What you need to know about the listeriosis outbreak

The National Department of Health gave an update on 4 March 2018 about its investigation into the source of the outbreak, which has now been confirmed as a processed-meat production facility in Polokwane.

"We advise people not to spread unnecessary panic, but to look to reputable and trusted sources for updates and information," says Dr Noluthando Nematswerani, Head of the Centre for Clinical Excellence at Discovery.

Here's what you need to know about the disease and how to prevent yourself and your family getting infected, by following food safety principles.

What is listeriosis?

Listeriosis is food poisoning that's caused by eating foods contaminated with the Listeria monocytogenes bacterium. An otherwise healthy person who is not pregnant typically doesn't need treatment. Symptoms will usually go away within a few weeks.

Where and how did the current Listeriosis outbreak start?

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Who is at high risk?

Listeriosis mainly affects pregnant women, new-borns (in the first 28 days of life), young infants, the elderly, and adults with impaired immune systems (due to HIV infection, cancer, diabetes, kidney disease, liver disease people with transplants and those on immunosuppressive therapy such as oral corticosteroids, chemotherapy, or anti-TNF therapy for auto-immune disease). In pregnant women, the infection can result in miscarriage, premature delivery or serious infection of the new-born.

Pregnant women who are otherwise healthy usually have only minor symptoms. However, being infected with Listeria during pregnancy can seriously affect the health of the foetus. The pregnant woman usually has a good prognosis, but her foetus or new-born has a guarded prognosis, depending how quickly the mother or new-born is effectively treated.

What are the symptoms?

The symptoms of listeriosis include fever, muscle aches, and sometimes nausea or diarrhoea. If infection spreads to the nervous system, symptoms such as headache, stiff neck, confusion, loss of balance, or convulsions can occur. But infected pregnant women may experience only a mild, flu-like illness - so if you suspect anything, go see a doctor.

How is listeriosis diagnosed?

Listeriosis is diagnosed based on a medical history and physical exam. Your doctor will ask you about foods you’ve recently eaten, and your work and home environments. A blood test or spinal fluid test may be done to confirm the diagnosis.

How is listeriosis treated?

Most people with listeria infections spontaneously clear the infection in about seven days. But patients at high risk, especially pregnant women, need immediate IV antibiotic treatment to prevent, stop or slow the development of more severe disease. Early effective antibiotic treatment of pregnant women can be lifesaving for the foetus.

Babies who have listeriosis receive the same antibiotics as adults, although a combination of antibiotics is often used until your doctor is sure the cause is listeriosis.

Is listeria contagious?

No, it's not contagious from person to person. The one exception is pregnant women, who can transfer the bacteria to their foetus. Babies can be born with listeriosis if their mothers eat contaminated food during pregnancy, or become infected through contaminated fluids at birth.

How can you prevent listeriosis?

The National Department of Health emphasises the importance of the five food-safety rules which should be followed at all times:

• Always wash your hands well with soap and in warm running water before and after handling food, and after using the bathroom.
• Wash non-cooked food (like fresh vegetables) under clean running water.
• Store food at an appropriate temperature and keep raw food separate from cooked food (for example, when you pack and store it).
• Make sure that food is well cooked.
• Only use pasteurised or boiled milk products.

The National Institute for Communicable Diseases (NICD) reminds the public that unlike most other foodborne pathogens, Listeria monocytogenes can grow in refrigerated foods that are contaminated. To prevent this, keep fridge temperatures below 4°C and freezer temperatures below -18°C.

Avoid these foods if you're at high risk

The NICD also suggests that if you’re pregnant or at high risk for listeriosis, you should avoid the following foods:

• Dairy products that contain unpasteurised milk.
• Soft cheeses (e.g. feta, goat, Brie, Camembert).
• Foods from deli counters (e.g. prepared salads, cold meats, sausages) that may not have been cooked adequately (hot foods should be kept at 60°C or above and cold foods at 4°C or below).
• Make sure that food is well cooked.
• Refrigerated pâtés, meat spreads, or smoked refrigerated seafood (canned foods are fine).

If in doubt, throw it out

If you're not sure whether a food is safe, don't taste it. Reheating food that is contaminated will not make it safe. Use bleach diluted in water to wipe up any fridge spills, and wash and decontaminate your kitchen appliances, surfaces and utensils, especially after preparing raw meat, poultry and eggs.

You should also bag raw meat, poultry, or fish separately from other food items when you shop and get home right after finishing your shopping so you can store all foods properly (lead the food labels to learn what's recommended).

Practising good food hygiene is vital

"As there's no vaccine or for preventing infection, the main preventive measure is to follow good hygiene and basic food safety principles," emphasises Dr Noluthando Nematswerani. "Follow the recommended guidelines to avoid infection, and if you're in a high-risk category - especially you're pregnant - consult a doctor right away if you experience any symptoms."

Sources

^{http://www.nicd.ac.za/wp-content/uploads/2018/03/Update-on-Listeriosis-Press-Conference-Monday-04-March-2018-FINAL.pdf}

^{https://www.webmd.com/food-recipes/food-poisoning/tc/listeriosis-topic-overview}

^{https://www.medicinenet.com/listeria/article.htm#if_a_person_has_eaten_recalled_food_potentially_contaminated_with_listeria_what_should_he_or_she_do}