In Los Angeles County, California, 142 cases of human listeriosis were reported from January 1 through August 15, 1985. Ninety-three cases (65.5 percent) occurred in pregnant women or their offspring, and 49 (34.5 percent) in nonpregnant adults. There were 48 deaths: 20 fetuses, 10 neonates, and 18 nonpregnant adults. Of the nonpregnant adults, 98 percent (48 of 49) had a known predisposing condition. Eighty-seven percent (81 of 93) of the maternal/neonatal cases were Hispanic. Of the Listeria monocytogenes isolates available for study, 82 percent (86 of 105) were serotype 4b, of which 63 of 86 (73 percent) were the same phage type. A case-control study implicated Mexican-style soft cheese (odds ratio, 5.5; 95 percent confidence interval, 1.2 to 24.8) as the vehicle of infection; a second case-control study showed an association with one brand (Brand A) of Mexican-style soft cheese (odds ratio, 8.5; 95 percent confidence interval, 2.4 to 26.2). Laboratory study confirmed the presence of L. monocytogenes serogroup 4b of the epidemic phage type in Brand A Mexican-style cheese. In mid-June, all Brand A cheese was recalled and the factory was closed. An investigation of the cheese plant suggested that the cheese was commonly contaminated with unpasteurized milk. We conclude that the epidemic of listeriosis was caused by ingestion of Brand A cheese contaminated by one phage type of L. monocytogenes serotype 4b.
In an investigation of a 1981-1982 outbreak of nosocomial Salmonella saintpaul infection in hospitalized horses at the University of California Veterinary Medical Teaching Hospital in Davis, California, a case-control study was performed using data gathered from the records of 33 cases and 132 controls. Multiple logistic regression risk analysis was used to identify factors associated with isolation of the organism, controlling for the effects of other, possibly confounding variables. Horses receiving parenteral antibiotics were at 10.9 times greater risk of having S. saintpaul isolated than were horses not receiving parenteral antibiotics. Horses intubated with nasogastric tubes were 3.9 times more likely to have had the organism isolated from fecal specimens than horses not intubated, and horses with a presenting complaint of colic were at 2.2 times greater risk of isolation than horses with other presenting complaints.
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