September5, 2024

Dear USET/USET SPF Family,

The USET Office of Tribal Public Health (OTPH) is committed in keeping USET member Tribal Nations informed with proactive information that is essential for protecting individual and Tribal Nation communities. As of July 26, 2024, a multistate outbreak of Listeria monocytogenes infections is currently under investigation by the Centers of Disease Control and Prevention (CDC), public health officials, and the United States Department of Agriculture- Food Safety Inspection Service (USDA-FSIS). USET’s OTPH aims to bring attention to this outbreak due to the concentration of the location of sick people within the region. The map below shows the residence of those impacted by this outbreak so far. There are likely more people infected and the outbreak is not confined to the below pictured states.

What is Listeria?

Listeria are bacteria that can contaminate food and cause an infection called listeriosis. It primarily affects:

• Pregnant individuals and their newborns
• Adults aged 65 or older
• People with weakened immune systems

Seriousness:

• Listeria is the third leading cause of death from foodborne illnesses in the U.S.
• Invasive infections can lead to severe health issues such as bloodstream infections (sepsis) or brain infections (meningitis).
• For pregnant individuals, Listeria can cause miscarriage, stillbirth, or severe newborn infections. Fetal loss occurs in about 20% of cases and newborn death in about 3%.
• In non-pregnant adults, invasive Listeria infections often require hospitalization and can have a 16% mortality rate.

Symptoms: Symptoms can vary but may include fever, muscle aches, and gastrointestinal issues. Invasive infections can cause more severe symptoms.

Number of Sick People by State of Residence

Outbreak Overview:

• Confirmed Cases: As of July 26, 2024, there have been 34 reported cases across 13 states. The outbreak strain has been linked to meats sliced at deli counters, including Boar’s Head brand liverwurst.
• Health Impact: All 33 individuals with available information have been hospitalized, and two deaths have been reported (in Illinois and New Jersey). One case involved a pregnant individual who remained pregnant after recovery.
• At-Risk Groups: Pregnant individuals, those aged 65 and older, and people with weakened immune systems are at higher risk.

Key Findings:

• Epidemiologic Data: Most individuals interviewed reported consuming deli meats, with a significant number noting liverwurst consumption, particularly Boar’s Head brand.
• Laboratory Findings: Listeria was identified in an unopened Boar’s Head liverwurst product, which matches the strain causing the outbreak.

Public Health Recommendations:

1. Avoid Recalled Products: Do not consume any deli meats, particularly those from Boar’s Head, that have been recalled.
2. Safe Food Handling: If you choose to consume deli meats, ensure they are heated to a steaming hot temperature before eating.
3. Special Precautions: Individuals who are pregnant, elderly, or have weakened immune systems should avoid deli meats altogether or heat them thoroughly.

Stay Informed: Please share this alert with community members and remain vigilant about food safety practices. Your health and well-being are our top priority.

To reduce the risk of Listeria contamination, here are some key food safety practices:

1. Refrigeration:
• Keep Refrigerators Cold: Maintain your refrigerator at 40°F (4°C) or below to inhibit bacterial growth.
• Check Temperature: Regularly check your refrigerator’s temperature with a thermometer.
2. Food Handling:
• Cook Thoroughly: Cook meats, poultry, and seafood to their recommended internal temperatures. For example, ground meats should reach at least 160°F (71°C), and poultry should reach 165°F (74°C).
• Reheat Properly: Reheat deli meats and other ready-to-eat foods until steaming hot (165°F or 74°C) to kill potential bacteria.
3. Avoid Contaminated Foods:
• Check Recalls: Stay informed about food recalls, especially for deli meats and soft cheeses, which are commonly associated with Listeria outbreaks.
• Avoid High-Risk Foods: Pregnant individuals, the elderly, and those with weakened immune systems should avoid high-risk foods like unpasteurized dairy products, soft cheeses, and cold deli meats unless they are heated to steaming.
4. Cross-Contamination Prevention:
• Separate Foods: Use separate cutting boards and utensils for raw meats and ready-to-eat foods to prevent cross-contamination.
• Clean Surfaces: Wash hands, cutting boards, and kitchen utensils with hot, soapy water after handling raw foods.
5. Proper Storage:
• Store Foods Correctly: Store raw meats on the bottom shelf of the refrigerator to prevent their juices from dripping onto other foods.
• Use Containers: Store foods in clean, airtight containers to avoid contamination and preserve freshness.
6. Personal Hygiene:
• Wash Hands: Wash hands thoroughly with soap and water before and after handling food, especially raw meats.
• Clean Produce: Rinse fruits and vegetables under running water before eating, cutting, or cooking them.
7. Monitor Expiry Dates:
• Check Labels: Pay attention to “use by” and “sell by” dates on food products. Discard any expired or questionable items.

For additional information, please see the sources below. The USET TEC is available to assist with any questions or concerns. Please do not hesitate to contact the Infectious Disease Program Manager, Jewel Hunte at jhunte@usetinc.org or the Epidemiology team at usetepi@usetinc.org.

Sources

Investigation Details | Listeria Outbreak Linked to Meats Sliced at Delis | CDC

Where Sick People Lived | Listeria Outbreak Linked to Meats Sliced at Delis | CDC

When People Got Sick | Listeria Outbreak Linked to Meats Sliced at Delis | CDC

Listeria Outbreak Linked to Meats Sliced at Delis | CDC

Boar's Head Provisions Co. Expands Recall for Ready-To-Eat Meat and Poultry Products Due to Possible Listeria Contamination | Food Safety and Inspection Service (usda.gov)

Established in 1969, the United South and Eastern Tribes, Inc. (USET) is a non-profit, inter-Tribal organization serving thirty-three (33) federally recognized Tribal Nations from the Northeastern Woodlands to the Everglades and across the Gulf of Mexico. USET is dedicated to enhancing the development of Tribal Nations, improving the capabilities of Tribal governments, and improving the quality of life for Indian people through a variety of technical and supportive programmatic services.