title: Serving high-risk foods in a high-risk setting: survey of hospital food service practices after an outbreak of listeriosis in a hospital.
abstract: OBJECTIVE
  Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies and practices after a listeriosis outbreak occurred in a NYC hospital.
  
  
  METHODS
  From August through October 2008, a listeriosis outbreak in a NYC hospital was investigated. From February through April 2009, NYC's 61 acute-care hospitals were asked to participate in a telephone survey regarding food safety practices and policies, specifically service of high-risk foods to patients at increased risk for listeriosis.
  
  
  RESULTS
  Five patients with medical conditions that put them at high risk for listeriosis had laboratory-confirmed Listeria monocytogenes infection. The Listeria outbreak strain was isolated from tuna salad prepared in the hospital. Fifty-four (89%) of 61 hospitals responded to the survey. Overall, 81% of respondents reported serving ready-to-eat deli meats to patients, and 100% reported serving prepared ready-to-eat salads. Pregnant women, patients receiving immunosuppressive drugs, and patients undergoing chemotherapy were served ready-to-eat deli meats at 77%, 59%, and 49% of hospitals, respectively, and were served prepared ready-to-eat salads at 94%, 89%, and 73% of hospitals, respectively. Only 4 (25%) of 16 respondents reported having a policy that ready-to-eat deli meats must be heated until steaming hot before serving.
  
  
  CONCLUSIONS
  Despite the potential for severe outcomes of Listeria infection among hospitalized patients, the majority of NYC hospitals had no food preparation policies to minimize risk. Hospitals should implement policies to avoid serving high-risk foods to patients at risk for listeriosis.
authors: Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York, USA.
authors: Carolyn
authors: C
authors: Cokes
authors: Anne Marie
authors: AM
authors: France
authors: Vasudha
authors: V
authors: Reddy
authors: Heather
authors: H
authors: Hanson
authors: Lillian
authors: L
authors: Lee
authors: Laura
authors: L
authors: Kornstein
authors: Faina
authors: F
authors: Stavinsky
authors: Sharon
authors: S
authors: Balter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D003625:Data Collection; D005260:Female; D005511:Food Handling / Q000379:methods; D005521:Food Service, Hospital / Q000458:organization & administration / Q000592:standards*; D005517:Foodborne Diseases / Q000517:prevention & control*; D006801:Humans; D008089:Listeria monocytogenes / Q000302:isolation & purification*; D008088:Listeriosis / Q000517:prevention & control*; D008297:Male; D008460:Meat / Q000382:microbiology* / Q000506:poisoning; D008875:Middle Aged; D017747:Seafood / Q000382:microbiology* / Q000506:poisoning; D014413:Tuna / Q000382:microbiology*; D014422:Turkeys / Q000382:microbiology