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  • Multistate outbreak of List...
    ANGELO, K. M.; CONRAD, A. R.; SAUPE, A.; DRAGOO, H.; WEST, N.; SORENSON, A.; BARNES, A.; DOYLE, M.; BEAL, J.; JACKSON, K. A.; STROIKA, S.; TARR, C.; KUCEROVA, Z.; LANCE, S.; GOULD, L. H.; WISE, M.; JACKSON, B. R.

    Epidemiology and infection, 04/2017, Letnik: 145, Številka: 5
    Journal Article

    Whole apples have not been previously implicated in outbreaks of foodborne bacterial illness. We investigated a nationwide listeriosis outbreak associated with caramel apples. We defined an outbreak-associated case as an infection with one or both of two outbreak strains of Listeria monocytogenes highly related by whole-genome multilocus sequence typing (wgMLST) from 1 October 2014 to 1 February 2015. Single-interviewer open-ended interviews identified the source. Outbreak-associated cases were compared with non-outbreak-associated cases and traceback and environmental investigations were performed. We identified 35 outbreak-associated cases in 12 states; 34 (97%) were hospitalized and seven (20%) died. Outbreak-associated ill persons were more likely to have eaten commercially produced, prepackaged caramel apples (odds ratio 326·7, 95% confidence interval 32·2–3314). Environmental samples from the grower's packing facility and distribution-chain whole apples yielded isolates highly related to outbreak isolates by wgMLST. This outbreak highlights the importance of minimizing produce contamination with L. monocytogenes. Investigators should perform single-interviewer open-ended interviews when a food is not readily identified.