Bille J, Blanc D S, Schmid H, Boubaker K, Baumgartner A, Siegrist H H, Tritten M L, Lienhard R, Berner D, Anderau R, Treboux M, Ducommun J M, Malinverni R, Genné D, Erard P H, Waespi U
National Reference Center for Listeriosis (CNRL), Lausanne, Switzerland.
Euro Surveill. 2006;11(6):91-3.
During an eight week period in spring 2005, 10 cases of listeriosis were reported in a small area of northwest Switzerland (150,000 inhabitants). Eight cases were in older immunocompromised patients who became ill with bacteraemia (three deaths), and two cases were in pregnant women who had septic abortion. All cases were due to a serotype 1/2a isolate with one of two pulsovars found by PFGE. Patient interviews quickly revealed that a locally made and distributed soft cheese (known as 'tomme') was the food source responsible for the outbreak. Samples of this cheese, and of butter made in the same factory, revealed Listeria monocytogenes sv 1/2a of the same pulsovar in amounts of 1000-10 000 and 10-100 cfu/g, respectively. The prompt suspension of production, the market recall of the product, and a public alert terminated the outbreak. However, two cases of febrile gastroenteritis due to the same strains were reported within 10 days of product recall. The restricted distribution area of the contaminated cheese and the collaboration of local physicians, medical microbiologists and food health services all contributed to a rapid and successful investigation. This small outbreak of listeriosis reinforces the need for a laboratory-based surveillance system with rapid typing, as well as collaboration between physicians and microbiologists.
2005年春季的八周时间里，瑞士西北部一个小地区（15万居民）报告了10例李斯特菌病病例。8例发生在免疫功能低下的老年患者中，他们因菌血症发病（3例死亡），2例发生在有败血症性流产的孕妇中。所有病例均由一种血清型1/2a分离株引起，该分离株是通过脉冲场凝胶电泳（PFGE）发现的两种脉冲型之一。对患者的访谈很快发现，一种当地生产和销售的软奶酪（称为“托姆奶酪”）是此次疫情的食物来源。这种奶酪以及同一家工厂生产的黄油样本显示，相同脉冲型的单核细胞增生李斯特菌1/2a血清型分别为每克1000 - 10000和10 - 100菌落形成单位（cfu）。生产的迅速暂停、产品的市场召回以及公众警报终止了此次疫情。然而，在产品召回的10天内报告了两例由相同菌株引起的发热性肠胃炎病例。受污染奶酪的分布区域有限以及当地医生、医学微生物学家和食品卫生服务部门的合作都有助于快速且成功地进行调查。这次小规模的李斯特菌病疫情强化了建立基于实验室的快速分型监测系统以及医生与微生物学家之间合作的必要性。
