Listeriosis outbreak caused by contaminated stuffed pork, Andalusia, Spain, July to October 2019

Abstract

Between 1 July and 26 October 2019 in Andalusia, Spain, a large outbreak with 207 confirmed cases of listeriosis was identified. Confirmed cases had a median age of 44 years (range: 0–94) and 114 were women (55.1%). Most cases (n = 154) had mild gastroenteritis, 141 (68.1%) required hospitalisation and three died; five of 34 pregnant women had a miscarriage. The median incubation period was 1 day (range: 0–30), and was significantly shorter in cases presenting with gastroenteritis compared to those presenting without gastroenteritis (1 day vs. 3 days, respectively, p value < 0.001). Stuffed pork, a ready-to-eat product consumed unheated, from a single producer contaminated with Listeria monocytogenes ST388 was identified as the source of infection. The outbreak strain was identified in 189 human samples and 87 non-human (82 food and 5 environmental) samples. Notification of new cases declined abruptly after control measures were implemented. These included contaminated food recall, protocols for clinical management of suspected cases and for post-exposure prophylaxis in pregnant women and communication campaigns with concise messages to the population through social media. Given that there were 3,059 probable cases, this was the largest L. monocytogenes outbreak ever reported in Europe.

SIEGA the integrated genomic surveillance system of Andalusia, a One Health regional resource connected with the clinic

“…The SIEGA includes a dataset comprising 678 whole genome sequences of Listeria monocytogenes , which were sequenced from June 2019 to July 2023. Within this dataset, 69.61% (472) of the samples were sourced from clinical origins, including all the samples from Andalusia sequenced by the Neisseria, Listeria and Bordetella Unit of the National Centre for Microbiology in Spain while investigating the Listeriosis outbreak caused by contaminated stuffed pork in Spain in 2019 29 , and 30.38% (206) from food origin. A total of 248 distinct STs were identified and categorized into CCs.…”

High density genomic surveillance and risk profiling of clinical Listeria monocytogenes subtypes in Germany, 2018-2021

“…Several of the clusters identified also reflected real listeriosis outbreaks (Tab.1). Their recognition can initiate successful back-tracing of L. monocytogenes clones to their infection source as demonstrated during past outbreaks (17)(18)(19).…”

“…Moreover, European legislation has defined contamination limits for L. monocytogenes in ready-to-eat or infant food (16). While all these measures doubtlessly help to keep listeriosis incidence low, large and protracted outbreaks of listeriosis regularly occur (17)(18)(19), highlighting the importance of disease surveillance systems for detection of clusters of epidemiologically linked cases over a prolonged time as a prerequisite to identify and inactivate the underlying source.…”

Consumer attitudes and perceptions towards chilled ready-to-eat foods: a multi-national study

“…contaminated RTE meat products resulted in more than 200 confirmed cases and 3 deaths(Fernández-Martínez et al 2022). Also, in Portugal contaminated cheese induced an outbreak with more than 30 cases and 1 death(Magalhães et al 2015).…”