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Listeria

Listeria monocytogenes (commonly called Listeria) is a type of bacterium often found in food and elsewhere in nature. It can cause a rare but serious disease called listeriosis, especially among pregnant women, the elderly or individuals with a weakened immune system. In serious cases it can lead to brain infection and even death.

Background
Listeria is widespread in the environment - found in soil, vegetation, water, sewage, silage and in the faeces of humans and animals. Animals and humans can carry the bacterium without knowing it.

Plants and vegetables can become contaminated with Listeria from the soil, water and manure-based fertilizers. Farm animals that appear healthy may also carry Listeria and contaminate foods such as meats and dairy products.

Unlike most bacteria, Listeria can survive and sometimes grow on foods being stored in the refrigerator. Moreover, foods that are contaminated with this bacterium look, smell and taste normal. Listeria can be killed by proper cooking procedures.

Listeria is more likely to cause death than other bacteria that cause food poisoning. In fact, 20 to 30 percent of foodborne listeriosis infections in high-risk individuals may be fatal. However, it should be noted that listeriosis is a relatively rare disease in Canada.

The Health Risks of Listeria
Many people may be carriers of Listeria , but few will actually develop listeriosis. Those who do will likely become ill from eating food contaminated with the bacteria, often seen as an outbreak of what people would call 'food poisoning'. Symptoms may start suddenly and include:

Vomiting;
Nausea;
Cramps;
Diarrhea;
Severe Headache;
Constipation; or
Persistent fever.
In some instances, these symptoms may be followed by meningitis encephalitis (an infection of the brain or its surrounding tissues) and/or septicemia (blood poisoning), either of which can result in death.

The mild form of foodborne listeriosis usually begins about one day after eating heavily contaminated food. For the more serious form of the disease, the incubation period is generally much longer - up to 90 days after exposure.

Those who are at the highest risk of serious illness include:

Pregnant women and their unborn/newborn children. Pregnant women are about 20 times more likely to get listeriosis than other healthy adults. If a pregnant woman develops listeriosis during the first three months of her pregnancy, she may miscarry. Up to two weeks before a miscarriage, pregnant women may experience a mild flu-like illness with chills, fatigue, headache as well as muscular and joint pain. Listeriosis later on in the pregnancy can result in a stillbirth or the birth of an acutely-ill child.
The elderly. The risk increases with age.
People with weakened immune systems, such as those undergoing chemotherapy, transplant patients, those with HIV, diabetics and alcoholics. The highest risk group includes those whose immune systems are highly compromised, such as bone marrow transplant patients, blood-borne cancer patients and those with full-blown AIDS. People with AIDS are at least 300 times more likely to get listeriosis than those with a normal immune system.
The disease can be effectively treated with antibiotics, but early diagnosis can be critical to the success of the treatment, especially for those at high risk. At the moment, there is no vaccine to prevent listeriosis.

Minimizing Your Risk
You can minimize your chances of contracting listeriosis (as well as other foodborne illnesses) by following these steps.

Read and follow all package labels and instructions on food preparation and storage.
After handling foods in the kitchen, especially raw foods such as meat and fish, thoroughly clean and sanitize all surfaces used for food preparation with a kitchen sanitizer (following the directions on the container) or use a bleach solution (5 ml household bleach to 750 ml of water), and rinse with water.
To avoid cross-contamination, clean all knives, cutting boards and utensils used with raw food before using them again.
Thoroughly clean fruits and vegetables before you eat them.
Refrigerate or freeze perishable food, prepared food and leftovers within two hours.
Defrost food in the refrigerator, in cold water or in the microwave, but never at room temperature.
Keep leftovers for a maximum of four days only and reheat them to an internal temperature of 74°C (165°F) before eating them.
Check the temperature in your refrigerator using a thermometer to make sure it is at 4°C (40°F) or below. As the storage temperature increases, so does the growth of Listeria in foods. The higher the number of bacteria in foods, the greater is the risk of getting sick.
Frequently wash and disinfect the refrigerator. The more often it is cleaned, the less chance there will be for Listeria to be transferred from contaminated food and surfaces to non-contaminated foods.
In addition, the recommendations below should be followed by high-risk individuals:

Foods to Avoid: Safer alternatives:
Hot dogs, especially straight from the package without further heating. The fluid within hot dog packages may contain more Listeria than the hot dogs.

Avoid spreading fluid from packages onto other foods, cutting boards, utensils, dishes and food preparation surfaces. Wash your hands after handling hot dogs.
Hot dogs reheated until steaming hot
Non-dried deli-meats Dried and salted deli-meats such as salami and pepperoni, as they generally do not support the growth of Listeria. In addition, you can reduce your risk by reheating deli-meats until steaming hot.
Soft and semi-soft cheeses such as feta, Brie, Camembert and blue-veined cheese if they are made from unpasteurized milk Pasteurized milk and milk products including cheeses made from pasteurized milk
Refrigerated pâté and meat spreads Canned or shelf-stable pâté and meat spreads
Refrigerated smoked seafood and fish Cooked refrigerated smoked seafood and fish. Canned or shelf-stable smoked seafood and fish.
Raw or undercooked meat, poultry and fish Thoroughly cooked meat, poultry and fish

The Government of Canada's Role
Health Canada develops food safety standards and policies to help minimize the risk of foodborne illnesses. The Canadian Food Inspection Agency (CFIA) oversees the food industry to ensure that it meets its food safety responsibilities. Health Canada, in collaboration with the CFIA, has developed a Policy on Listeria monocytogenes in ready-to-eat foods which includes inspection and corrective measures.

Health Canada also briefs the medical community, public health officials, the food industry and the public on matters related to listeriosis. As a founding member of the Canadian Partners for Consumer Food Safety Education, Health Canada also participates in public awareness campaigns about safe food practices.

Need More Info?
For more information visit Health Canada's Food and Nutrition Web site.

For more information about foodborne illnesses, visit the Public Health Agency of Canada's Laboratory for Foodborne Zoonoses Web site.

For more information on Listeria go to the Canadian Food Inspection Agency fact sheet, Food Safety Facts on Listeria.

For the Centre for Disease Control, Listeriosis Web site.

For information on Canadian food issues/recalls, visit the Canadian Food Inspection Agency.

For more Fight BAC!® tips.

For more information on foodborne disease internationally go to the World Health Organization, foodborne diseases Web site.

For additional articles on health and safety issues go to the It's Your Health Web site. You can also call toll free at 1-866-225-0709 or TTY at 1-800-267-1245*.

© Her Majesty the Queen in Right of Canada,
represented by the Minister of Health, 2005
Original: November 2005

Healthy Living Features
It's Your Health - Listeria and Food Safety
 
Last edited:
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Hepatitis B


Key facts
Hepatitis B is a viral infection that attacks the liver and can cause severe and chronic illness, and death.
The virus is transmitted through contact with the blood or other body fluids of an infected person - not through casual contact.
About 2 billion people worldwide are infected with the virus and more than 350 million live with chronic liver disease.
About 25% of adults who become chronically infected during childhood later die from liver cancer or cirrhosis (scarring of the liver) caused by the persistent infection.
The hepatitis B virus is 50 to 100 times more infectious than HIV.
Hepatitis B virus is a primary occupational hazard for health workers.
Hepatitis B is preventable with a safe and effective vaccine.


Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus. It is a major global health problem and the most serious type of viral hepatitis. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer.

Worldwide, an estimated two billion people have been infected with the hepatitis B virus (HBV), and more than 350 million have chronic (long-term) liver infections.

A vaccine against hepatitis B has been available since 1982. Hepatitis B vaccine is 95% effective in preventing HBV infection and its chronic consequences, and is the first vaccine against a major human cancer.

Symptoms
Hepatitis B virus can cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. People can take several months to a year to recover from the symptoms. HBV can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer.

Who is most at risk for chronic disease?
The likelihood that an HBV infection will become chronic depends upon the age at which a person becomes infected, with young children who become infected with HBV being the most likely to develop chronic infections. About 90% of infants infected during the first year of life develop chronic infections; 30% to 50% of children infected between one to four years of age develop chronic infections. About 25% of adults who become chronically infected during childhood die from HBV-related liver cancer or cirrhosis.

About 90% of healthy adults who are infected with HBV will recover and be completely rid of the virus within six months; 8% to 10% of the adult population are chronically infected. Liver cancer caused by HBV is among the first three causes of death from cancer in men, and a major cause of cancer in women.

Where is hepatitis B most common?
Hepatitis B is endemic in China and other parts of Asia. Most people in the region become infected with HBV during childhood. High rates of chronic infections are found in the Amazon and the southern parts of eastern and central Europe. In the Middle East and Indian sub-continent, an estimated 2% to 5% of the general population is chronically infected. Less than 1% of the population in western Europe and North American is chronically infected.

Transmission
Hepatitis B only affects humans. The virus is transmitted between people by contact with the blood or other body fluids (i.e. semen and vaginal fluid) of an infected person. Modes of transmission are the same for the human immunodeficiency virus (HIV), but HBV is 50 to 100 times more infectious Unlike HIV, HBV can survive outside the body for at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.

Common modes of transmission in developing countries are:

perinatal (from mother to baby at birth)
child-to-child
unsafe injections practices
blood transfusions
sexual contact
In many developed countries (e.g. those in western Europe and North America), patterns of transmission are different than those mentioned above. Today, the majority of infections in these countries are transmitted during young adulthood by sexual activity and injecting drug use. HBV is a major infectious occupational hazard of health workers.

HBV is not spread by contaminated food or water, and cannot be spread casually in the workplace.

The virus incubation period is 75 days on average, but can vary from about 30 to 180 days. HBV may be detected 30 to 60 days after infection and persist for widely variable periods of time.

Treatment
There is no specific treatment for hepatitis B. Care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.

Chronic hepatitis B can be treated with drugs, including interferon and anti-viral agents, which can help some patients. Treatment can cost thousands of dollars per year and is not available to most patients in developing countries.

Liver cancer is almost always fatal, and usually develops in people when they are most productive and have family responsibilities. In developing countries, most people with liver cancer die within months of diagnosis. In higher income countries, surgery and chemotherapy can prolong life for up to a few years in some patients.

Patients with cirrhosis are sometimes given liver transplants, with varying success.

Prevention
All infants should receive the hepatitis B vaccine: this is the mainstay of hepatitis B prevention.

The vaccine can be given as either three or four separate doses, as part of existing routine immunization schedules. In areas where mother-to-infant spread of HBV is high the first dose of vaccine should be given as soon as possible after birth (i.e. within 24 hours).

The complete vaccine series induces protective antibody levels in more than 95% of infants, children and young adults. After age 40, protection following the primary vaccination series drops below 90%. At 60 years old, protective antibody levels are achieved in only 65 to 75% of those vaccinated. Protection lasts at least 20 years and should be lifelong.

All children and adolescents younger than 18 years old and not previously vaccinated should receive the vaccine. People in high risk groups should also be vaccinated, including:

persons with high-risk sexual behaviour;
partners and household contacts of HBV positive persons;
injecting drug users;
persons who frequently require blood or blood products;
recipients of solid organ transplantation;
those at occupational risk of HBV infection, including health care workers; and
international travellers to countries with high rates of HBV.
The vaccine has an outstanding record of safety and effectiveness. Since 1982, over one billion doses of hepatitis B vaccine have been used worldwide. In many countries where 8% to 15% of children used to become chronically infected with HBV, vaccination has reduced the rate of chronic infection to less than 1% among immunized children.

As of December 2006, 164 countries vaccinate infants against hepatitis B during national immunization programmes - a major boost in coverage from 31 countries in 1992, the year that the World Health Assembly passed a resolution to recommend global vaccination against hepatitis B.

Related links
Hepatitis B

For more information contact:


WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int
Corporate linksContacts | E-mail scams | Employment | FAQs | Feedback | Privacy | RSS feeds
© WHO 2008

WHO | Hepatitis B
 
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Case of Marburg Haemorrhagic Fever imported into the Netherlands from Uganda
10 July 2008

WHO has been notified by the Government of the Netherlands of a case of Marburg haemorrhagic fever (MHF) in a Dutch tourist who visited Uganda. Marburg virus infection has been demonstrated by laboratory tests performed by the Bernhard Nocht Institute in Hamburg, Germany.

The 40-year-old woman travelled in Uganda from 5-28 June, 2008, and entered caves on two occasions. The first cave was visited on 16 June at Fort Portal. No bats were seen in this cave. She was reportedly exposed to fruit bats during a visit to the “python cave” in the Maramagambo Forest between Queen Elisabeth Park and Kabale on 19 June. This cave is thought to harbour bat species that have been found to carry filoviruses in other locations in sub-Saharan Africa. Filoviruses cause two types of viral haemorrhagic fever: Marburg and Ebola. A large bat population was seen in the cave and the woman is reported to have had direct contact with one bat.

The woman returned to the Netherlands on 28 June in good health. The first symptoms (fever, chills) occurred on 2 July and she was admitted to hospital on 5 July. Rapid clinical deterioration with liver failure and severe haemorrhaging occurred on 7 July. The patient remains in a critical clinical condition.

Contact tracing and temperature monitoring have been initiated for unprotected contacts with a history of possible exposure to the case after 2 July. Although further epidemiological investigation is needed to exclude other possible sites of exposure to MHF virus, as a precaution Dutch authorities have alerted the tour operator to avoid visits to the caves until further information is available.

No citizens of other countries were involved in this trip except for a local tour guide, but the cave in the Maramagambo Forrest is known to be a tourist attraction. No measures were taken with respect to the passengers on the flight from Uganda as the flight occurred four days before the onset of symptoms in the patient.

WHO has informed the Ministry of Health Uganda which will take appropriate steps nationally to investigate these events, and WHO has recommended that the MoH advise all residents and travellers to avoid entering caves with bat populations.

For more information
- WHO Marburg haemorrhagic fever website

WHO | Case of Marburg Haemorrhagic Fever imported into the Netherlands from Uganda
 
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West Nile case is suspected
Star report • August 22, 2008



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The Indiana State Department of Health also has seen one case in a bird and has found 26 pools of mosquitoes across 12 Indiana counties in the past three weeks.

Health departments in Hamilton, Hancock and Marion counties have reported mosquitoes testing positive for the disease.

Although people of any age can be infected, those older than 50 are at the greatest risk, according to state public health officials.

Mosquitoes that have bitten infected birds can then transmit the disease -- which can spur fever, headaches, body aches, swollen lymph glands or a rash -- to humans. More severe cases also can include encephalitis or meningitis, and death.

Symptoms can appear three to 15 days after a person is bitten by an infected mosquito.

Last year, the state recorded 13 human cases of West Nile, down from 80 cases in 2006.

West Nile case is suspected | IndyStar.com | The Indianapolis Star
 
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Every year I get a flu shot and still get the Flu, Last year I didn't get the shot and no Flu:lol:
 
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