An Advent to Listeria
Listeria (pronounced liss-STEER-ē-uh) is a gram-positive rod-shaped bacterium that may develop beneath both anaerobic (with out oxygen) or cardio (with oxygen) stipulations. [4, 18] Of the six species of Listeria, handiest L. monocytogenes (pronounced maw-NO-site-aw-JUH-neez) reasons illness in people. [18] Those micro organism multiply absolute best at 86-98.6 levels F (30-37 levels C), but in addition multiply higher than all different micro organism at fridge temperatures, one thing that permits temperature for use as a way of differentiating Listeria from different contaminating micro organism. [18]
Referred to as an “opportunistic pathogen,” Listeria is famous to motive an estimated 2,600 instances according to yr of critical invasive sickness. [26] In all probability no longer unusually then, “foodborne sickness brought about by means of Listeria monocytogenes has raised important public well being fear in the US, Europe, and different spaces of the sector.” [3] As one famous professional noticed, summarizing the historical past of those micro organism and their importance for public well being,
Even though L. monocytogenes used to be known as an animal pathogen over 80 years in the past, the primary outbreak confirming an oblique transmission from animals to people used to be reported handiest in 1983, in Canada’s Maritime provinces. In that outbreak, cabbages, saved within the chilly over the wintry weather, have been infected with Listeria thru publicity to contaminated sheep manure. A next outbreak in California in 1985 proven the function of meals in disseminating listeriosis. Since then, Listeria has been implicated in lots of outbreaks of food-borne sickness, maximum frequently from publicity to infected dairy merchandise and ready meat merchandise, together with turkey and deli meats, pâté, sizzling canine and seafood and fish. [4]
Given its fashionable presence within the atmosphere and meals provide, the ingestion of Listeria has been described as an “exceedingly not unusual incidence.” [18]
The Prevalence of Listeria Infections
Listeria micro organism are discovered broadly within the atmosphere in soil, together with in decaying plants and water, and is also a part of the fecal plants of numerous mammals, together with wholesome human adults. [4, 18] In line with the FDA, “research recommend that 1-10% of people is also intestinal carriers of Listeria.” [14] Any other authority notes that the “organism has been remoted from the stool of roughly 5% of wholesome adults.” [18] Total, seasonal traits display a notable top in overall Listeria instances and linked deaths from July thru October. [3]
Ingested by means of mouth, Listeria is one of the maximum virulent foodborne pathogens, with as much as 20% of medical infections leading to dying. [3] Those micro organism basically motive critical sickness and dying in individuals with immature or compromised immune methods. [13, 18] As a result, maximum wholesome adults will also be uncovered to Listeria with little to any threat of an infection and sickness. [4, 11]
A be taught revealed in 1995 projected Listeria infection-rates to the U.S. inhabitants, suggesting that an estimated 1,965 instances and 481 deaths happened in 1989 when compared with an estimated 1,092 instances and 248 deaths in 1993, a 44% and 48% relief in sickness and dying, respectively. [25] When put next, a USDA be taught revealed in 1996 estimated that there have been 1,795-1860 Listeria-related instances in 1993, and 445-510 deaths, with 85-95% of those as a result of the intake of infected meals. [28] Listeriosis-related mortality charges reduced once a year by means of 10.7% from 1990 thru 1996, and by means of 4.3% from 1996 thru 2005. [3]
Amongst adults 50 years of age and older, an infection charges have been estimated to have declined from 16.2 according to 1 million in 1989 to ten.2 according to 1 million in 1993. [25] Perinatal illness reduced from 17.4 instances according to 100,000 births in 1989 to eight.6 instances according to 100,000 births in 1993. [25] Neonatal infections are regularly critical, with a mortality fee of 25-50%. [4]
In line with the CDC’s Nationwide Heart for Zoonotic, Vector-Borne, and Enteric Illnesses:
Listeriosis used to be added to the checklist of nationally notifiable sicknesses in 2001. To fortify surveillance, the Council of State and Territorial Epidemiologists has really useful that each one L. monocytogenes isolates be forwarded to state public well being laboratories for subtyping during the Nationwide Molecular Subtyping Community for Foodborne Illness Surveillance (PulseNet). All states have laws requiring well being care suppliers to document instances of listeriosis and public well being officers attempt to interview all individuals with listeriosis promptly the usage of a regular questionnaire about high-risk meals. As well as, FoodNet conducts energetic laboratory- and population-based surveillance. [7]
In 2006, public well being officers from 48 states reported 1,270 foodborne illness outbreaks, with a proven or suspect supply in 884 of the outbreaks (70%). [8] Best one of the crucial outbreaks with a proven supply used to be attributed to Listeria, with this outbreak involving 11 hospitalizations and one dying. [8] The following yr, of 17,883 lab-confirmed infections, the CDC attributed 122 to Listeria. [9] In 2009, there have been 158 proven Listeria infections, representing an incidence-rate of .34 instances for each and every 100,000 individuals in the US. [10] Such records printed an incidence-rate of 0.27 instances according to 100,000 individuals, a lower of 42% when compared with 1996—1998. [10] However, in line with CDC’s Technical Knowledge website online, it’s estimated that there are 1,600 instances of Listeria an infection once a year in the US, in keeping with records thru 2008. [7]
The 2009 numbers represented a reported 30% lower within the selection of infections in comparison to the 1996—1998 charges of an infection. [10] Even though the character and level of underreporting is topic to dispute, all agree that the proven instances constitute simply the top of the iceberg. [6, 13] Certainly, one be taught estimates the once a year prevalence fee for Listeria to be round 1,795-1,860 instances according to 100,000 individuals, with 445-510 of the instances finishing in dying. [28]
In spite of everything, in a be taught of FoodNet laboratory-confirmed invasive instances—the place an infection is detected in blood, cerebrospinal fluid, amniotic fluid, placenta or merchandise of conception—the selection of listeriosis instances reduced by means of 24% from 1996 thru 2003. [33] All through this similar length, pregnancy-associated illness reduced by means of 37%, whilst instances amongst the ones fifty years previous and older reduced by means of 23%. [33]
The Incidence of Listeria in Meals and the Surroundings
Listeria is a not unusual presence in nature, discovered broadly in such puts as water, soil, contaminated animals, human and animal feces, uncooked and handled sewage, leafy greens, effluent from poultry and meat processing amenities, decaying corn and soybeans, improperly fermented silage, and uncooked (unpasteurized) milk. [18, 23, 27] Meals frequently recognized as resources of Listeria an infection come with improperly pasteurized fluid milk, cheeses (in particular soft-ripened sorts, comparable to conventional Mexican cheeses, Camembert and ricotta), ice cream, uncooked greens, fermented raw-meat sausages, uncooked and cooked poultry, and cooked, ready-to-eat (RTE) sliced meats—regularly known as “deli meats”. [18, 21, 23, 28] One be taught discovered that, over a five-year length of checking out, in more than one processing amenities, Listeria monocytogenes used to be remoted from 14% of one,080 samples of smoked finfish and smoked shellfish. [16]
Able-to-eats meals had been discovered to be a notable and constant supply of Listeria. [14, 21] As an example, a research-study performed by means of the Listeria Find out about Staff discovered that Listeria monocytogenes grew from no less than one meals specimen within the fridges of 64% of individuals with a proven Listeria an infection (79 of 123 sufferers), and in 11% of greater than 2000 meals specimens gathered within the be taught. [21] Additionally, 33% of fridges (26 of 79) contained meals that grew the similar pressure with which the person have been contaminated, a frequency a lot upper than can be anticipated by accident. [21] A broadly cited USDA be taught that reviewed the to be had literature additionally summarized that:
In samples of raw meat and poultry from seven international locations, as much as 70 % had detectable ranges of Listeria [13]. Schuchat [23] discovered that 32 % of the 165 culture-confirmed listeriosis instances may well be attributed to consuming meals bought from retailer delicatessen counters or tender cheeses. In Pinner [21] microbiologic survey of refrigerated meals specimens got from families with listeriosis sufferers, 36 % of the meat samples and 31 % of the poultry samples have been infected with Listeria.
The superiority of Listeria in ready-to-eat meats has no longer confirmed tricky to provide an explanation for. [26, 29] As one professional in some other much-cited article has famous:
The centralized manufacturing of ready ready-to-eat meals merchandise…will increase the danger of upper ranges of contamination, because it calls for that meals be saved for lengthy classes at refrigerated temperatures that choose the expansion of Listeria. All through the preparation, transportation and garage of ready meals, the organism can multiply to succeed in a threshold had to motive an infection. [4]
The chance posed by means of the danger of Listeria in ready-to-eat meats has precipitated the USDA to claim the bacterium an adulterant in these types of meat merchandise and, because of this, to undertake a zero-tolerance coverage for the presence of this fatal pathogen. [7, 29]
A USDA Baseline Information Assortment Program performed in 1994 documented Listeria contamination on 15.0% of broiler-chicken carcasses [30]. Next USDA data-collection didn’t take a look at for the superiority of Listeria in white meat or in turkeys. [31, 32]
Transmission and An infection
Aside from for the transmission of mom to fetus, human-to-human transmission of Listeria isn’t recognized to happen. [18] An infection is brought about virtually completely by means of the ingestion of the micro organism, maximum regularly during the intake of infected meals. [18, 21, 23] Essentially the most broadly permitted estimate of foodborne transmission is 85-95% of all Listeria instances. [23, 28]
The infective dose—this is, the selection of micro organism that should be ingested to motive sickness—isn’t recognized. [4, 18, 26] In an another way wholesome individual, a particularly massive selection of Listeria micro organism should be ingested to motive sickness—estimated to be someplace between 10–100 million viable micro organism (or colony forming devices “CFU”) in wholesome folks, and handiest 0.1–10 million CFU in other people at excessive threat of an infection. [4, 18, 26] Even with any such dose, a wholesome particular person will endure just a fever, diarrhea, and linked gastrointestinal signs. [4, 18].
The period of time from an infection to the onset of signs—normally known as the incubation length—can range to a vital level. Signs of Listeria an infection can broaden at any time from 2 to 70 days after consuming infected meals. [4, 5] In line with one authoritative textual content,
The incubation length for invasive sickness isn’t smartly established, however proof from a couple of instances linked to precise ingestions issues to 11 to 70 days, with an average of 31 days. In a single document, two pregnant girls whose handiest not unusual publicity used to be attendance at a celebration evolved Listeria bacteremia with the similar unusual enzyme sort; incubation classes for sickness have been 19 and 23 days. [18]
Adults can get listeriosis by means of consuming meals infected with Listeria, however young children will also be born with listeriosis if their moms devour infected meals all over being pregnant. [4, 24] The mode of transmission of Listeria to the fetus is both transplacental by way of the maternal blood circulation or ascending from a colonized genital tract. [24] Infections all over being pregnant could cause untimely supply, miscarriage, stillbirth, or severe well being issues for the baby. [18, 24]
Prevalence of Listeria an infection in HIV-positive folks is upper than within the basic inhabitants. [17, 18] One be taught discovered that:
The estimated prevalence of listeriosis amongst HIV-infected sufferers in metropolitan Atlanta used to be 52 instances according to 100,000 sufferers according to yr, and amongst sufferers with AIDS it used to be 115 instances according to 100,000 sufferers according to yr, charges 65–145 instances upper than the ones a few of the basic inhabitants. HIV-associated instances happened in adults who have been 29–62 years of age and in postnatal babies who have been 2 and six months of age. [17]
Pregnant girls make up round 30% of all an infection instances, whilst accounting for 60% of instances involving the 10- to 40-year age team. [18]
The ones Maximum Liable to An infection
A number of segments of the inhabitants are at larger threat and want to learn in order that correct precautions will also be taken. [19,20, 27] The frame’s protection in opposition to Listeria is known as “cell-mediated immunity” for the reason that luck of shielding in opposition to an infection depends upon our cells (versus our antibodies), particularly lymphocytes referred to as “T-cells.” [12] Subsequently, folks whose cell-mediated immunity is suppressed are extra vulnerable to the devastating results of listeriosis, together with particularly HIV-infected folks, who’ve been discovered to have a Listeria-related mortality of 29%. [12, 17, 18]
Pregnant girls naturally have a depressed cell-mediated immune machine. [18, 24] As well as, the immune methods of fetuses and newborns are very immature and are extraordinarily vulnerable to most of these infections. [24] Different adults, particularly transplant recipients and lymphoma sufferers, are given essential remedies with the precise intent of miserable T-cells, and those folks turn into particularly vulnerable to Listeria as smartly. [7, 18, 27]
In line with the CDC and different public well being organizations, folks at larger threat for being contaminated and changing into significantly unwell with Listeria come with the next teams:
· Pregnant girls: They’re about 20 instances much more likely than different wholesome adults to get listeriosis. About one-third of listeriosis instances occur all over being pregnant.
· Newborns: Newborns somewhat than the pregnant girls themselves endure the intense results of an infection in being pregnant.
· Individuals with weakened immune methods
· Individuals with most cancers, diabetes, or kidney illness
· Individuals with AIDS: They’re virtually 300 instances much more likely to get listeriosis than other people with standard immune methods.
· Individuals who take glucocorticosteroid medicines (comparable to cortisone)
· The aged [11, 20, 21]
Signs of Listeria an infection
When an individual is contaminated and develops signs of Listeria an infection, the ensuing sickness is known as listeriosis. [4, 11, 18] Just a small share of individuals who ingest Listeria fall unwell or broaden signs. [18] For individuals who do broaden signs on account of their an infection, the ensuing sickness is both gentle or reasonably critical—occasionally known as a “bimodal distribution of severity.” [13, 28]
At the gentle finish of the spectrum, listeriosis generally is composed of the unexpected onset of fever, chills, critical headache, vomiting, and different influenza-type signs. [18, 28] Alongside those similar strains, the CDC notes that contaminated folks would possibly broaden fever, muscle aches, and occasionally gastrointestinal signs comparable to nausea or diarrhea. [11] When provide, the diarrhea generally lasts 1-4 days (with 42 hours being reasonable), with 12 bowel actions according to day at its worst. [18]
Maximum wholesome adults and youngsters who devour infected meals enjoy handiest gentle to reasonable signs. The an infection is generally self-limited, since, in wholesome hosts, publicity to Listeria stimulates the manufacturing of tumor necrosis issue and different cytokines, which turn on monocytes and macrophages to remove the organism. Few other people with standard immune serve as cross directly to have extra critical, life-threatening kinds of listeriosis, characterised by means of septic surprise, meningitis and encephalitis. [4]
As already famous, when pregnant, girls have a mildly impaired immune machine that makes them vulnerable to Listeria an infection. [19] If contaminated, the sickness seems as an acute fever, muscle ache, backache, and headache. [18, 24] Sickness generally happens within the 0.33 trimester, which is when immunity is at its lowest. [18] An infection all over being pregnant may end up in untimely hard work, miscarriage, an infection of the baby, and even stillbirth. [24, 28] Twenty-two % of such infections lead to stillbirth or neonatal dying. [18]
Newborns would possibly provide clinically with early-onset (lower than 7 days) or late-onset kinds of an infection (7 or extra days). [3] The ones with the early-onset shape are regularly identified within the first 24 hours of existence with sepsis (an infection within the blood). [3, 18] Early-onset listeriosis is maximum regularly bought thru trans-placental transmission. [18, 24] Past due-onset neonatal listeriosis is much less not unusual than the early-onset shape. [4, 18, 24] Scientific signs is also delicate and come with irritability, fever and deficient feeding. [24] The mode of acquisition of past due onset listeriosis is poorly understood. [18, 24]
Analysis and Remedy of Listeria Infections
As a result of there are few signs which can be distinctive to listeriosis, docs should imagine plenty of attainable reasons for an infection, together with viral infections (like flu), and different bacterial infections that can motive sepsis or meningitis. [4, 18, 19]
Early prognosis and medicine of listeriosis in high-risk sufferers is important, for the reason that end result of untreated an infection will also be devastating. That is very true for pregnant girls on account of the larger threat of spontaneous abortion and preterm supply. Relying at the threat team, charges of dying from listeriosis vary from 10% to 50%, with the best fee amongst newborns within the first week of existence. [4]
Strategies normally used to spot diarrhea-causing micro organism in stool cultures intrude or restrict the expansion of Listeria, making it much less more likely to be recognized and remoted for additional checking out. [18] Alternatively, regimen strategies are efficient for separating Listeria from spinal fluid, blood, and joint fluid. [4, 18] Magnetic-resonance imaging (MRI) is used to verify or rule out mind or mind stem involvement. [18]
Listeriosis is generally a self-limited sickness—because of this {that a} majority of contaminated folks will fortify with out the will for hospital treatment. [4, 11, 14, 18] However for the ones sufferers with a excessive fever, a stool tradition and antibiotic-treatment is also justified for another way wholesome folks. [4, 18] Even though there were no research performed to resolve what medication or medicine period is absolute best, ampicillin is typically thought to be the “most popular agent.” [18] There is not any consensus on the most efficient means for sufferers who’re allergic to penicillin.[18]
Invasive infections with Listeria will also be handled with antibiotics. [18] When an infection happens all over being pregnant, antibiotics given promptly to the pregnant girl can regularly save you an infection of the fetus or new child. [18, 24] Young children with listeriosis obtain the similar antibiotics as adults, even supposing a mixture of antibiotics is regularly used till physicians are positive of the prognosis.
Headaches of Listeria an infection
For the ones individuals that suffer a Listeria an infection that doesn’t get to the bottom of by itself, the headaches (or sequelae) will also be many. [4, 28] The most typical is septicemia (bacterial pathogens within the blood, sometimes called bacteremia), with meningitis being the second one maximum not unusual. [4, 18] Different headaches can come with irritation of the mind or mind stem (encephalitis), mind abscess, irritation of the heart-membrane (endocarditis), and localized an infection, both internally or of the surface. [18]
Dying is essentially the most critical end result of listeriosis, and it’s tragically not unusual. [3] As an example, in keeping with 2009 FoodNet surveillance records, 89.2% of Listeria sufferers ended up within the clinic, the best hospitalization fee for pathogenic bacterial an infection. [10] In individuals 50 years of age and older, there used to be a 17.5% fatality fee—additionally the best relative to different pathogens. [10, 18]
The Prevention of Listeria an infection
Given its fashionable presence within the atmosphere, and the truth that nearly all of Listeria infections are the results of eating infected meals or water, combating sickness and dying is essentially (and understandably) a meals protection factor.
L. monocytogenes items a specific fear with admire to meals dealing with as a result of it could develop at fridge temperatures (4°C to ten°C), temperatures frequently used to management pathogens in meals. Freezing additionally has little damaging impact at the microbe. Even though pasteurization is enough to kill Listeria, failure to succeed in the required temperature in massive programs can permit the organism to continue to exist. Meals will also be infected after processing by means of the advent of unpasteurized subject material, as occurs all over the preparation of a few cheeses. Listeria will also be unfold by means of touch with infected palms, apparatus and countertops. [4]
Using irradiation to scale back Listeria to secure ranges in meals has many proponents. [26] As famous by means of an eminent CDC researcher, Robert V. Tauxe,
Able-to-eat meats, comparable to sizzling canine, have already been subjected to a pathogen-killing step when the beef is cooked on the manufacturing unit, so contamination is normally the results of in-plant contamination after that step. Stepped forward sanitation in lots of crops has lowered the prevalence of an infection by means of part since 1986, however the threat persists, as illustrated by means of a big sizzling dog-associated outbreak that happened in 1999. Further warmth medicine or irradiation of meat after it’s packaged would get rid of Listeria that may well be provide at that time. [26]
The CDC supplies a complete checklist of suggestions and precautions to steer clear of changing into contaminated with Listeria, that are as follows:
· Totally prepare dinner uncooked meals from animal resources, comparable to red meat, beef, or poultry to a secure inner temperature. For an inventory of really useful temperatures for meat and poultry, discuss with http://www.fsis.usda.gov/PDF/IsItDoneYet_Magnet.pdf.
· Rinse uncooked greens totally beneath operating faucet water sooner than consuming.
· Stay raw meats and poultry become independent from greens and from cooked meals and ready-to-eat meals.
· Don’t drink uncooked (unpasteurized) milk, and don’t devour meals that experience unpasteurized milk in them.
· Wash palms, knives, counter tops, and chopping forums after dealing with and making ready raw meals.
· Eat perishable and ready-to-eat meals once conceivable.
Suggestions for individuals at excessive threat, comparable to pregnant girls and individuals with weakened immune methods, along with the suggestions indexed above, come with:
· Meats
o Don’t devour sizzling canine, luncheon meats, chilly cuts, different deli meats (e.g., bologna), or fermented or dry sausages except they’re heated to an inner temperature of 165°F or till steaming sizzling simply sooner than serving.
o Steer clear of getting fluid from sizzling canine and lunch meat programs on different meals, utensils, and meals preparation surfaces, and wash palms after dealing with sizzling canine, luncheon meats, and deli meats.
o Don’t devour refrigerated pâté or meat spreads from a deli or meat counter or from the refrigerated phase of a shop. Meals that would not have refrigeration, like canned or shelf-stable pâté and meat spreads, are fit to be eaten. Refrigerate after opening.
· Cheeses
o Don’t devour tender cheese comparable to feta, queso blanco, queso fresco, brie, Camembert, blue-veined, or panela (queso panela) except it’s classified as made with pasteurized milk. Make certain the label says, “MADE WITH PASTEURIZED MILK.”
· Seafood
o Don’t devour refrigerated smoked seafood, except it’s contained in a cooked dish, comparable to a casserole, or except this can be a canned or shelf-stable product. Refrigerated smoked seafood, comparable to salmon, trout, whitefish, cod, tuna, and mackerel, is maximum regularly classified as “nova-style,” “lox,” “kippered,” “smoked,” or “jerky.” Those fish are normally discovered within the fridge phase or bought at seafood and deli counters of grocery shops and delicatessens. Canned and shelf secure tuna, salmon, and different fish merchandise are fit to be eaten.
Suggestions to stay meals secure:
· Remember that Listeria monocytogenes can develop in meals within the fridge. Use an equipment thermometer, comparable to a fridge thermometer, to test the temperature within your fridge. The fridge will have to be 40°F or decrease and the freezer 0°F or decrease.
· Blank up all spills for your fridge instantly–particularly juices from sizzling canine and lunch meat programs, uncooked meat, and uncooked poultry.
· Blank the interior partitions and cabinets of your fridge with sizzling water and liquid cleaning soap, then rinse.
· Divide leftovers into shallow bins to advertise speedy, even cooling. Quilt with hermetic lids or enclose in plastic wrap or aluminum foil. Use leftovers inside of 3 to 4 days.
· Use precooked or ready-to-eat meals once you’ll be able to. Don’t retailer the product within the fridge past the use-by date; apply USDA fridge garage time pointers:
o Scorching Canine – retailer opened programs not than 1 week and unopened programs not than 2 weeks within the fridge.
o Luncheon and Deli Meat – retailer factory-sealed, unopened programs not than 2 weeks. Retailer opened programs and meat sliced at a neighborhood deli not than 3 to five days within the fridge. [11]
Further preventive steps and precautions will also be discovered on the internet sites of maximum State Departments of Well being, together with, for instance, the Minnesota Division of Well being. [20] There could also be superb knowledge to be discovered on the Extension Carrier website online of the Institute of Meals and Agricultural Sciences at College of Florida. [27]
References
1. Angulo, F.J., et al., “Antimicrobial Use in Agriculture: Controlling the Switch of Antimicrobial Resistance to People,” SEMINARS IN PEDIATRIC INFECTIOUS DISEASES, Vol. 15, No. 2, pp. 78-85 (April 2004).
2. Angulo, F.J., et al., “Proof of an Affiliation Between Use of Anti-microbial Brokers in Meals Animals and Anti-microbial Resistance Amongst Micro organism Remoted from People and the Human Well being Penalties of Such Resistance, JOURNAL OF VETERINARY MEDICINE, Collection-B, Vol. 51, Factor 8-9, pp. 374-79 (Oct. 2004).
3. Bennion, J.R., et al., “Reducing Listeriosis Mortality in the US, 1990-2005,” CLINICAL INFECTIOUS DISEASES, Vol. 47, No. 7, pp. 867-74 (2008), to be had on-line at http://cid.oxfordjournals.org/content material/47/7/867.lengthy
4. Bortolussi, R, “Listeriosis: A Primer,” CANADIAN MEDICAL ASSOCIAION JOURNAL, Vol. 179, No. 8, pp. 795-7 (Oct. 7, 2008), on-line at http://www.cmaj.ca/content material/179/8/795.lengthy
5. Bryan, Frank, “Procedures to Examine Foodborne Sickness,” World Affiliation for Meals Coverage, p. 119 (fifth ed. 1999).
6. Buzby, Jean and Roberts, Tonya, “The Economics of Enteric Infections: Human Foodborne Illness Prices, GASTROENTEROLOGY, Vol. 136, No. 6, pp. 1851-62 (Might 2009).
7. CDC, Nationwide Heart for Zoonotic, Vector-Borne, and Enteric Illnesses, “Listeriosis—Technical Knowledge,” (final up to date: April 6, 2011), to be had on-line at http://www.cdc.gov/nczved/divisions/dfbmd/sicknesses/listeriosis/technical.html
8. CDC, “Surveillance for Foodborne Illness Outbreaks—United States, 2006,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 58, No. 22, pp. 609-15 (June 12, 2007) at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5822a1.htm
9. CDC, “Initial FoodNet Information at the Prevalence of An infection with Pathogens Transmitted Repeatedly thru Meals—10 States, 2007,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 57, No. 14, pp. 366-70 (April 11, 2008), to be had on-line at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5714a2.htm
10. CDC, “Initial FoodNet Information at the Prevalence of An infection with Pathogens Transmitted Repeatedly thru Meals—10 States, 2009,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 59, No. 14, pp. 418-22 (April 16, 2010) to be had on-line at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5914a2.htm
11. CDC, Nationwide Heart for Zoonotic, Vector-Borne, and Enteric Illnesses, “Listeriosis—Normal Knowledge and Ceaselessly Requested Questions,” (final up to date: April 6, 2011), to be had at http://www.cdc.gov/nczved/divisions/dfbmd/sicknesses/listeriosis/
12. Cossart, P. and Bierne, H., “The Use of Host Mobile Equipment within the Pathogenesis of Listeria monocytogenes,” CURRENT OPINIONS IN IMMUNOLOGY, Vol. 13, No. 1, pp. 96-103 (Feb. 2001).
13. Council for Agriculture, Science and Generation (CAST), “Foodborne Pathogens: Dangers and Penalties: Process Pressure File No.122,” pp. 1-87 (Sept. 1994) obtain at http://www.cast-science.org/publications/index.cfm/foodborne_pathogens_risks_and_consequences?display=product&productID=2852
14. FDA, “Dangerous Computer virus E book: Foodborne Pathogenic Microorganisms and Herbal Toxins Guide—Listeria monocytogenes,” at http://www.cfsan.fda.gov/~mow/chap6.html (website final up to date: June 18, 2009).
15. FDA, Public Assembly, “Listeria monocytogenes Chance Overview and Chance Control: December 4, 2003 Assembly,” Assembly Time table and Displays, to be had on-line at http://www.fda.gov/Meals/ScienceResearch/ResearchAreas/RiskAssessmentSafetyAssessment/ucm209515.htm For Understand of Public Assembly, see 68 Fed. Reg., Vol. 68, No. 216, at 63108-09, on-line at http://www.fda.gov/OHRMS/DOCKETS/98fr/03-28045.pdf
16. Heinitz, M.L. and Johnson, J.M., “The prevalence of Listeria spp., Salmonella spp., and Clostridium botulinum in Smoked Fish and Shellfish,” Magazine of Meals Coverage, Vol. 61, pp. 318-23 (March 1998).
17. Jurado, R.L., et al., “Higher Chance of Meningitis and Bacteremia Because of Listeria monocytogenes in Sufferers with Human Immunodeficiency Virus An infection,” Scientific Infectious Illnesses, Vol. 17, No. 2, pp. 224-7 (1993).
18. Lorber, Bennett, “Listeria monocytogenes,” in Mandell, Douglas, And Bennett’s PRINCIPLES AND PRACTICE OF INFECTIOUS DISEASES, 5th Version, Chap. 195, pp. 2208-14 (2000, Mandell, Bennett, and Dolan, Editors).
19. Mayo Health facility. (2009). Listeria an infection (listeriosis). Retrieved November 1, 2009, from Mayo Health facility website online: http://www.mayoclinic.com/well being/Listeria-infection/DS00963.
20. Minnesota Division of Well being (MDH), “Fighting Listeriosis,” to be had on-line at http://www.well being.state.mn.us/divs/idepc/sicknesses/listeriosis/prevention.html
21. Pinner, R.W., et al., “Function of Meals in Sporadic Listeriosis. II. Microbiologic and epidemiologic investigation, JOURNAL OF AMERICAN MEDICAL ASSOCIATION, Vol. 267, No. 15, pp. 2046-50 (April 15, 1992).
22. Roberts, T, “Human Sickness Prices of Foodborne Micro organism,” AMERICAN JOURNAL OF AGRICULTURE ECONOMICS, Vol. 71, No. 2, pp. 468-474 (1989).
23. Schuchat, A, et al., “Function of Meals in Sporadic Listeriosis. I. Case-control Find out about of Nutritional Chance Components,” JOURNAL OF AMERICAN MEDICAL ASSOCIATION, Vol. 267, No. 15, pp. 2041-5 (April 15, 1992).
24. Silver, HM, “Listeriosis all over being pregnant,” OBSTETRICAL AND GYNECOLOGICAL SURVEY, Vol. 53, Factor 12, pp. 737-740 (Dec. 1998).
25. Tappero, JW, et al., “Aid within the Prevalence of Human Listeriosis in the US: Effectiveness of Prevention Efforts,” JOURNAL OF AMERICAN MEDICAL ASSOCIATION, Vol. 273, No. 14, pp. 1118-22 (April 12, 1995).
26. Tauxe, Robert, CDC, “Meals Protection and Irradiation: Protective the Public from Foodborne Infections,” EMERGING INFECTIOUS DISEASES, Vol. 7, No. 3, pp. 516-21 (June 2001) at http://www.ncbi.nlm.nih.gov/%/articles/PMC2631852/pdf/11485644.pdf
27. College of Florida, IFIS Extension, “Fighting Foodborne Sickness: Listeriosis,” Meals Science and Human Diet Division, Florida Cooperative Extension Carrier, (Jan. 2003) on-line at http://edis.ifas.ufl.edu/fs102
28. USDA Financial Analysis Carrier, “Bacterial Foodborne Illness—Scientific Prices and Productiveness Losses,” AER-741, August 1996 (authors: Jean C. Buzby, et al.) on-line at http://www.ers.usda.gov/Publications/AER741/
28a. USDA Financial Analysis Carrier, S. Crutchfield and T. Roberts, “Meals Protection Efforts Boost up within the 90’s,” FOOD REVIEW, Vol. 23, No. 3, pp. 44-49 (Sept.-Dec. 2000), on-line at http://www.ers.usda.gov/publications/foodreview/septdec00/FRsept00h.pdf
29. USDA Meals Protection and Inspection Carrier (FSIS), “Assessing the Effectiveness of the
Listeria monocytogenes Meantime Ultimate Rule, Abstract File,” (Sept. 28, 2004), to be had on-line at http://www.fsis.usda.gov/Oppde/rdad/frpubs/97-013F/LM_Assessment_Report_2004.pdf
30. USDA FSIS, NATIONWIDE BROILER CHICKEN MICROBIOLOGICAL BASELINE DATA COLLECTION PROGRAM, July 1994—July 1995, (April 1996), complete document to be had on-line at http://www.fsis.usda.gov/OPHS/baseline/broiler1.pdf
31. USDA FSIS, THE NATIONWIDE MICROBIOLOGICAL BASELINE DATA COLLECTION PROGRAM: YOUNG CHICKEN SURVEY, July 2007—June 2008, complete document to be had on-line at http://www.fsis.usda.gov/PDF/Baseline_Data_Young_Chicken_2007-2008.pdf
32. USDA FSIS, THE NATIONWIDE MICROBIOLOGICAL BASELINE DATA COLLECTION PROGRAM: YOUNG TURKEY SURVEY, Aug. 2008—July 2009, at http://www.fsis.usda.gov/PDF/Baseline_Data_Young_Turkey_2008-2009.pdf
33. Voetsch, AC, et al., “Aid within the Prevalence of Invasive Listeriosis in Foodborne Illnesses Lively Surveillance Community Websites, 1996-2003,” CLINICAL INFECTIOUS DISEASES, Vol. 44, No. 4, pp. 513-20 (CDC Keep watch over & Prevention Rising Infections Program, Foodborne Illnesses Lively Surveillance Community Running Staff 2007).
34. Wallinga, D, “Antimicrobial Use in Animal Feed: An Ecological and Public Well being Downside,” MINNESOTA MEDICINE, Vol. 85, No. 10 pp. 12-16 (Oct. 2002).