COMMENT

EDITORIAL BOARD
David Aldulaimi, Consultant Physician,

Frozen food dangers

Gastroenterologist, Worcestershire Acute
Hospitals NHS Trust
Irene Anderson, Principal Lecturer and Reader
in Learning and Teaching in Healthcare Practice,
University of Hertfordshire
Russell Ashmore, Senior Lecturer in Mental
Health Nursing, Sheffield Hallam University
Steve Ashurst, Critical Care Nurse Lecturer, Hamish Hamilton, George Cairns, Year 5 medical students, University of Bristol, Siba
Maelor Hospital, Wrexham
Christopher Barber, Residential Nurse Prosad Paul, Consultant Paediatrician (siba@doctors.org.uk), Torbay Hospital, Torbay

L
Dimitri Beeckman, Lecturer and Researcher,
Florence Nightingale School of Nursing &
Midwifery, King’s College London isteriosis is a rare bacterial infection of non-specific symptoms such as headache, vomiting
Lizzy Bernthal, Research Fellow and Lead caused by Listeria monocytogenes.While and malaise, followed by fever, altered consciousness
Nursing Lecturer, Medical Directorate,
Birmingham most individuals remain asymptomatic, it and headache (National Institute for Health and
Jacqueline Boulton, Tutor/International Strategy
Lead:Student Mobility and Electives, Florence
can cause serious problems in pregnant Care Excellence (NICE), 2016).The CNS is affected
Nightingale School of Nursing and Midwifery, women and the immunosuppressed in >50% cases of adult listeriosis and carries a 20%
King’s College London
Martyn Bradbury, Clinical Skills Network Lead, (Wadhwa Desai and Smith, 2017). Manifestations mortality. In pregnancy, Listeria mostly complicates
University of Plymouth
Beverley Brathwaite, Senior Lecturer Adult
can range from a simple febrile gastroenteritis to the third trimester and can lead to neonatal listeriosis
Nursing, University of Hertfordshire life-threatening meningitis, sepsis and spontaneous with pneumonia, bacteraemia or meningitis
Nicholas Castle, Head of Professions/Assistant
Executive Director, Hamad Medical Corporation miscarriage (Wadhwa Desai and Smith, 2017). It is (Vázquez-Boland et al, 2001).
Ambulance Service, Qatar the third leading cause of death from food-borne The principles of managing listeriosis are early
Jothi Clara J Micheal, Group Director – Nursing,
Global Hospitals Group, India illnesses in developed countries (European Food suspicion and diagnosis, administration of antibiotics
Emma Collins, Senior Sister, Practice
Development Lead, Brighton and Sussex
Safety Authority (EFSA)/European Centre for and other supportive management. Obtaining a full
University Hospitals NHS Trust Disease Prevention and Control (ECDC), 2017). history of food eaten in the previous 3 days is vital,
Alison Coull, Lecturer, Department of Nursing
and Midwifery, University of Stirling, Scotland Listeria poses a major problem to the food- with emphasis on any refrigerated products that may
David Delaney, Charge Nurse, Clinical Research, processing industry as it can replicate at refrigeration have been consumed without proper cooking (NICE,
Alder Hey Children’s Hospital
Alan Glasper, Emeritus Professor of Child Health temperatures and survive disinfection procedures 2016). A recent study showed that Listeria can be
Nursing, University of Southampton
on preparation surfaces. Refrigerated food products reduced to a safe level by immersing vegetables in hot
Angela Grainger, Nurse Lecturer, BPP University
Michelle Grainger, Ward Manager, Moseley Hall that are ‘ready-to-eat’ without cooking (soft cheeses, water (~85°C) or steaming for 1 minute (Ceylan et
Hospital, Birmingham
Barry Hill, Senior Lecturer in Adult Nursing,
smoked fish, salads and ‘delicatessen’ products) pose al, 2017). Individuals from high-risk groups (pregnant
University of Northumbria at Newcastle the highest risk. Long-standing contamination at women, the immunocompromised) should avoid
Helen Holder, Senior Lecturer, Nursing Studies,
Birmingham City University production sites can lead to widespread listeriosis dairy products made from unpasteurised milk, deli
Mina Karamshi, Specialist Sister in Radiology, outbreaks when such produce is distributed across meats, ready-to-eat meats and smoked fish.
Royal Free Hospital, Hampstead
Joanne McPeake, Acute Specialist Nurse/ borders. Since 2015, outbreaks have been reported in Prevention of listeriosis relies on selection and safe
Senior Staff Nurse in Critical Care; Honorary
Lecturer/Practitioner in Critical Care, University
many European countries, including the UK (EFSA/ preparation of food. Educating families about the
of Glasgow ECDC, 2017); there have been 47 confirmed cases of risks of listeriosis and the importance of cooking/
John McKinnon, Senior Lecturer, School of
Health and Social Care, University of Lincoln listeriosis, with 9/47 (19%) deaths (EFSA 2018). heating frozen food properly is crucial. Health
Danny Meetoo, Lecturer in Adult Nursing, Recently, genetic sequencing has enabled the professionals should be aware of the subclinical signs
University of Salford
Mervyn Morris, Director, Centre for Mental causative strain of Listeria responsible for these of listeriosis and actively enquire about exposure
Health Policy, Birmingham City University
outbreaks to be traced to a frozen vegetable company to undercooked frozen food products in patients
Aru Narayanasamy, Associate Professor,
University of Nottingham based in Hungary (EFSA, 2018).The same strain of presenting with febrile gastroenteritis. It is vital to
Anne-Maria Newham, Director of Nursing,
Lincolnshire Partnership Trust
bacteria was already known to have caused invasive give clear instructions to parents/patients at discharge
Ann Norman, RCN Criminal Justice Services listeriosis in 2016 and 2017 (EFSA/ECDC, 2017), for close monitoring at home as invasive CNS disease
Nursing Adviser and Learning Disability Nursing
Adviser probably due to a failure to thoroughly heat/cook is known to occur after a latent period. BJN
Joy Notter, Professor, Birmingham City
University & Saxion University of Applied
the frozen vegetables. A ban on all products from Ceylan E, McMahon W, Garren DM. Thermal inactivation of
Science, Netherlands that company and a massive product recall is under Listeria monocytogenes and Salmonella during water and steam
Hilary Paniagua, Senior Lecturer, School
of Nursing & Midwifery, University of way, including of vegetables sold in major UK blanching of vegetables. J Food Prot. 2017;80(9):1550–6.
https://doi.org/10.4315/0362-028X.JFP-16-517
Wolverhampton supermarkets (EFSA, 2018). However, Listeria has a European Food Safety Authority, European Centre for Disease
Ian Peate, Director of Studies, Head of School,
Gibraltar Health Authority 70-day incubation period which, coupled with the Prevention and Control. The European Union summary report
on trends and sources of zoonoses, zoonotic agents and food-
Bernadette Porter, Nurse Consultant, National
Hospital for Neurology and Neurosurgery, UCLH
long shelf life of frozen vegetables, means new cases borne outbreaks in 2016. EFSA Journal 2017;15(12):5077.
NHS Trust could continue to emerge for some time. https://doi.org/10.2903/j.efsa.2017.5077
John Tingle, Associate Professor (Teaching and European Food Safety Authority. Listeria monocytogenes: update
Scholarship), Nottingham Trent University Listeria enters the body through the gut and
on foodborne outbreak. 2018. https://tinyurl.com/y8zjrflv
Geoffrey Walker, Matron for Medicine, travels to the liver, where a T-cell mediated (accessed 10 September 2018)
Cardiology and Specialist Nursing Services,
Poole Hospital NHS Foundation Trust immune response is mounted.The infection is National Institute for Health and Care Excellence. Meningitis—
bacterial meningitis and meningococcal disease. 2016. https://
Catherine Whitmore, Research Nurse, Diabetes
and Endocrinology, University of Liverpool
usually contained, remaining asymptomatic or tinyurl.com/yd2raa67 (accessed 10 September 2018)
causing febrile gastroenteritis. In some patients Vázquez-Boland JA, Kuhn M, Berche P, Chakraborty T,
© 2018 MA Healthcare Ltd

Karen Wild, Nurse

Jo Wilson, Director, Wilson Healthcare Services,
Newcastle
Cate Wood, Associate Professor (Community
& Primary Care Nursing) Faculty of Health,
Education and Society Plymouth University
Sue Woodward, Lecturer, Specialist and
Palliative Care, Florence Nightingale School of
Nursing and Midwifery, King’s College London
(e.g. immunocompromised), Listeria travels via Domínguez-Bernal G, Goebel W et al. Listeria pathogenesis
and molecular virulence determinants. Clin Microbiol Rev.
the bloodstream to target primarily the brain or 2001;14(3):584–640. https://doi.org/10.1128/CMR.14.3.584-
uterus. Invasive central nervous system (CNS) 640.2001
Wadhwa Desai R, Smith M. Pregnancy-related listeriosis. Birth
disease (meningitis, meningoencephalitis, brainstem Defects Res. 2017;109(5):324–35. https://doi.org/10.1002/
encephalitis) may follow a variable subclinical period bdr2.1012

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