title: Multistate outbreak of Listeria monocytogenes infection linked to delicatessen turkey meat.
abstract: BACKGROUND
  Despite a decreasing incidence of listeriosis in the United States, molecular subtyping has increased the number of recognized outbreaks. In September 2000, the New York City Department of Health identified a cluster of infections caused by Listeria monocytogenes isolates with identical molecular subtypes by pulsed-field gel electrophoresis (PFGE) and ribotyping.
  
  
  METHODS
  To determine the magnitude of the outbreak and identify risk factors for infection, we notified state health departments and conducted a case-control study. A case was defined as a patient or mother-infant pair infected with Listeria monocytogenes whose isolate yielded the outbreak PFGE pattern. Controls were patients infected with Listeria monocytogenes whose isolate yielded a different PFGE pattern. Patients were asked about food and drink consumed during the 30 days before the onset of illness.
  
  
  RESULTS
  Between May and December 2000, there were 30 clinical isolates of Listeria monocytogenes with identical PFGE patterns identified in 11 US states. Cases of infection caused by these isolates were associated with 4 deaths and 3 miscarriages. A case-control study implicated sliced processed turkey from a delicatessen (Mantel-Haenszel odds ratio, 8.0; 95% confidence interval, 1.2-43.3). A traceback investigation identified a single processing plant as the likely source of the outbreak, and the company voluntarily recalled 16 million pounds of processed meat. The same plant had been identified in a Listeria contamination event that had occurred more than a decade previously.
  
  
  CONCLUSIONS
  Prevention of persistent L. monocytogenes contamination in food processing plants presents a critical challenge to food safety professionals.
authors.affiliation: Foodborne and Diarrheal Diseases Branch, Centers for DiseaseControl and Prevention, Atlanta, USA. sco2@cdc.gov
authors.forename: Sonja J
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authors.lastname: Olsen
authors.forename: Mary
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authors.lastname: Patrick
authors.forename: Susan B
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authors.lastname: Hunter
authors.forename: Vasudha
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authors.lastname: Reddy
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authors.lastname: Kornstein
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authors.lastname: Bidol
authors.forename: Gillian A
authors.initials: GA
authors.lastname: Stoltman
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authors.initials: DM
authors.lastname: Frye
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authors.lastname: Hurd
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Jones
authors.forename: Tracy N
authors.initials: TN
authors.lastname: LaPorte
authors.forename: Wallis
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authors.lastname: Dewitt
authors.forename: Lewis
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authors.lastname: Graves
authors.forename: Martin
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authors.lastname: Wiedmann
authors.forename: Dianna J
authors.initials: DJ
authors.lastname: Schoonmaker-Bopp
authors.forename: Ada J
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authors.lastname: Huang
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authors.lastname: Corby
authors.forename: Edmund R
authors.initials: ER
authors.lastname: Carloni
authors.forename: Mara E
authors.initials: ME
authors.lastname: Holcomb
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Woron
authors.forename: Shelley M
authors.initials: SM
authors.lastname: Zansky
authors.forename: Gerrie
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authors.lastname: Dowdle
authors.forename: Forrest
authors.initials: F
authors.lastname: Smith
authors.forename: Susann
authors.initials: S
authors.lastname: Ahrabi-Fard
authors.forename: Anna Rae
authors.initials: AR
authors.lastname: Ong
authors.forename: Nicole
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authors.lastname: Tucker
authors.forename: Noreen A
authors.initials: NA
authors.lastname: Hynes
authors.forename: Paul
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mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D016022:Case-Control Studies; D004196:Disease Outbreaks; D005260:Female; D005516:Food Microbiology; D006801:Humans; D008088:Listeriosis / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011202:Poultry Products / Q000382:microbiology*; D014422:Turkeys / Q000382:microbiology*; D014481:United States / Q000453:epidemiology