Emergence of pregnancy-related listeriosis amongst ethnic minorities in England and Wales.
Listeriosis is a rare but severe food-borne disease that predominantly affects pregnant women, the unborn, newborns, the elderly and immunocompromised people. Following a large outbreak in the 1980s, specific food safety advice was provided to pregnant women and the immunocompromised in the United Kingdom. Following two coincident yet unconnected cases of pregnancy-related listeriosis in eastern European women in 2008, a review of the role of ethnicity in pregnancy-related listeriosis in England and Wales was undertaken in 2009. Cases reported to the national listeriosis surveillance scheme were classified as 'ethnic', belonging to an ethnic minority, or 'non-ethnic' based on their name, and trends were examined. Between 2001 and 2008, 1,510 cases of listeriosis were reported in England and Wales and, of these, 12% were pregnancy-related cases. The proportion of pregnancy-related cases classified as ethnic increased significantly from 16.7% to 57.9% (chi-square test for trend p=0.002). The reported incidence among the ethnic population was higher than that among the non-ethnic population in 2006, 2007 and 2008 (Relative Risk: 2.38, 95% confidence interval: 1.07 to 5.29; 3.82, 1.82 to 8.03; 4.33, 1.74 to 10.77, respectively). This effect was also shown when analysing data from January to September 2009, using extrapolated live births as denominator. Increased immigration and/or economic migration in recent years appear to have altered the population at risk of pregnancy-related listeriosis in England and Wales. These changes need to be taken into account in order to target risk communication strategies appropriately.
Mook
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Health Protection Agency, Centre for Infections, London, United Kingdom. Piers.mook@hpa.org.uk
Grant
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Little
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Kafatos
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Gillespie
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D000328:Adult; D001208:Asia / Q000208:ethnology; D017691:Caribbean Region / Q000208:ethnology; D021821:Communicable Diseases, Emerging / Q000191:economics / Q000208:ethnology* / Q000382:microbiology / Q000635:transmission; D004196:Disease Outbreaks; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000191:economics / Q000208:ethnology; D005506:Food Contamination; D005516:Food Microbiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008089:Listeria monocytogenes / Q000302:isolation & purification; D008088:Listeriosis / Q000191:economics / Q000208:ethnology* / Q000635:transmission; D008913:Minority Groups / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics / Q000208:ethnology* / Q000382:microbiology; D012189:Retrospective Studies; D035862:Vulnerable Populations; D014852:Wales / Q000453:epidemiology