Tappero J W, Schuchat A, Deaver K A, Mascola L, Wenger J D
Childhood and Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
JAMA. 1995 Apr 12;273(14):1118-22. doi: 10.1001/jama.1995.03520380054035.
Food-borne transmission is now recognized as a major cause of human listeriosis.
To assess the impact of prevention efforts, listeriosis rates before interventions were initiated in 1989 were compared with more recent rates (1990 through 1993).
From 1989 through 1993, multistate, laboratory-based active surveillance was conducted to identify all cases in which Listeria monocytogenes was isolated from cultures or ordinarily sterile sites in an aggregate population of more than 19 million.
All laboratories serving acute care hospitals in up to nine surveillance areas in the United States.
In 1989, a well-publicized case report of listeriosis linked to processed poultry led US regulatory agencies to enforce aggressive food monitoring policies and prompted industry to invest in cleanup efforts. In May 1992, consumer guidelines for listeriosis prevention were disseminated.
Cases of perinatal and nonperinatal listeriosis.
The rate of listeriosis decreased in all surveillance areas. Projection of these rates to the US population suggests an estimated 1965 cases and 481 deaths occurred in 1989 compared with an estimated 1092 cases and 248 deaths in 1993, a 44% and 48% reduction in illness and death, respectively. Among adults 50 years of age and older, rates declined from 16.2 per 1 million in 1989 to 10.2 per 1 million in 1993 (P = .02). Perinatal disease decreased from 17.4 cases per 100,000 births in 1989 to 8.6 cases per 100,000 births in 1993 (P = .003). Three serotypes (1/2a, 1/2b, and 4b) of L monocytogenes accounted for more than 96% of cases during each year of the study (1989 through 1993).
The incidence of listeriosis in study areas was substantially lower in 1993 than in 1989. The temporal association of this reduction with industry, regulatory, and educational efforts suggests these measures were effective.
食源性传播现已被公认为人类李斯特菌病的主要病因。
为评估预防措施的效果，将1989年开始采取干预措施之前的李斯特菌病发病率与最近的发病率（1990年至1993年）进行比较。
从1989年至1993年，开展了基于实验室的多州主动监测，以识别从超过1900万总人口的培养物或通常无菌部位分离出单核细胞增生李斯特菌的所有病例。
为美国多达9个监测地区的急诊医院提供服务的所有实验室。
1989年，一份广为宣传的与加工禽肉相关的李斯特菌病病例报告促使美国监管机构实施积极的食品监测政策，并促使行业投资于清理工作。1992年5月，发布了预防李斯特菌病的消费者指南。
围产期和非围产期李斯特菌病病例。
所有监测地区的李斯特菌病发病率均有所下降。将这些发病率推算至美国总人口，结果显示1989年估计有1965例病例和481例死亡，而1993年估计有1092例病例和248例死亡，疾病和死亡人数分别减少了44%和48%。在50岁及以上的成年人中，发病率从1989年的每100万人16.2例降至1993年的每100万人10.2例（P = 0.02）。围产期疾病从1989年的每10万例出生17.4例降至1993年的每10万例出生8.6例（P = 0.003）。在研究的每年（1989年至1993年）中，三种单核细胞增生李斯特菌血清型（1/2a、1/2b和4b）占病例的比例超过96%。
1993年研究地区的李斯特菌病发病率显著低于1989年。发病率下降与行业、监管和教育措施在时间上的关联表明这些措施是有效的。
