Listeriosis 885739 224718231 2008-07-10T02:51:53Z 66.25.65.63 /* Pathogenesis */ {{Infobox_Disease | Name = Listeriosis | Image = | Caption = | DiseasesDB = 7503 | ICD10 = {{ICD10|A|32||a|30}} | ICD9 = {{ICD9|027.0}} | ICDO = | OMIM = | MedlinePlus = 001380 | eMedicineSubj = med | eMedicineTopic = 1312 | eMedicine_mult = {{eMedicine2|ped|1319}} | MeshID = | }} '''Listeriosis''' is a [[list of infectious diseases|bacterial infection]] caused by a [[gram-positive]], [[Motility|motile]] bacterium, ''[[Listeria monocytogenes]]''.<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> Listeriosis is relatively rare and occurs primarily in newborn infants, elderly patients, and patients who are [[immunocompromised]].<ref name=Baron>{{cite book | author = Hof H | title = Listeria Monocytogenes ''in:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | id = [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.973#982 (via NCBI Bookshelf)] ISBN 0-9631172-1-1 }}</ref> In veterinary medicine, however, listeriosis can be a quite common condition in some farm outbreaks. It can also be found in wild animals. See : "[[listeriosis in animals]]". ==Epidemiology== Incidence in 2004–2005 was 2.5–3 cases per million population and year in the USA, where pregnant women accounted for 30% of all cases.<ref>Center for Infectious Disease Research & Policy, [[University of Minnesota]] – [http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/causes/listerioview.html Listeriosis]</ref> Of all nonperinatal infections, 70% occur in immunocompromised patients. Incidence in the USA has been falling since the 1990s, in contrast to Europe where changes in eating habits have lead to an increase during the same time. In Sweden, it has stabilized at around 5 cases per annum and million population, with pregnant women typically accounting for 1–2 of some 40 total yearly cases. <ref>[[Smittskyddsinstitutet]] – [http://www.smittskyddsinstitutet.se/statistik/listeriainfektion/?t=com&p=6912]</ref> ==Pathogenesis== ''Listeria monocytogenes'' is ubiquitous in the environment. The main route of acquisition of ''Listeria'' is through the ingestion of contaminated food products. ''Listeria'' has been isolated from raw meat, dairy products, vegetables, and seafood. Soft cheeses, unpasteurized milk and unpasteurised [[pâté]] are potential dangers, however post-[[pasteurization]] outbreaks of infection from dairy have been from pasteurized milk.<ref name=Sherris/> There are four distinct clinical syndromes: :*Infection in pregnancy: ''Listeria'' can proliferate asymptomatically in the vagina and uterus. If the mother becomes symptomatic, it is usually in the third trimester. Symptoms include [[fever]], [[myalgia]]s, [[arthralgias]] and [[headache]]. Abortion, stillbirth and preterm labor are complications of this infection. :*Neonatal infection (granulomatosis infantisepticum): There are two forms. One, an early-onset [[sepsis]], with ''Listeria'' acquired in utero, results in premature birth. ''Listeria'' can be isolated in the [[placenta]], [[blood]], [[meconium]], [[nose]], [[ear]]s, and [[throat]]. Another, late-onset meningitis is acquired through vaginal transmission, although it also has been reported with caesarean deliveries. :*[[Central nervous system|CNS]] infection: ''Listeria'' has a predilection for the brain [[parenchyma]], especially the [[brain stem]], and the [[meninges]]. It can cause [[cranial nerve]] palsies, [[encephalitis]], [[meningitis]], [[meningoencephalitis]] and [[abscess]]es. Mental status changes are common. Seizures occur in at least 25% of patients. :*[[Gastroenteritis]]: ''L monocytogenes'' can produce food-borne diarrheal disease, which typically is noninvasive. The median incubation period is 21 days, with diarrhea lasting anywhere from 1-3 days. Patients present with fever, muscle aches, gastrointestinal nausea or diarrhea, headache, stiff neck, confusion, loss of balance, or convulsions. ==Diagnosis and treatment== In CNS infection cases, ''L. monocytogenes'' can often be cultured from the blood, and always cultured from the [[Cerebrospinal fluid|CSF]]. There are no reliable serological or stool tests. [[Bacteremia]] should be treated for 2 weeks, [[meningitis]] for 3 weeks, and [[brain abscess]] for at least 6 weeks. [[Ampicillin]] generally is considered [[antibiotic]] of choice; [[gentamicin]] is added frequently for its synergistic effects. Overall mortality rate is 20-30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive.{{Fact|date=February 2007}} ==Prevention== The main means of prevention is through the promotion of safe handling, cooking and consumption of food. This includes washing raw vegetables and cooking raw food throroughly, as well as reheating leftover or ready-to-eat foods like hot dogs until steaming hot. <ref name=CDC_Listeriosis>{{cite web | title=Listeriosis | work=CDC: Division of Bacterial and Mycotic Diseases | url=http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_g.htm#prevented | accessdate=2006-05-02}}</ref> Another aspect of prevention is in giving advice to high-risk groups such as pregnant women and immunocompromised patients to avoiding unpasteurised pâtés and foods such as soft cheeses like [[feta]], [[Brie cheese|Brie]], [[Camembert (cheese)|Camembert cheese]], [[bleu cheese|bleu]]. Cream cheese, yogurt, and cottage cheese are considered safe. In the United Kingdom, advice along these lines from the [[Chief Medical Officer (United Kingdom)|Chief Medical Officer]] posted in maternity clinics led to a sharp decline in cases of listeriosis in pregnancy in the late 1980s <ref Skinner et al. Food Control 1996; 7:245-247.> {{cite journal|author=Skinner et al.|title=Listeria: the state of the science Rome 29–30 June 1995 Session IV: country and organizational postures on Listeria monocytogenes in food Listeria: UK government's approach |publisher=Food control|date=1996|volume=7|pages=245–247}}</ref> ==See also== *[[List of foodborne illness outbreaks]] ==References== <div class="references-small"><references/></div> ==External links== *[http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_t.htm CDC Listeriosis site] {{Bacterial diseases}} [[Category:Bacterial diseases]] {{Link FA|de}} [[ar:داء الليستَريات]] [[ca:Listeriosi]] [[cs:Listerióza]] [[de:Listeriose]] [[es:Listeriosis]] [[fr:Listériose]] [[hr:Listerioza]] [[is:Votheysveiki]] [[it:Listeriosi]] [[pl:Listerioza]] [[pt:Listeriose]] [[wa:Listeriôze]]