases, we applied prevalence estimates of these diseases to the French population. Underlying conditions were ranked by the degree to which they increased the risk of listeriosis.

Results. From 2001 to 2008, 1959 cases of listeriosis were reported in France (mean annual incidence 0.39 per 100 000 residents). Compared with persons <65 years with no underlying conditions, those with chronic lymphocytic leukemia had a >1000-fold increased risk of acquiring listeriosis, and those with liver cancer; myeoloproliferative disorder; multiple myeloma; acute leukemia; giant cell arteritis; dialysis; esophageal, stomach, pancreas, lung, and brain cancer; cirrhosis; organ transplantation; and pregnancy had a 100–1000-fold increased risk of listeriosis.

Conclusions. To be effective and acceptable to physicians and patients, listeriosis prevention strategies should be targeted based on evidence of increased risk. Stringent dietary guidance, to avoid specific foods with a high risk for Listeria contamination, should be targeted to pregnant women and to others at highest risk of listeriosis.