Prevention

Recommendations for prevention of listeriosis from a food-borne source have been developed by the CDC (Broome 1993) and are presented in Table 2.2.

Except from infected mother to fetus, human-to-human transmission of liste-riosis does not occur; therefore, patients do not require isolation. Neonatal listerial infection complicating successive pregnancies is virtually unheard of, and intra-partum antibiotics are not recommended for mothers with ahistory of perinatal liste-riosis. There is no vaccine. Listerial infections are effectively prevented by TMP-SMX, given as prophylaxis against P. jiroveci to recipients of organ transplants or to individuals with the human immunodeficiency virus (Dworkin et al. 2001). The utility, or even the feasibility, of eradicating gastrointestinal colonization as a means to prevent invasive listeriosis is unknown. However, asymptomatic persons at high risk for listeriosis, known to have ingested a food implicated in an outbreak, couldreasonably be given several days of oral ampicillin or trimethoprim-sulfamethoxasole.

Table 2.2. Dietary recommendations for preventing food-borne listeriosis.

For all persons

1. Cook raw food from animal sources (e.g., beef, pork, and poultry) thoroughly.

2. Wash raw vegetables thoroughly before eating.

3. Keep uncooked meats separate from vegetables, cooked foods, and ready-to-eat foods.

4. Avoid consumption of raw (unpasteurized) milk or foods made from raw milk.

5. Wash hands, knives, and cutting boards after handling uncooked foods.

Additional recommendations for persons at high riska

1. Avoid soft cheeses (e.g., Mexican-style, feta, Brie, Camembert) and blue-veined cheese; there is no need to avoid hard cheeses, cream cheese, cottage cheese, or yogurt.

2. Leftover foods or ready-to-eat foods (e.g., hot dogs) should be reheated until steaming hot before eating.

3. Consider avoidance of foods in delicatessen counters.b a Those immunocompromised by illness or medications, pregnant women, and the elderly.

b Although the risk for listeriosis associated with foods from delicatessen counters is relatively low, pregnant women and immunosuppressed persons may choose to avoid these foods or to thoroughly reheat cold cuts before consumption.

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