listeriosis

Listeriosis: description

Listeriosis is caused by the bacterium Listeria monocytogenes. An infection almost always occurs when consumed with listeria of contaminated food. Listeria are found primarily in animal products. Rarely, impurities can also affect non-pet foods such as salads.

In Germany, there have been on average around 350 cases of listeriosis every year in recent years. About eight percent of them are neonatal diseases. Overall, slightly more men than women develop listeriosis. However, among young adults, 80 percent of patients are women. Above all, listeriosis occurs frequently in pregnancy.

Listeriosis: symptoms

The time between the infection and the onset of listeriosis (incubation period) is between 3 and 70 days (usually about three weeks). However, there are isolated reports of very short incubation times of only a few hours. In these cases, large amounts of Listeria were ingested.

In otherwise healthy people often shows only a slight feverish reaction, which is usually not attributed to those affected by contaminated food. The risk of severe illness due to Listeria exists especially for immunocompromised patients. In rare cases, however, severe listeriosis can also break out in people with a normal immune system.

Easy course

Listeria reaches the body through food and through the gastrointestinal tract. For this reason, the digestive tract is the first affected by the complaints. Patients develop listeriosis symptoms such as vomiting and diarrhea, which are consistent with gastrointestinal flu, and also complain of the following common symptoms:

• fever
• Limb and muscle pain
• fatigue
• malaise

With a mild course of these complaints usually resolve within a few days on their own.

Difficult course

In rare cases, however, the Listeria can also spread further in the body. If they reach the bloodstream, sepsis is possible. This is fatal in about one fifth of the cases. Also particularly dreaded is a spreading of the pathogens on the brain and the meninges. Listeriosis can cause brain inflammation (encephalitis) or meningitis. In this case, serious neurological symptoms such as disorders of sense of balance or consciousness are expected.

Basically, the listeria can infect any organ, causing purulent infections at virtually any part of the body. For example, in the context of listeriosis, inflammation of the heart’s lining (endocarditis) or the conjunctiva in the eye (conjunctivitis), as well as joint inflammation (arthritis) may occur.

Listeriosis symptoms in pregnancy

Pregnant women are particularly affected by listeriosis. With them, the infection is often symptom-poor or the listeriosis symptoms are reminiscent of a flu infection. If listeriosis is transmitted to the unborn child during pregnancy via the placenta, there is a risk of premature birth or stillbirth. Also transfers during the birth are possible.

Listeriosis symptoms in neonates (neonatal listeriosis)

The listeriosis symptoms in the newborn can distinguish two clinical pictures: the early infection (appearance of symptoms in the first week of life) and the late infection (appearance of symptoms from the second week of life). In premature infection, which is also called granulomatosis infantiseptica, the newborn suffers:

• Blood poisoning (sepsis)
• respiratory distress syndrome
• Pus accumulations (abscesses)
• Nodules (granulomas)

Newborns with a late Listeria infection often suffer from meningitis as part of the infection (meningitis).

Listeriosis: causes and risk factors

The listeriosis is caused by rod-shaped bacteria, the Listeria. Listeria is found in the environment worldwide, but most species are harmless to humans. Only “Listeria monocytogenes” leads to listeriosis. The bacteria can live and multiply in the earth, in water, on plants or in animals or in humans.

They are extremely resistant. They can easily survive temperatures from -0.5 ° C to + 45 ° C and can also multiply in the refrigerator (temperature around + 4 ° C). In order to kill the pathogens of listeriosis, high temperatures are required, such as cooking, frying, sterilizing or pasteurising. In individual cases, however, infections from pasteurized foods have also been reported. Infections are mainly caused by contaminated foods: foods that are often contaminated with Listeria are:

• raw meat
• Smoked fish (eg smoked salmon)
• pre-cut, packaged salads
• Cheese rind (especially in red smoked cheese such as Romadur or Brie)
• Raw milk and raw milk products (rarely even with pasteurized milk)

Healthy people usually do not contract when they come into contact with the pathogens. Particularly at risk are those with a weakened immune system, such as newborns and the elderly, organ transplant patients, as well as those who need to take immune-suppressing medications (such as cortisone) or suffer from chronic diseases (tumors, AIDS, etc.). In addition, pregnant women are more likely to develop listeriosis. Pregnancy and childbirth are risky for the child. Firstly, the pathogens can be transmitted to the unborn child via the placenta. On the other hand, the child may become infected with the mother during birth in the birth canal.

Up to five percent of people have Listeria in their gastrointestinal tract without developing listeriosis. As a result, they secret the bacteria unnoticed in their chair and thus represent another source of infection for their environment.

Listeriosis: examinations and diagnosis

The right contact for suspected listeriosis is the family doctor or a doctor with the additional name infectiology. To diagnose a listeriosis, the doctor asks about your medical history (medical history). He puts you under other questions:

• Since when do you feel sick?
• Do you have fever?
• Do you suffer from a disease that weakens your immune system?
• Do you take immunodeficient medications?
• Are you pregnant?

If a listeriosis is suspected, the doctor will take a sample of blood, stool, cerebrospinal fluid (cerebrospinal fluid), vaginal secretions, weekly flow, pus or amniotic fluid, depending on the course of the disease. This material is used in a laboratory to grow and detect the pathogen. If it is suspected that listeriosis has been acquired through the recent consumption of food, pick up suspicious food particles and have them also examined in the laboratory. Thus, in some cases, the source of the infection can be located.

Listeriosis: treatment

Listeriosis is treated with antibiotics. The drug of choice is the antibiotic ampicillin in combination with an aminoglycoside. Other antibiotics such as erythromycin, cotrimoxazole or tetracycline are also effective against Listeria.

Important for antibiotic therapy is the application over a period of at least three weeks. Otherwise the listeriosis threatens to break out again, as not all bacteria have been killed before. If listeriosis causes complications such as encephalitis, antibiotic therapy may need to be continued for up to six weeks.

Listeriosis: prevention

Listeria infection is almost always due to contaminated food. Since vaccination is not possible, it is best to prevent listeriosis by following certain rules of conduct for the preparation and consumption of food. Especially for people at risk (pregnant women, people with weakened immune systems), these are important:

• Do not eat raw meat, such as B. minced meat. Roast this well before eating.
• Fish and meat should always be cooked completely.
• Wash vegetables thoroughly before eating.
• Always clean your hands, dishes and kitchen utensils thoroughly.
• Above all, process vacuum-packed and perishable food quickly after purchase.
• Prepare fresh leafy lettuce and skip pre-cut salads.
• Remove the bark before consuming red greasy cheese (eg Romadur, Limburger, Brie).

Persons in contact with listeriosis sufferers should follow the usual hygiene measures such as a subsequent hand disinfection. Isolation of the patient suffering from listeriosis is not necessary.

Listeriosis: disease course and prognosis

In most cases listeriosis is mild and heals without consequences within a few days. In some cases, especially in immunocompromised people, the disease can also be very serious and even lead to death. Developed, for example, in the context of listeriosis Sepsis is fatal in about 20 percent of cases. In the case of meningitis caused by Listeria, about 13 percent of those affected die.