Abstract
Listeriosis is a rare but severe food-borne disease that predominantly affects pregnant women, the unborn, newborns, the elderly and immunocompromised people. Following a large outbreak in the 1980s, specific food safety advice was provided to pregnant women and the immunocompromised in the United Kingdom. Following two coincident yet unconnected cases of pregnancy-related listeriosis in eastern European women in 2008, a review of the role of ethnicity in pregnancy-related listeriosis in England and Wales was undertaken in 2009. Cases reported to the national listeriosis surveillance scheme were classified as 'ethnic', belonging to an ethnic minority, or 'non-ethnic' based on their name, and trends were examined. Between 2001 and 2008, 1,510 cases of listeriosis were reported in England and Wales and, of these, 12% were pregnancy-related cases. The proportion of pregnancy-related cases classified as ethnic increased significantly from 16.7% to 57.9% (chi-square test for trend p=0.002). The reported incidence among the ethnic population was higher than that among the non-ethnic population in 2006, 2007 and 2008 (Relative Risk: 2.38, 95% confidence interval: 1.07 to 5.29; 3.82, 1.82 to 8.03; 4.33, 1.74 to 10.77, respectively). This effect was also shown when analysing data from January to September 2009, using extrapolated live births as denominator. Increased immigration and/or economic migration in recent years appear to have altered the population at risk of pregnancy-related listeriosis in England and Wales. These changes need to be taken into account in order to target risk communication strategies appropriately.
Highlights
Listeriosis is a rare but severe bacterial disease that predominantly affects pregnant women, the unborn, newborns, the elderly and immunocompromised individuals
Listeriosis is mainly transmitted via the consumption of foods contaminated with Listeria monocytogenes and recent estimates suggest that listeriosis is the greatest cause of food-related deaths in the United Kingdom (UK) [1]
We report a sustained increase in the incidence of pregnancy-related cases of listeriosis from ethnic
Summary
Listeriosis is a rare but severe bacterial disease that predominantly affects pregnant women, the unborn, newborns, the elderly and immunocompromised individuals. The elderly and immunocompromised individuals, the disease usually manifests as meningitis and/or septicaemia, with high mortality rates reported amongst these risk groups. It has been reported that pregnant women have a 12-fold increased risk of developing disease after the consumption of contaminated food when compared with the general population [2], indicating that pregnancy may constitute a disposition to acquiring listeriosis. Pregnant women rarely have central nervous system infection [3] but may experience fever, miscarriage, premature delivery or stillbirth. Pregnant women infected with L. monocytogenes may be asymptomatic
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