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Red Book Online Outbreaks: Listeria Outbreak Linked to Ice Cream

August 10, 2022

CDC is currently investigating a Listeria monocytogenes outbreak linked to ice cream. As of August 4, 2022, 25 people in 11 states have been infected with Listeria monocytogenes possibly due to eating Big Olaf Creamery brand ice cream or eating ice cream at locations that might have been supplied by Big Olaf Creamery. Of the 25 people infected, 24 (96%) have been hospitalized. One death has been reported. Where Sick People Lived | Listeria Outbreak | CDC

 

Clinical Guidance

Presentation:

  • Patients should call their pediatrician right away if they exhibit any signs or symptoms of Listeria infection after eating ice cream.
  • Listeria usually causes common food poisoning signs and symptoms, like fever and diarrhea. People who experience these symptoms usually recover without treatment. Symptoms of self-limited febrile gastroenteritis usually start within 24 hours of ingesting a contaminated food and last 2-3 days.
  • Less commonly, Listeria can cause severe illness (known as invasive listeriosis) when the bacteria spread beyond the gut to other parts of the body. Symptoms of invasive listeriosis usually start 1 to 4 weeks after eating contaminated food but may occasionally start even later.
    • Pregnant people with invasive listeriosis usually experience only fever, fatigue, muscle aches, and occasionally gastrointestinal tract infections.
    • Non-pregnant people with invasive listeriosis may experience headaches, stiff neck, confusion, loss of balance, and convulsions, in addition to fever and muscle aches.

 Who is at the highest risk/complications?

  • Those at highest risk from Listeria infections include people who are 65 years or older, are pregnant, or are immunocompromised.
  • Listeria can cause pregnancy loss or premature birth.
  • Listeria can also cause serious illness or death in newborns.

Diagnosis:

  • L monocytogenes can be recovered readily on blood agar from cultures of blood, cerebrospinal fluid (CSF), meconium, placental or fetal tissue specimens, amniotic fluid, and other infected tissue specimens, including joint, pleural, or peritoneal fluid. 
  • Polymerase chain reaction (PCR) assays can be used to detect L monocytogenes in blood and CSF. 
  • Stool cultures are generally not useful for the diagnosis of Listeria.

Precautions:

  • Big Olaf Creamery in Sarasota, FL, is contacting retail locations to recommend against selling their ice cream products. Do not eat any recalled ice cream (discard or return product to store).
  • Ensure proper cleaning after exposure because Listeria can survive in the refrigerator and can easily spread to other foods and surfaces.

Risk Mitigation:

  • Antimicrobial therapy for infection diagnosed during pregnancy may prevent fetal or perinatal infection and its consequences.

Treatment:

  • Combination therapy using ampicillin and a second agent in doses appropriate for meningitis is recommended for severe infections (see Treatment section in Red Book chapter).

Reporting:

  • Listeriosis is a nationally notifiable disease in the United States.
  • Cases should be reported promptly to the state or local health department to facilitate early recognition and control of common-source outbreaks.
  • Clinical isolates should be forwarded to a public health laboratory for genetic sequencing.

Resources

 

Pediatric Practice Tools and Information

Listeria (Listeriosis) | CDC

 

Public Health Resources

Investigation Details | Listeria Outbreak | CDC

Where Sick People Lived | Listeria Outbreak | CDC

When People Got Sick | Listeria Outbreak | CDC

 

Infection Prevention and Control Resources

Project Firstline (aap.org)

 

Information for Patients and Caregivers

HealthyChildren.org: Listeriosis Infection | Spanish: Infección por listeriosis

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