dc.contributor.author | Thomas, J. | |
dc.contributor.author | Govender, N. | |
dc.contributor.author | McCarthy, K.M. | |
dc.contributor.author | Erasmus, L.K. | |
dc.contributor.author | Doyle, T.J. | |
dc.contributor.author | Allam, M. | |
dc.contributor.author | Ismail, A. | |
dc.contributor.author | Ramalwa, Ntsieni | |
dc.contributor.author | Sekwadi, P. | |
dc.contributor.author | Ntshoe, Genevie M. | |
dc.contributor.author | Shonhiwa, A. | |
dc.contributor.author | Essel, V. | |
dc.contributor.author | Tau, N. | |
dc.contributor.author | Smouse, S. | |
dc.contributor.author | Ngomane, H.M. | |
dc.contributor.author | Disenyeng, B. | |
dc.contributor.author | Page, Nicola Anne | |
dc.contributor.author | Govender, N.P. | |
dc.contributor.author | Duse, A.G. | |
dc.contributor.author | Stewart, R. | |
dc.contributor.author | Thomas, T. | |
dc.contributor.author | Mahoney, D. | |
dc.contributor.author | Tourdjman, M. | |
dc.contributor.author | Disson, O. | |
dc.contributor.author | Thouvenot, P. | |
dc.contributor.author | Maury, M.M. | |
dc.contributor.author | Leclercq, A. | |
dc.contributor.author | Lecuit, M. | |
dc.contributor.author | Smith, Anthony M. | |
dc.contributor.author | Blumberg, Lucille Hellen | |
dc.date.accessioned | 2021-10-27T09:30:52Z | |
dc.date.available | 2021-10-27T09:30:52Z | |
dc.date.issued | 2020-02 | |
dc.description.abstract | BACKGROUND: An outbreak of listeriosis was identified in South Africa in 2017. The source was unknown. METHODS: We conducted epidemiologic, trace-back, and environmental investigations and used whole-genome sequencing to type Listeria monocytogenes isolates. A case was defined as laboratory-confirmed L. monocytogenes infection during the period from June 11, 2017, to April 7, 2018. RESULTS: A total of 937 cases were identified, of which 465 (50%) were associated with pregnancy; 406 of the pregnancy-associated cases (87%) occurred in neonates. Of the 937 cases, 229 (24%) occurred in patients 15 to 49 years of age (excluding those who were pregnant). Among the patients in whom human immunodeficiency virus (HIV) status was known, 38% of those with pregnancy-associated cases (77 of 204) and 46% of the remaining patients (97 of 211) were infected with HIV. Among 728 patients with a known outcome, 193 (27%) died. Clinical isolates from 609 patients were sequenced, and 567 (93%) were identified as sequence type 6 (ST6). In a case–control analysis, patients with ST6 infections were more likely to have eaten polony (a ready-to-eat processed meat) than those with non-ST6 infections (odds ratio, 8.55; 95% confidence interval, 1.66 to 43.35). Polony and environmental samples also yielded ST6 isolates, which, together with the isolates from the patients, belonged to the same core-genome multilocus sequence typing cluster with no more than 4 allelic differences; these findings showed that polony produced at a single facility was the outbreak source. A recall of ready-to-eat processed meat products from this facility was associated with a rapid decline in the incidence of L. monocytogenes ST6 infections. CONCLUSIONS: This investigation showed that in a middle-income country with a high prevalence of HIV infection, L. monocytogenes caused disproportionate illness among pregnant girls and women and HIV-infected persons. Whole-genome sequencing facilitated the detection of the outbreak and guided the trace-back investigations that led to the identification of the source. | en_ZA |
dc.description.department | Medical Virology | en_ZA |
dc.description.librarian | pm2021 | en_ZA |
dc.description.uri | http://content.nejm.org | en_ZA |
dc.identifier.citation | TThomas, J., Govender, N., McCarthy, K.M. et al. Outbreak of listeriosis in South Africa associated with processed meat. New England Journal of Medicine 2020 Feb 13; 382:632. https://doi.org/10.1056/NEJMoa1907462 | en_ZA |
dc.identifier.issn | 0028-4793 (print) | |
dc.identifier.issn | 1533-4406 (online) | |
dc.identifier.other | 10.1056/NEJMoa1907462 | |
dc.identifier.uri | http://hdl.handle.net/2263/82262 | |
dc.language.iso | en | en_ZA |
dc.publisher | http://content.nejm.org/ | en_ZA |
dc.rights | © 2020 Massachusetts Medical Society | en_ZA |
dc.subject | Food-borne | en_ZA |
dc.subject | Outbreak | en_ZA |
dc.subject | Listeriosis | en_ZA |
dc.subject | South Africa (SA) | en_ZA |
dc.title | Outbreak of listeriosis in South Africa associated with processed meat | en_ZA |
dc.type | Article | en_ZA |