CDC: Outbreak of Listeria Infections Linked to Deli-Sliced Meats and Cheeses

CDC and several states are investigating a multistate outbreak of Listeriainfections linked to deli-sliced meats and cheeses. The U.S. Department of Agriculture’s Food Safety and Inspection Service and the U.S. Food and Drug Administration are monitoring the outbreak.

Latest Outbreak Information

• A total of 8 people infected with the outbreak strain of Listeria monocytogenes have been reported from 4 states.
  • All 8 people have been hospitalized, and one death has been reported from Michigan.
• Epidemiologic and laboratory evidence indicates that meats and cheeses sliced at deli counters might be contaminated with Listeria monocytogenes and could make people sick.
• In interviews, ill people report eating different types and brands of products, including meats and cheeses, purchased from and sliced at deli counters in many different retail locations.
• The outbreak strain has been identified in samples taken from meat sliced at a deli and from deli counters in multiple stores.
• A single, common supplier of deli products has not been identified.
• CDC is not advising that consumers avoid eating products prepared at delis, or that retailers stop selling deli-sliced products.
• Retailers should clean and sanitize deli slicersExternal frequently and other areas where deli products are prepared, stored, or served to avoid cross contamination.
• This outbreak is a reminder that people at higher risk for severe Listeria infection should handle deli-sliced meats and cheeses carefully to prevent illness. Pregnant women and their newborns, adults age 65 and older, and people with weakened immune systems are more likely to get sick with listeriosis.

Advice to Consumers and Retailers

People who are at higher risk for Listeria infection should avoid eating lunch meats, cold cuts, or other deli meats, unless they are heated to an internal temperature of 165°F or until steaming hot just before serving.

• If you develop symptoms of a Listeria infection after eating deli-sliced products, contact a healthcare provider and tell them you ate deli-sliced products. This is especially important if you are pregnant, age 65 or older, or have a weakened immune system.
• If you have eaten deli-sliced products and do not have any symptoms of a Listeria infection, most experts believe that tests or treatment are not needed, even for people who have a higher chance of Listeria infection.
• Listeria bacteria can survive at very low temperatures and can spread easily to other foods and surfaces. Consumers should clean refrigerators, kitchen countertops, utensils, and other surfaces that touch deli-sliced products.
• You can take steps to prevent Listeria infection:
  • Don’t let juice from lunch meat and hot dog packages get on other foods, utensils, and food preparation surfaces.
  • Wash hands after handling deli meats, lunch meats, deli cheeses, and hot dogs.
  • Store opened packages of meat sliced at a local deli no longer than 3 to 5 days in the refrigerator.
• Retailers should clean and sanitize deli slicersExternal frequently and other areas where deli products are prepared, stored, or served. Follow the manufacturer’s recommendations for sanitizer strength and application to ensure it is effective.
  • Regularly clean food contact surfaces, equipment, and utensils in direct contact with deli products, such as cutting boards, tables, cheese slicers, and knives.
  • Make sure food contact surfaces, such as cutting boards, are smooth, sealed, non-porous, and easily cleanable.
  • The FDA website has printable materials and more information about sanitizing commercial deli slicersExternal.

CDC will update the advice to consumers and retailers if more information comes available, such as a supplier or type of deli product linked to illness.Symptoms of Listeria Infection

• Listeriosis can cause different symptoms, depending on the person and the part of the body affected.
  • Pregnant women typically experience only fever and other flu-like symptoms, such as fatigue and muscle aches. However, infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.
  • People other than pregnant women: Symptoms can include headache, stiff neck, confusion, loss of balance, and convulsions in addition to fever and muscle aches.
• People with invasive listeriosis usually report symptoms starting 1 to 4 weeks after eating food contaminated with Listeria; some people have reported symptoms starting as late as 70 days after exposure or as early as the same day of exposure.
• Listeriosis is treated with antibiotics.

Investigation Details

April 17, 2019

CDC and several states are investigating a multistate outbreak of Listeriainfections linked to deli-sliced meats and cheeses. The U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) and the U.S. Food and Drug Administration (FDA) are monitoring the outbreak.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on Listeria bacteria isolated from ill people by using a technique called whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS performed on Listeria isolated from ill people in this outbreak showed that they are closely related genetically. This means that people in this outbreak are more likely to share a common source of infection.

As of April 15, 2019, 8 people infected with the outbreak strain of Listeria monocytogenes have been reported from 4 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.

Listeria specimens from ill people were collected from November 13, 2016 to March 4, 2019. Ill people range in age from 40 to 88 years, with a median age of 57. Thirty-eight percent are female. All 8 people (100%) have been hospitalized. One death has been reported from Michigan.

Investigation of the Outbreak

Epidemiologic and laboratory evidence indicates that deli-sliced meats and cheeses might be contaminated with Listeria monocytogenes and could make people sick.

In interviews, ill people answered questions about the foods they ate and other exposures in the four weeks before they became ill. Of 6 people interviewed, 5 (83%) reported eating products sliced at a deli counter, including meats and cheeses. Delis where ill people shopped served many different brands of products and there is limited information about the brands ill people bought.

USDA-FSIS and FDA evaluated records state inspectors collected from delis where ill people ate to determine whether a common meat or cheese product was served at the delis. The analysis of the available documentation could not identify a common product. USDA-FSIS and FDA will continue to assist with the investigation should additional information become available.

The outbreak strain of Listeria monocytogenes has been identified in samples from meat sliced at a deli, and from deli counters in multiple retail locations in New York and Rhode Island. WGS showed that the Listeria strain from these samples is closely related genetically to the Listeria strain from ill people. This result provides more evidence that people in this outbreak got sick from eating deli-sliced products. At this time, the investigation has not identified a common product that was sliced or prepared in the delis.

This outbreak is a reminder that deli products, such as sliced meats and cheeses, can have Listeria bacteria. People who are at higher risk for Listeriainfections should avoid eating lunch meats, cold cuts, or other deli meats, unless they are heated to an internal temperature of 165°F or until steaming hot just before serving.