UK Publishes Guide for Health Care Professionals on Reducing the Risk of Listeriosis

The United Kingdom Food Standards Agency (FSA) has published a guidance for healthcare and social service organizations who care for vulnerable populations at greater risk for contracting listeriosis and other food-borne diseases. The FSA believes the guidance will also be useful for those in environmental health, contract caterers, and charitable food delivery programs.

The 43-page document, “Reducing the Risk of Vulnerable Groups Contracting Listeriosis,” applies to England, Wales, and Northern Ireland. In Scotland the guidance is promoted by Food Standards Scotland and available through their website as well.

All healthcare and social care organizations that provide food are required by law to put procedures in place in accordance with Hazard Analysis and Critical Control Points (HACCP). They are also required to consider food safety in regards to the most health-sensitive consumer.

The guidance covers other legal requirements of food safety and hygiene legislation and introduces examples of good practice, such as, disinfecting standards, maintaining the “cold chain” at 5°C or less, and other shelf life controls. Key principles for reducing the risks of infection include: preventing contamination, controlling and limiting opportunities for growth, and thoroughly cooking food in order to ensure that all bacteria have been killed.

The guidance covers controls for Listeria monocytogenes specifically and is designed to, “determine what steps can be put in place to reduce the risk of L. monocytogenes in foodstuffs, and makes the assumption that appropriate measures for effective general food hygiene and food safety management controls are in place. These are an essential foundation for specific controls for L. monocytogenes and all food businesses must comply,” according to the document.

L. monocytogenes is a bacterium of concern because it is "widespread in vegetation, raw foods, soil, water, and animal feces" and is “able to attach to surfaces and adhere together to form biofilms, not usually visible” that are extremely difficult to remove, contaminating foods that come into contact with the biofilm. Unlike most other pathogenic bacteria, Listeria also have the potential to grow in low temperatures and low oxygen environments and the ability to survive freezing environments.

The guidance lists foods linked to outbreaks and common pathways, such as vending machines and meal delivery services, to vulnerable groups. Those at higher risk include: adults older than 65, people with weakened immune systems, pregnant women, and children, particularly those younger than the age of 5.

It is important to note that there are foods outside of the scope of this new guidance; they include: food designed to be cooked and served hot, frozen food designed to be cooked/reheated from frozen and served hot, newborn foods, and foods for special medical purposes.

Non-invasive listeriosis symptoms are similar to that of mild flu-like symptoms. However, invasive listeriosis is extremely serious and can result in “conditions such as, bacteremia, septicemia, meningitis and, in pregnant women, miscarriage or stillbirth.”

According to the FSA, in 2011 listeriosis caused approximately 1,500 illnesses. Although a low number of cases are reported annually, the disease places significant health and economic burdens on the United Kingdom. Listeriosis causes high rates of hospitalization and approximately a third of the cases result in death.