Emerging Infectious Diseases (Jul 2020)

Large Nationwide Outbreak of Invasive Listeriosis Associated with Blood Sausage, Germany, 2018–2019

  • Sven Halbedel,
  • Hendrik Wilking,
  • Alexandra Holzer,
  • Sylvia Kleta,
  • Martin A. Fischer,
  • Stefanie Lüth,
  • Ariane Pietzka,
  • Steliana Huhulescu,
  • Raskit Lachmann,
  • Amrei Krings,
  • Werner Ruppitsch,
  • Alexandre Leclercq,
  • Rolf Kamphausen,
  • Maylin Meincke,
  • Christiane Wagner-Wiening,
  • Matthias Contzen,
  • Iris Barbara Kraemer,
  • Sascha Al Dahouk,
  • Franz Allerberger,
  • Klaus Stark,
  • Antje Flieger

DOI
https://doi.org/10.3201/eid2607.200225
Journal volume & issue
Vol. 26, no. 7
pp. 1456 – 1464

Abstract

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Invasive listeriosis is a severe foodborne infection in humans and is difficult to control. Listeriosis incidence is increasing worldwide, but some countries have implemented molecular surveillance programs to improve recognition and management of listeriosis outbreaks. In Germany, routine whole-genome sequencing, core genome multilocus sequence typing, and single nucleotide polymorphism calling are used for subtyping of Listeria monocytogenes isolates from listeriosis cases and suspected foods. During 2018–2019, an unusually large cluster of L. monocytogenes isolates was identified, including 134 highly clonal, benzalkonium-resistant sequence type 6 isolates collected from 112 notified listeriosis cases. The outbreak was one of the largest reported in Europe during the past 25 years. Epidemiologic investigations identified blood sausage contaminated with L. monocytogenes highly related to clinical isolates; withdrawal of the product from the market ended the outbreak. We describe how epidemiologic investigations and complementary molecular typing of food isolates helped identify the outbreak vehicle.

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