Listeriosis
Listeriosis is an infection caused by Listeria bacteria. There are 10 distinct species of Listeria; the variant that most commonly impacts humans is Listeria monocytogenes. It strikes pregnant women, newborns, the elderly, and anyone with a weakened immune system. Pregnant women are 10 times more likely to be infected with Listeria than the general population.
Symptoms –
The incubation period between exposure and symptoms is quite variable (three to 70 days, with 21 days as average) and may extend up to about two months or more after consuming food with Listeria.
The following symptoms of Listeria infection are likely to last 1-3 days:
• muscle aches
• fever
• flu-like symptoms
• nausea
• diarrhea
For many people, a Listeria infection will pass unnoticed. However, in some individuals, the infection will spread to the nervous system where symptoms might include:
• headache
• confusion
• stiff neck
• tremors and convulsions
• loss of balance
In susceptible individuals, listeriosis can lead to a serious blood infection (septicemia) or inflammation of the membranes around the brain (meningitis).
If the listeriosis infection spreads to the brain, the outcomes can be severe and may include:
• Cranial nerve palsies: Paralysis and tremors.
• Encephalitis: Inflammation of the brain.
• Meningitis: Inflammation of the membranes covering the brain and spinal cord.
• Meningoencephalitis: A combination of meningitis and encephalitis.
• Cerebral abscesses: Localized pus build-up within the brain.
Symptoms during pregnancy or for newborn infants
While a mother with a Listeria infection may not show any outward symptoms, an unborn child might be severely affected. Listeriosis can result in miscarriage or premature birth. There is a possibility that a newborn might suffer a life-threatening infection in the days and weeks after birth.
The symptoms in a newborn child can be subtle but may include:
• irritability
• fever
• vomiting
• loss of interest in feeding
Listeriosis in newborns is divided into 2 categories –
• Early onset.
Early onset listeriosis happens within 6 days of birth. A newborn acquires the infection from their parent’s placenta. Early onset infections typically cause meningitis, septicemia (blood infection), and pneumonia.
• Late onset.
Late onset listeriosis happens between 7 to 28 days after birth. Medical professionals believe newborns with this type of listeriosis get the infection during delivery or due to an exposure in the hospital. It tends to cause meningitis and septicemia.
Causes –
Listeriosis develops after you come into contact with the bacteria L. monocytogenes. Most commonly, a person gets listeriosis after eating contaminated food. Listeria bacteria can be found in soil, water and animal feces. They can also live on food, on food production equipment, and in cold food storage.
People can get infected by eating the following:
• Raw vegetables that have been contaminated from the soil or from contaminated manure used as fertilizer
• Contaminated meat
• Unpasteurized milk or foods made with unpasteurized milk
• Certain processed foods — such as soft cheeses, hot dogs and deli meats that have been contaminated after processing
Unborn babies can contract a listeria infection from the mother.
Risk Factors –
Pregnant women and people who have weak immune systems are at highest risk of contracting a listeria infection.
▪︎ Pregnant women and their babies
Pregnant women are much more susceptible to listeria infections than are other healthy adults. Although a listeria infection might cause only a mild illness in pregnant women, consequences for their babies can include:
• Miscarriage
• Stillbirth
• Premature birth
• A potentially fatal infection after birth
▪︎ People who have weak immune systems
This category includes people who:
• Are older than 65
• Have AIDS
• Are receiving chemotherapy
• Have diabetes or kidney disease
• Take high-dose prednisone or certain rheumatoid arthritis drugs
• Take medications to block rejection of a transplanted organ
Complications –
The potential complications of listeriosis include:
• bacterial meningitis, inflammation of the membranes surrounding the brain and spinal cord
• encephalitis, inflammation of the brain
• endocarditis, an infection and inflammation of the inner lining of the heart
• septicemia, an infection of the bloodstream
• pneumonia, an infection of the lungs
• osteomyelitis, an infection of the bone
• septic arthritis, an infection of the joints
• sepsis, a life threatening condition that’s caused by your body’s response to an infection
Listeriosis in pregnant people may lead to miscarriage, premature delivery, or stillbirth. Listeriosis during pregnancy results in fetal death about 20 percent of the time.
In cases where the baby survives, they may develop a serious infection of the brain, blood, or lungs. This can cause lifelong health problems, such as seizures, paralysis, or intellectual disability.
Diagnosis –
Physicians base their preliminary diagnosis on the patient’s clinical history and physical exam, especially after the patient gives a history of likely exposure to a contaminated food source during a Listeria outbreak.
Definitive diagnosis of listeriosis is by culturing Listeria monocytogenes bacteria from the patient’s blood, cerebrospinal fluid, or amniotic fluid, usually on a medium that is selective for Listeria. In some cases, samples of urine or spinal fluid will be tested as well.
Treatment –
▪︎ For minor infections, medication might not be required.
If your symptoms are mild and you are otherwise in good health, treatment may not be necessary. Instead, your doctor may instruct you to stay home and care for yourself with close follow-up.
Home treatment for listeriosis is similar to treatment for any foodborne illness. To treat a mild infection at home, you can:
• Prevent dehydration by drinking water and clear liquids if vomiting or diarrhea occur.
• Use over-the-counter medications to manage body aches and fever, such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil or Motrin) or naproxen (Aleve).
• During recovery, eat foods that are easy to process. These include bananas, rice, applesauce, and toast. Limit spicy foods, dairy, alcohol, or fatty foods like meat.
▪︎ For more serious cases of listeriosis, antibiotics are the most common treatment choice; ampicillin and trimethoprim-sulfamethoxazole, can be used alone or in conjunction with another antibiotic (often gentamicin).
▪︎ If septicemia or meningitis occur, the individual will be given intravenous antibiotics and require up to 6 weeks of care and treatment. Antibiotics through an IV can help eliminate the infection, and the hospital staff can watch for complications.
Prevention –
Practicing food safety measures is the best way to prevent listeriosis. To do this, follow the tips below:
• Keeping clean.
Cleanliness is key. Clean your hands, counters, and appliances. Reduce the possibility of cross-contamination by washing your hands before and after cooking, cleaning produce, or unloading groceries.
• Washing produce thoroughly.
Under running water, scrub all fruits and vegetables with a produce brush. It’s best to do this even if you plan to peel the fruit or vegetable.
• Cooking foods well.
Kill bacteria by fully cooking meats. Try using a meat thermometer to ensure you’ve reached recommended safe cooking temperatures.
• Avoiding certain foods if you’re pregnant.
During pregnancy, limit foods that could be contaminated with Listeria bacteria. Some examples include unpasteurized cheeses, deli and processed meats, or smoked fish.
• Cleaning your fridge regularly.
Wash shelves, drawers, and handles with warm water and soap regularly to kill bacteria.
• Keeping temperatures cold enough.
Listeria bacteria don’t die in cold temperatures, but a properly cooled fridge can slow bacteria growth. If you can, invest in an appliance thermometer and maintain a refrigerator temperature at or below 40°F (4.4°C). The freezer should be at or below 0°F (-17.8°C).
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