Immunocompromised

  • Leukemia patients, pregnant women at greatest risk of listeriosis

    Posted: December 25th, 2011 - 1:21pm by Doug Powell

    People with certain conditions, including leukemia, other cancers and pregnancy, are at the greatest risk of getting sick from the foodborne bacterium Listeria, French researchers report in a new study.

    Doctors and public health officials have known that these conditions make people more vulnerable to listeriosis, but this study is the first to rank the size of the risk for people with each condition.

    The results "will help focus risk communication for the medical community," said Ramon Guevara, an epidemiologist for the County of Los Angeles Department of Public Health, who was not involved in the study.

    The study looked at nearly 2,000 cases of listeriosis in France -- affecting 39 out of every 10 million people -- from 2001 to 2008.

    Despite its rarity, listeriosis is still considered an important public health concern because it's relatively deadly compared to other food-borne illnesses, lead author Dr. Véronique Goulet at the Institut de Veille Sanitaire in Saint-Maurice wrote in an email to Reuters Health.

    More than 400 of the 2,000 people who developed listeriosis died.

    None of the cases involved an outbreak.

    About one in six of the listeriosis cases in France affected pregnant women.

    Incidence of Listeriosis and related mortality among groups at risk of acquiring Listeriosis
    23.dec.11
    Clinical Infectious Diseases
    Véronique Goulet, Marjolaine Hebert, Craig Hedberg, Edith Laurent, Véronique Vaillant, Henriette De Valk, and Jean-Claude Desenclos
    http://cid.oxfordjournals.org/content/early/2011/12/12/cid.cir902
    Abstract
    Background. Listeriosis is a foodborne disease of significant public health concern that primarily affects persons with recognized underlying conditions or diseases that impair cell-mediated immunity. The degree of risk posed by the different underlying conditions is crucial to prioritize prevention programs that target the highest risk populations.

    Methods. We reviewed cases of listeriosis reported in France from 2001 to 2008. Numbers of cases and deaths were tabulated by age and underlying condition. Measures of the impact of specific underlying conditions on the occurrence of listeriosis were calculated. For estimating the total number of persons living with specific diseases, we applied prevalence estimates of these diseases to the French population. Underlying conditions were ranked by the degree to which they increased the risk of listeriosis.

    Results. From 2001 to 2008, 1959 cases of listeriosis were reported in France (mean annual incidence 0.39 per 100 000 residents). Compared with persons <65 years with no underlying conditions, those with chronic lymphocytic leukemia had a >1000-fold increased risk of acquiring listeriosis, and those with liver cancer; myeoloproliferative disorder; multiple myeloma; acute leukemia; giant cell arteritis; dialysis; esophageal, stomach, pancreas, lung, and brain cancer; cirrhosis; organ transplantation; and pregnancy had a 100–1000-fold increased risk of listeriosis.

    Conclusions. To be effective and acceptable to physicians and patients, listeriosis prevention strategies should be targeted based on evidence of increased risk. Stringent dietary guidance, to avoid specific foods with a high risk for Listeria contamination, should be targeted to pregnant women and to others at highest risk of listeriosis.

    Your rating: None (1 vote)
    Bookmark and Share
    Listeria  |  0 Comments
    food safety, Immunocompromised, leukemia, Listeria, Pregnant
  • Should deli meats be on the menu for pregnant women and at medical care facilities?

    Posted: September 1st, 2008 - 8:19pm by Doug Powell

    After four kids, I was familiar with the look.

    “How long have you been pregnant,” I asked the thirty-something as we filled our plates during the catered lunch at a meeting in 2000 in Ottawa.

    “About six weeks.”

    The American media had been filled with coverage of listeria after the 1998-1999 Sara Lee Bil Mar hot dog outbreak in which 80 were sickened, 15 killed and  at least 6 pregnant women had miscarriages. Risk assessments had been conducted, people were talking about warning labels, and especially, the risks to pregnant women.

    There was no such public discussion in Canada.

    So as I watched the pregnant PhD load up on smoked salmon, cold cuts and soft cheese for lunch, I wondered, do I say something?

    One of the biggest risks in pregnancy is protein deficiency. What if smoked salmon, cold cuts and soft cheeses were this woman’s biggest source of protein? (Turns out they were.)

    Another big risk factor is stress. I didn’t want to freak her out. Besides, who the hell am I to say anything?

    We sat together during lunch and chatted about babies, her aspirations and how she was feeling. Eventually I introduced the subject of listeria by talking about a risk assessment that had recently been published by the U.S. Food and Drug Administration, and that maybe she would be interested in looking at the results. I felt sorta goofy.

    Eight years later, I don’t feel so goofy. Instead I’m frustrated at the lack of awareness, not only amongst pregnant women but amongst the elderly, other immunocompromised individuals, and the institutions and professionals that are supposed to look out for others.

    Most of the now 12 confirmed and 6 suspected deaths related to Maple Leaf deli meats were consumed in places like nursing homes.

    The Ontario Association of Non-Profit Homes and Services for Seniors, an umbrella group, was unaware of the recommendation that immunocompromised avoid deli meats to reduce the risk of listeria, unless they are thoroughly heated.

    Association executive director Donna Rubin said,

    "We've contacted dietitians that have long-standing experience in our homes and they've never been warned about listeriosis or deli meats being a huge issue or that they should be avoided.”

    An Ontario Health Ministry spokesman said it has no specific policy against serving sliced meats in nursing homes, and Health Canada officials said banning certain foods from seniors homes is not in its jurisdiction. Health Canada has never recommended health facilities stop serving deli meats, noting that hospitals are a provincial responsibility.

    In Calgary, two nursing home operators, Carewest and Bethany Care Society, confirmed some of their facilities serve cold meats.

    Janice Kennedy, a Bethany spokeswoman, said,

    "If public health says not to serve cold cuts to seniors, then we wouldn't. We're still meeting requirements."

    It all sounds bureaucratic to me, as the death toll increases.

    And the pregnant woman? When I saw her at another meeting a couple of months later, she thanked me for providing her with information about listeria and risky foods for pregnant mothers.
     

     

    Your rating: None
    Bookmark and Share
    Listeria  |  0 Comments
    Baby, Elderly, Immunocompromised, Maple Leaf, Pregnant