Multistate outbreak of Listeria monocytogenes infections linked to whole apples used in commercially produced, prepackaged caramel apples: United States, 2014-2015

ANGELO, K.M.; CONRAD, A.R.; SAUPE, A.; DRAGOO, H.; WEST, N.; SORENSON, A.; BARNES, A.; DOYLE, M.; BEAL, J.; JACKSON, K.A.; STROIKA, S.; TARR, C.; KUCEROVA, Z.; LANCE, S.; GOULD, L.H.; WISE, M.; JACKSON, B.R.

doi:10.1017/S0950268816003083

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Multistate outbreak of Listeria monocytogenes infections linked to whole apples used in commercially produced, prepackaged caramel apples: United States, 2014-2015

Published Date:

January 09 2017

Publisher's site:

http://dx.doi.org/10.1017/S0950268816003083 New Site Icon

Source:

Epidemiol Infect. 145(5):848-856

Language:

English

[PDF-430.66 KB]

Details:

Personal Authors:

ANGELO, K.M. ; CONRAD, A.R. ; SAUPE, A. ; DRAGOO, H. ; WEST, N. ; ... More ▼

Keywords:

[+]

Pubmed ID:

28065170

Pubmed Central ID:

PMC6542465

Description:

Whole apples have not been previously implicated in outbreaks of foodborne bacterial illness. We investigated a nationwide listeriosis outbreak associated with caramel apples. We defined an outbreak-associated case as an infection with one or both of two outbreak strains of Listeria monocytogenes highly related by whole-genome multilocus sequence typing (wgMLST) from 1 October 2014 to 1 February 2015. Single-interviewer open-ended interviews identified the source. Outbreak-associated cases were compared with non-outbreak-associated cases and traceback and environmental investigations were performed. We identified 35 outbreak-associated cases in 12 states; 34 (97%) were hospitalized and seven (20%) died. Outbreak-associated ill persons were more likely to have eaten commercially produced, prepackaged caramel apples (odds ratio 326·7, 95% confidence interval 32·2-3314). Environmental samples from the grower's packing facility and distribution-chain whole apples yielded isolates highly related to outbreak isolates by wgMLST. This outbreak highlights the importance of minimizing produce contamination with L. monocytogenes. Investigators should perform single-interviewer open-ended interviews when a food is not readily identified.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

CC999999/Intramural CDC HHS/United States

Main Document Checksum:

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Supporting Files:

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