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Role of Foods in Sporadic ListeriosisI. Case-Control Study of Dietary Risk Factors
Anne Schuchat, MD;
Katherine A. Deaver;
Jay D. Wenger, MD;
Brian D. Plikaytis, MS;
Laurene Mascola, MD;
Robert W. Pinner, MD;
Arthur L. Reingold, MD;
Claire V. Broome, MD;
Listeria Study Group;
B. Swaminathan, PhD;
Peggy S. Hayes;
Lewis Graves;
Richard Pierce, MPH;
Vincent Przybyszewski;
Ray Ransom;
Michael Reeves, PhD;
Robert Weaver, MD, PhD;
Gretchen Anderson;
Elizabeth Stone;
Kevin Krauss;
Maribel Castillon;
Christopher Harvey;
Tina Stull, MD;
David Stephens, MD;
Monica Farley, MD;
Pam Archer;
Jane Strack;
Gregory Istre, MD;
Margaret Rados;
Jo Taylor;
Lewis Lefkowitz, MD
JAMA. 1992;267(15):2041-2045.
Abstract
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Objective.
—To identify dietary risk factors for sporadic listeriosis.
Design.
—Case-control study with blinded telephone interviews.
Setting.
—Multistate population of 18 million persons, November 1988 through December 1990.
Participants.
—One hundred sixty-five patients with culture-confirmed listeriosis and 376 control subjects matched for age, health care provider, and immunosuppressive condition.
Results.
—The annual incidence of invasive listeriosis was 7.4 cases per million population; 23% of the infections were fatal. Cases were more likely than matched controls to have eaten soft cheeses (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4 to 4.8; P =.002) or food purchased from store delicatessen counters (OR, 1.6; 95% CI, 1.0 to 2.5; P=.04); 32% of sporadic disease could be attributed to eating these foods. Sixty-nine percent of cases in men and nonpregnant women occurred in cancer patients, persons with the acquired immunodeficiency syndrome, organ transplant recipients, or those receiving corticosteroid therapy. Among these immunosuppressed patients, eating undercooked chicken also increased the risk of listeriosis (OR, 3.3; 95% CI, 1.2 to 9.2; P=.02
Conclusions.
—Foodborne transmission may account for a substantial portion of sporadic listeriosis. Prevention efforts should include dietary counseling of high-risk patients and continued monitoring of food production.
(JAMA. 1992;267:2041-2045)
Author Affiliations
Centers for Disease Control, Atlanta, Ga; San Francisco (Calif) Department of Health; Alameda County Department of Health, Oakland, Calif; University of California at Berkeley; Los Angeles County (Calif) Health Department; Department of Medicine, Emory University, Atlanta, Ga; Oklahoma State Department of Health, Oklahoma City; Department of Preventive Medicine, Vanderbilt University, Nashville, Tenn.
From the Meningitis and Special Pathogens Branch (Drs Schuchat, Wenger, Pinner, Broome, and Ms Deaver), Biostatistics and Information Branch (Mr Plikaytis), Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, Ga; Acute Communicable Disease Control, Los Angeles (Calif) County Health Department (Dr Mascola); and the Department of Biomedical and Environmental Health Sciences, University of California at Berkeley (Dr Reingold).
Footnotes
Reprint requests to Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control, Mailstop C09, Atlanta, GA 30333 (Dr Schuchat).
A complete list of the members of the Listeria Study Group appears at the end of this article.
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