LISTERIOSIS UP­DATE

We keep hear­ing about the out­break of Lis­te­ria mono­cy­to­genes – how wor­ried should we be?

Fairlady - - CONTENTS - By Dr Natasha Dole Dr Natasha Dole grad­u­ated from Stel­len­bosch Univer­sity in 2009 and has since been a med­i­cal of­fi­cer mainly in emer­gency medicine.

What you need to know. Plus 8 ways to avoid it

AM I AT RISK?

That de­pends. You don’t need to be a par­tic­u­lar phys­i­cal type to get it – any­one can, from new­borns to healthy (or pre­vi­ously healthy!) adults. But it’s worth not­ing that most of the 748 lab­o­ra­tory-con­firmed cases are peo­ple who al­ready had some kind of un­der­ly­ing im­mune su­pres­sion like HIV, can­cer, chronic kid­ney or liver dis­ease, or those on pro­longed steroid ther­apy, or or­gan trans­plant re­cip­i­ents.

Hav­ing said that, if you’re preg­nant you need to be care­ful, es­pe­cially if you’re in your third trimester, be­cause it can af­fect new­borns and there is a pos­si­bil­ity of com­pli­ca­tions if the cen­tral ner­vous sys­tem (brain or spinal cord) gets in­volved. You’ll prob­a­bly feel as if you have flu, but with back­ache too. Don’t worry: it’s most of­ten very mild and can eas­ily be fixed, but if you have diar­rhoea that just doesn’t seem to get bet­ter, best you see your doc­tor for a stool and blood cul­ture.

ANY SYMP­TOMS I SHOULD LOOK OUT FOR?

Symp­toms vary de­pend­ing on which sys­tem is in­volved – your brain, spinal cord, blood stream or your di­ges­tive sys­tem. But you may no­tice any or all of these: wa­tery stools, fever, headache, dizzi­ness, nau­sea, vom­it­ing, gen­er­al­ized malaise, your joints and mus­cles will ache, you may have a stiff neck, feel con­fused or even, in a bad case, have a seizure. These symp­toms usu­ally last up to 48 hours, and then you sim­ply re­cover from them.

There is a very tiny pos­si­bil­ity of com­pli­ca­tions like menin­gi­tis, en­cephali­tis, en­do­cardi­tis, sep­ti­caemia, brain abcess and so on, but it’s very rare and un­likely if you’re healthy.

WHAT CAUSES IT?

Ge­netic test­ing has iden­ti­fied a sin­gle strain of the bac­te­ria, se­quence type 6 (ST6), that seems to be caus­ing the ma­jor­ity of in­fec­tions. It’s most of­ten found in soil, veg­e­ta­tion, wa­ter and fae­ces, but it’s ex­tremely dif­fi­cult to find the ac­tual source and elim­i­nate it, which would ob­vi­ously be the best so­lu­tion. This par­tic­u­lar out­break is most likely from ‘a food prod­uct on the mar­ket or a se­ries of food prod­ucts pro­duced in the same man­u­fac­tur­ing en­vi­ron­ment’‚ says South African food mi­cro­bi­ol­o­gist and food safety ex­pert Dr Lu­cia Anelich, but ‘as things stand‚ the source is still not known’.

IS LISTERIOSIS CON­TA­GIOUS?

No. It can’t be trans­mit­ted from per­son to per­son. You’ll get it from drink­ing con­tam­i­nated wa­ter, or eat­ing con­tam­i­nated food. Al­though it tends to thrive in sum­mer, the lat­est stud­ies have shown that lis­te­ria ac­tu­ally ac­counts for less than one per­cent of re­ported cases of bac­te­rial food-borne in­fec­tions.

HOW IS IT DI­AG­NOSED?

The di­ag­no­sis is con­firmed by the re­sults of a blood cul­ture or from fluid taken from the cen­tral ner­vous sys­tem via a lum­bar punc­ture. Listeriosis is now a no­ti­fi­able dis­ease, which means all health­care work­ers are legally obliged to re­port all new cases to the Depart­ment of Health. This, of course, helps with trac­ing the source of the in­fec­tion.

WHAT’S THE TREAT­MENT?

For­tu­nately, healthy peo­ple may not re­quire any treat­ment – listeriosis usu­ally re­solves it­self within a cou­ple of days. Some peo­ple may need an­tibi­otics, but the treat­ment varies from pa­tient to pa­tient and de­pends on other fac­tors too, like your un­der­ly­ing health, for in­stance.

SOME GOOD NEWS

Fi­nally, it’s im­por­tant to re­mem­ber that even though the num­bers look bad, most peo­ple with no un­der­ly­ing ill-health get bet­ter on their own, or with min­i­mal treat­ment. But if you’re in any doubt, err on the side of cau­tion and con­tact your near­est health care prac­ti­tioner.

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