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      LISTERIA MONOCYTOGENES: OCORRÊNCIA EM PRODUTOS LÁCTEOS E SUAS IMPLICAÇÕES EM SAÚDE PÚBLICA Translated title: LISTERIA MONOCYTOGENES: OCCURRENCE IN DAIRY PRODUCTS AND ITS IMPLICATIONS IN PUBLIC HEALTH

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          Abstract

          RESUMO Listeria monocytogenes é o agente causador da listeriose, uma grave doença de origem alimentar que causa severas infecções em humanos com altas taxas de mortalidade. O leite e seus derivados estão entre os produtos alimentícios mais frequentemente envolvidos na transmissão de L. monocytogenes. A listeriose acomete, sobretudo, indivíduos imunodeprimidos, grávidas, recém-nascidos e idosos, o que ressalta o caráter oportunista deste micro-organismo e sua importância para a saúde pública. No presente trabalho, faz-se uma revisão narrativa crítica sobre o risco à saúde humana decorrente da ingestão de leite e derivados contaminados por L. monocytogenes, bem como se discutem os fatores que determinam a contaminação por L. monocytogenes na cadeia de produção e distribuição de leite e derivados. São apresentados e avaliados os dados de ocorrência de L. monocytogenes em leite cru e em produtos lácteos no Brasil, tendo em vista seu potencial de envolvimento em casos de listeriose humana. Adicionalmente, são indicadas as principais áreas de pesquisa e atuação para prevenir a contaminação de L. monocytogenes em produtos lácteos.

          Translated abstract

          ABSTRACT Listeria monocytogenes is the causative agent of listeriosis, a serious foodborne disease that promotes severe human infections with high mortality rates. Milk and byproducts are among the food products most often involved in the transmission of L. monocytogenes. Listeriosis mainly affects immunodepressed individuals, pregnant women, neonates and the elderly, thus emphasizing its opportunistic character and importance to public health. The present article presents a narrative and critical review concerning the risk to human health from the consumption of dairy products contaminated with L. monocytogenes. Also, a discussion is made on the factors that determine the contamination by L. monocytogenes in the production and distribution chain of milk and dairy products. The available data on the occurrence of L. monocytogenes in raw milk and dairy products in Brazil are also presented and evaluated, taking into consideration its potential for involvement in human listeriosis outbreaks. Additionally, this review indicates the main research and work areas needed for the prevention of L. monocytogenes contamination in dairy products.

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          The epidemiology of human listeriosis.

          Listeriosis is a serious invasive disease that primarily afflicts pregnant women, neonates and immunocompromised adults. The causative organism, Listeria monocytogenes, is primarily transmitted to humans through contaminated foods. Outbreaks of listeriosis have been reported in North America, Europe and Japan. Soft cheeses made from raw milk and ready-to-eat meats are high risk foods for susceptible individuals. Efforts by food processors and food regulatory agencies to aggressively control L. monocytogenes in the high risk foods have resulted in significant decreases in the incidence of sporadic listeriosis.
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            Listeria monocytogenes virulence and pathogenicity, a food safety perspective.

            Several virulence factors of Listeria monocytogenes have been identified and extensively characterized at the molecular and cell biologic levels, including the hemolysin (listeriolysin O), two distinct phospholipases, a protein (ActA), several internalins, and others. Their study has yielded an impressive amount of information on the mechanisms employed by this facultative intracellular pathogen to interact with mammalian host cells, escape the host cell's killing mechanisms, and spread from one infected cell to others. In addition, several molecular subtyping tools have been developed to facilitate the detection of different strain types and lineages of the pathogen, including those implicated in common-source outbreaks of the disease. Despite these spectacular gains in knowledge, the virulence of L. monocytogenes as a foodborne pathogen remains poorly understood. The available pathogenesis and subtyping data generally fail to provide adequate insight about the virulence of field isolates and the likelihood that a given strain will cause illness. Possible mechanisms for the apparent prevalence of three serotypes (1/2a, 1/2b, and 4b) in human foodborne illness remain unidentified. The propensity of certain strain lineages (epidemic clones) to be implicated in common-source outbreaks and the prevalence of serotype 4b among epidemic-associated stains also remain poorly understood. This review first discusses current progress in understanding the general features of virulence and pathogenesis of L. monocytogenes. Emphasis is then placed on areas of special relevance to the organism's involvement in human foodborne illness, including (i) the relative prevalence of different serotypes and serotype-specific features and genetic markers; (ii) the ability of the organism to respond to environmental stresses of relevance to the food industry (cold, salt, iron depletion, and acid); (iii) the specific features of the major known epidemic-associated lineages; and (iv) the possible reservoirs of the organism in animals and the environment and the pronounced impact of environmental contamination in the food processing facilities. Finally, a discussion is provided on the perceived areas of special need for future research of relevance to food safety, including (i) theoretical modeling studies of niche complexity and contamination in the food processing facilities; (ii) strain databases for comprehensive molecular typing; and (iii) contributions from genomic and proteomic tools, including DNA microarrays for genotyping and expression signatures. Virulence-related genomic and proteomic signatures are expected to emerge from analysis of the genomes at the global level, with the support of adequate epidemiologic data and access to relevant strains.
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              An outbreak of gastroenteritis and fever due to Listeria monocytogenes in milk.

              After an outbreak of gastroenteritis and fever among persons who attended a picnic in Illinois, chocolate milk served at the picnic was found to be contaminated with Listeria monocytogenes. In investigating this outbreak, we interviewed the people who attended the picnic about what they ate and their symptoms. Surveillance for invasive listeriosis was initiated in the states that receive milk from the implicated dairy. Stool and milk samples were cultured for L. monocytogenes. Serum samples were tested for IgG antibody to listeriolysin O. Forty-five persons had symptoms that met the case definition for illness due to L. monocytogenes, and cultures of stool from 11 persons yielded the organism. Illness in the week after the picnic was associated with the consumption of chocolate milk. The most common symptoms were diarrhea (present in 79 percent of the cases) and fever (72 percent). Four persons were hospitalized. The median incubation period for infection was 20 hours (range, 9 to 32), and persons who became ill had elevated levels of antibody to listeriolysin O. Isolates from stool specimens from patients who became ill after the picnic, from sterile sites in three additional patients identified by surveillance, from the implicated chocolate milk, and from a tank drain at the dairy were all serotype 1/2b and were indistinguishable on multilocus enzyme electrophoresis, ribotyping, and DNA macrorestriction analysis. L. monocytogenes is a cause of gastroenteritis with fever, and sporadic cases of invasive listeriosis may be due to unrecognized outbreaks caused by contaminated food.
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                Author and article information

                Journal
                aib
                Arquivos do Instituto Biológico
                Arq. Inst. Biol.
                Instituto Biológico (São Paulo, SP, Brazil )
                0020-3653
                1808-1657
                March 2011
                : 78
                : 1
                : 155-168
                Affiliations
                [02] Piracicaba orgnameUniversidade de São Paulo orgdiv1Escola Superior de Agricultura “Luiz de Queiroz” Brazil
                [01] Pirassununga orgnameUniversidade de São Paulo orgdiv1Faculdade de Zootecnia e Engenharia de Alimentos Brazil
                Article
                S1808-16572011000100155 S1808-1657(11)07800100155
                10.1590/1808-1657v78p1552011
                1f838a6b-6594-434e-9d35-11a02d733fc8

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 05 November 2010
                : 18 December 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 113, Pages: 14
                Product

                SciELO Brazil

                Self URI: Texto completo somente em PDF (PT)
                Categories
                Artigo de Revisão

                listeriose,derivados de leite,Doenças transmitidas por alimentos,dairy products,listeriosis,Foodborne diseases

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