Check out how stuffed pork caused large listeriosis outbreak in Spain

A significant listeriosis outbreak with 207 confirmed cases in Andalusia in 2019 was linked to stuffed pork, a common "tapa" in southern Spain.

Consumption of food contaminated with Listeria monocytogenes is one of the main ways that food-borne outbreaks spread since listeria bacteria are so common in the environment. Adults in good health may not even experience symptoms after consuming tainted food. However, pregnant women, newborns, and those with compromised immune systems are particularly vulnerable to the health effects of listeriosis. Since 2008, there has been a steady rise in the prevalence of listeriosis across Europe, with a noticeable increase trend in Spain since 1997.

A significant outbreak with 207 confirmed cases was brought on by tainted food between July and the end of October 2019 in the Andalusia region of southern Spain. With a peak of 43 symptomatic patients reported on one day in mid-August 2019, Fernandez-Martnez et al. [2] outline the investigations to determine the aetiology of the illnesses and causes for the diseases' rapid spread (the median incubation time was 1 day). Active case finding was done both forward and backward during these investigations.

Food source and molecular typing identified the source within 10 days

Within ten days of the outbreak being discovered in early August, epidemiological interviews and whole genome sequencing were able to identify the food source and the appropriate listeria strain. Samples of food and possibly exposed surfaces from the environment were taken as part of the inquiry, which also included food factories, markets, grocery stores, pubs, and restaurants. Some patients also gave samples of food from their own kitchens.

Following the initial three cases of food poisoning that were recorded at the beginning of August, the regional health authorities issued a public health alert on August 15. Most of the patients who were interviewed throughout the study stated that they had purchased stuffed pork from a variety of eateries, primarily supermarkets and bars. These answers led to trace-back research in the aforementioned grocery store to a particular establishment where the stuffed pork was made.

The supermarket offered two separate brands of pork, each made by a different business. L. monocytogenes was detected in one sample from those goods. A recall was issued for any meat or meat derivative produced at the plant where a listeria-positive food sample was found, and food production was halted there. The warning was progressively expanded to cover all food products made at this facility.

The facility's distribution was nearly entirely limited to Andalusia, although the food recall touched roughly 8 tonnes of beef products. Notifications of listeriosis decreased after the product recall, indicating that food products from other facilities did not contribute significantly as a probable source in this outbreak.

Specific post-exposure protocol for pregnant women: 30,000 women were interviewed

3,582 suspected instances were looked at in total, 207 were found to be true, and 3,059 were deemed likely cases. An invasive clinical manifestation of the illness was seen in nearly all patients (94 per cent) with confirmed listeriosis, and two out of three (68 per cent) required hospitalization. The authors also note three fatalities connected to this outbreak and five miscarriages among 34 pregnant individuals.

The protocol for antibiotic post-exposure prophylaxis (PEP) in pregnant women with a history of stuffed pork intake is described by Fernandez-Martnez et al (after antimicrobial susceptibility testing excluded ampicillin resistance in the outbreak strain). This involved monitoring the ladies to see if listeriosis symptoms appeared.

Within a few weeks of the outbreak, authorities in Andalusia questioned more than 30,000 pregnant women. A PEP procedure was advised for about 5% of those women based on individual assessments. The authors claim that the regimen was created specifically for this outbreak to lessen any potential harm to expectant mothers.

By the time the outbreak came to a conclusion in October 2019, more than 1,800 food businesses had been tested, and 87 non-human samples had been contaminated with L. monocytogenes. The majority of positive samples and other pig derivatives originated from food products.

Ready-to-eat (RTE) goods, which may be consumed without prior heating and are more popular, are becoming an important source of listeriosis outbreaks, as noted by Fernandez-Martnez et al. Stuffed pork is a classic RTE dish that is highly well-liked in Andalusia since it is a reasonably priced food. It is made up of a cold cut of roasted pork with salt, garlic, and other seasonings. It is one of the most popular "tapas," frequently eaten in the summer and on special occasions, and is frequently used in aperitives and sandwiches. They discovered that an outbreak in Europe with 200 or more confirmed cases began in 1992 when 279 confirmed cases of listeriosis linked to eating jellied pig tongue were reported in France.

In order to prevent and control listeriosis, the authors argue that "efforts to include whole genome sequencing" into epidemic investigations and to coordinate various sectors at the regional and national levels are crucial.

( With inputs from ANI )

Disclaimer: This post has been auto-published from an agency feed without any modifications to the text and has not been reviewed by an editor