Friday, July 6, 2018

PRO/AH/EDR> Listeriosis - Europe (04): fatal, ST6, frozen corn, 2015-18, recall

LISTERIOSIS - EUROPE (04): FATAL, SEQUENCE TYPE 6, FROZEN CORN,
2015-2018, RECALL
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 3 Jul 2018
Source: Food Poison Journal [edited]
<http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/hungarian-frozen-vegetables-link-in-europe-listeria-outbreak/>


Frozen corn and possibly other frozen vegetables are the likely source
of an outbreak of _Listeria monocytogenes_ that has been affecting
Austria, Denmark, Finland, Sweden, and the United Kingdom since 2015.

Experts used whole genome sequencing to identify the food source,
which initially was thought to be limited to frozen corn. As of 8 Jun
2018, 47 cases including 9 deaths had been reported.

The same strains of _L. monocytogenes_ have been detected in frozen
vegetables produced by the same Hungarian company in 2016, 2017, and
2018. This suggests that the strains have persisted in the processing
plant despite the cleaning and disinfection procedures that were
carried out.

The available information confirms the contamination at the Hungarian
plant. However, further investigations, including thorough sampling
and testing, are needed to identify the exact points of environmental
contamination at the Hungarian plant. The same recommendation applies
to other companies belonging to the same commercial group if
environmental contamination is detected.

On 29 Jun 2018, the Hungarian Food Chain Safety Office banned the
marketing of all frozen vegetable and frozen mixed vegetable products
produced by the affected plant between August 2016 and June 2018, and
ordered their immediate withdrawal and recall. This last measure is
likely to significantly reduce the risk of human infections and
contain the outbreak. All freezing activity at the plant has been
stopped.

New cases could still emerge due to the long incubation period of
listeriosis (up to 70 days); the long shelf-life of frozen corn
products; and the consumption of frozen corn bought before the recalls
and eaten without being cooked properly.

To reduce the risk of infection, consumers should thoroughly cook non
ready-to-eat frozen vegetables, even though these products are
commonly consumed without cooking (such as in salads and smoothies).
This applies especially to consumers at highest risk of contracting
listeriosis -- such as the elderly, pregnant women, newborns and
adults with weakened immune systems.

[Byline: Josh Fensterbush]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[When last reported by ProMED-mail in March 2018 (Listeriosis - EU:
fatal, ST6, frozen corn, 2015-18, recall
http://promedmail.org/post/20180325.5708506), there was a total of 32
confirmed listeriosis cases, including 6 deaths, between December 2015
and 8 Mar 2018, in a multi-country outbreak in 5 EU member states
(Austria, Denmark, Finland, Sweden, and the United Kingdom) linked by
whole genome sequencing (genotyping) of clinical isolates of _Listeria
monocytogenes_ to frozen corn that was packed in Poland and
processed/produced in Hungary. As of 8 Jun 2018, there are now 47
reported cases, including 9 deaths.

Possibly other frozen vegetables produced by the Hungarian facility
are also being implicated and on 29 June 2018, the Hungarian Food
Chain Safety Office ordered recall and banned further the marketing of
all frozen vegetable and frozen mixed vegetable products produced by
the affected facility between August 2016 and June 2018. All freezing
activity at the plant has been stopped.

_Listeria monocytogenes_ is widely distributed in the environment
where it can form biofilms, which enables them to attach to solid
surfaces and become extremely difficult to remove, especially in parts
of equipment that are difficult to access. In a prior ProMED-mail
report of a listeriosis outbreak in Canada, the design of a commercial
meat slicer responsible for contamination of deli meat made its
regular cleaning difficult and costly for the food processor
(Listeriosis - South Africa (04): comment
http://promedmail.org/post/20180126.5586393). The contamination
occurred in parts of the machinery "well beyond the [manufacturer's]
recommended sanitation process" and was "found only after the devices
were completely disassembled"
(<https://www.theglobeandmail.com/news/national/maple-leaf-eyes-meat-slicers-in-outbreak/article1060898/>).
Perhaps a similar situation is responsible for this prolonged
multicountry EU outbreak.

Serotyping of _L. monocytogenes_ strains, based on variations in the
somatic (O) and flagellar (H) antigens, has determined that only 3
(1/2a, 1/2b, and 4b) of the 12 serotypes of _L. monocytogenes_ cause
95 per cent of human cases; serotype 4b is most commonly associated
with outbreaks
(<https://www.cdc.gov/listeria/pdf/listeriainitiativeoverview_508.pdf>).
The serotype of the strain of _L. monocytogenes_ responsible for this
multi-country European outbreak is 4b, multi-locus sequence type 6
(ST6). Whole genome sequence (WGS) analysis of _L. monocytogenes_
isolates from 2 different samples of mixed frozen vegetables and an
isolate from a surface where various vegetables could have been
processed closely matched that of the clinical isolates (ProMED-mail
post Listeriosis - EU: fatal, ST6, frozen corn, 2015-18, recall
http://promedmail.org/post/20180325.5708506).

HealthMap/ProMED-mail map of Europe:
<http://healthmap.org/promed/p/11767>. - Mod.ML]

[See Also:
Listeriosis - Europe (03): Sweden (VG) fatal, mashed potatoes, recall,
RFI http://promedmail.org/post/20180520.5807321
Listeriosis - Europe (02): background
http://promedmail.org/post/20180325.5709796
Listeriosis - Europe: fatal, ST6, frozen corn, 2015-18, recall
http://promedmail.org/post/20180325.5708506]
.................................................jh/ml/mj/jh
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