Language a ‘risk factor’ for listeria in Australia

Focusing on the language needs of expectant mothers and enhancing food safety in hospitals could reduce cases of foodborne illness caused by listeria.

Australian researchers report in the current Epidemiology and Infection that of 136 cases of listeriosis in Australia between Nov. 2001 and Dec. 2004, 40 per cent of cases with prior hospitalization were exposed to high-risk foods during hospitalization; consumption of camembert cheese was an additional risk factor.

Of the 19 perinatal cases — defined as illness in a pregnant woman, fetal loss, or illness in a baby aged less than 3 months with isolation of L. monocytogenes from at least one of the maternofetal pair — living in a household where a language other than English (LOTE) was spoken was the primary risk factor associated with listeriosis.

The numbers are small, but the researchers have identified a persistent problem – providing information is nice, but what if the target can’t read or understand (in this case) English?

“The Food Standards Australia and New Zealand (FSANZ) website only provides a brochure on listeriosis and food in English. Languages used in State and Territory brochures vary widely with some only including English while others provide up to 14 languages other than English.

“This study identified that listeriosis prevention messages need to be disseminated in multiple languages and primary-care practitioners should ensure that patients from households speaking a LOTE receive counselling on listeriosis prevention.”

Which sounds nice, but since hospitals are serving high-risk foods to others at risk, maybe the medical community is a limited source of information. And just because a brochure is in another language doesn’t mean anyone will read it or act upon the information. That requires far more rigorous evaluation in terms of information needs, delivery, messages and accuracy. The morons at Toronto Sick Kids hospital told moms-to-be that cold-cuts and raw fish were OK (they’re not).

As the authors conclude,

“The effectiveness of the implementation of the new food safety programs for food service to vulnerable persons should be carefully evaluated to ensure optimal protection of this group.”

A national case-control study of risk factors for listeriosis in Australia
30.apr.10
Epidemiology and Infection (2011), 139: 437-445
C.B. Dalton, T.D. Merritt, L.E. Unicomb, M.D. Kirk, R.J. Stafford, K. Lalor and the OzFoodNet Working Group
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8013904
Abstract
Listeriosis is a foodborne disease associated with significant mortality. This study attempts to identify risk factors for sporadic listeriosis in Australia. Information on underlying illnesses was obtained from cases’ treating doctors and other risk factors were elicited from the patient or a surrogate. We attempted to recruit two controls per case matched on age and primary underlying immune condition. Between November 2001 and December 2004 we recruited 136 cases and 97 controls. Of perinatal cases, living in a household where a language other than English was spoken was the main risk factor associated with listeriosis (OR 11·3, 95% CI 1·5–undefined). Of non-perinatal cases we identified the following risk factors for listeriosis: prior hospitalization (OR 4·3, 95% CI 1·0–18·3), use of gastric acid inhibitors (OR 9·4, 95% CI 2·4–37·4), and consumption of camembert (OR 4·7, 95% CI 1·1–20·6). Forty percent of cases with prior hospitalization were exposed to high-risk foods during hospitalization.