Febrile gastroenteritis after eating on-farm manufactured fresh cheese – an outbreak of listeriosis?

• Published in: Epidemiology and infection Vol. 130; no. 1; pp. 79 - 86
• Main Authors: CARRIQUE-MAS, J. J., HÖKEBERG, I., ANDERSSON, Y., ARNEBORN, M., THAM, W., DANIELSSON-THAM, M.-L., OSTERMAN, B., LEFFLER, M., STEEN, M., ERIKSSON, E., HEDIN, G., GIESECKE, J.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-02-2003
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Bacteriology; Biological and medical sciences; Campylobacter; Cheese - microbiology; Cheese industry; Child; Child, Preschool; Cohort Studies; Cows milk cheeses; Culinary Arts and Meal Science; Dairy products; Dairying; Diarrhea; Disease control; Disease Outbreaks; Diseases; Dosage; Drug dosages; Epidemiology; Feces - microbiology; Female; Fever; Food Microbiology; Fundamental and applied biological sciences. Psychology; Gastroenteritis; Gastroenteritis - epidemiology; Gastroenteritis - microbiology; Goats milk cheeses; Human bacterial diseases; Humans; Hypotheses; Illnesses; Infectious diseases; Investigations; Listeria; Listeria monocytogenes - genetics; Listeria monocytogenes - isolation & purification; Listeriosis - epidemiology; Listeriosis - microbiology; Male; Medical sciences; Medicin och hälsovetenskap; Microbiology; Middle Aged; Måltidskunskap; Polymerase Chain Reaction; Questionnaires; Salmonella; Seasons; Surveys and Questionnaires; Sweden - epidemiology; Veterinary medicine; Sweden; Europe; United Kingdom > UK; United States > US; Epidemic; Human; Gastroenteritis; Listeria monocytogenes; Listeriosis; Epidemiology; Infection; Etiology; Fresh cheese; Food poisoning; Bacteriosis; Digestive diseases; Bacteria; Intestinal disease; Gastric disease
• ISSN: 0950-2688; 1469-4409; 1469-4409
• DOI: 10.1017/S0950268802008014

An outbreak of febrile gastroenteritis affected consumers of on-farm manufactured dairy products from a summer farm in Sweden. Symptoms included diarrhoea, fever, stomach cramps and vomiting in 88, 60, 54 and 21% of cases identified. The median incubation period was 31 h. A cohort study with 33 consumers showed an attack rate of 52% and an association between the total amount of product eaten and illness (P=0·07). Twenty-seven of 32 (84%) stool samples cultured for Listeria monocytogenes tested positive, although there was no association between clinical disease and the isolation of L. monocytogenes. In addition, gene sequences for VTEC and ETEC were detected in 6 and 1 subjects, respectively. Bacteriological analysis of cheese samples revealed heavy contamination with L. monocytogenes and coagulase positive staphylococci in all of them and gene markers for VTEC in one of them. Molecular profiles for L. monocytogenes isolated from dairy products, stool samples and an abscess from 1 patient who developed septic arthritis were identical. Results of both microbiological and epidemiological analyses point to L. monocytogenes as the most likely cause of this outbreak. The finding of markers for VTEC in some humans and cheese samples means that a mixed aetiology at least in some cases cannot be conclusively ruled out.