RALEIGH – Officials with the North Carolina Division of Public Health are cautioning pregnant women against consumption of soft cheeses, hot dogs, deli-style meats and prepared salads.  The warning comes after three cases of listeriosis were identified in Moore, Durham and Mecklenburg counties and a probable case was identified in Buncombe County.

The three confirmed cases all involved Latinas; two (Durham and Mecklenburg counties) of them were pregnant women whose pregnancies resulted in miscarriages as a result of the infection. The third case (Moore County) involved a pregnant Latina as well.  As a result of the disease, she delivered early but she and the baby are doing well. All three had consumed soft cheese from a variety of sources. There is fourth potential case in Buncombe County – a woman who also lost her baby. That woman’s ethnicity has not been confirmed and that case remains under investigation. All the cases occurred since Thanksgiving.

Listeriosis is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes.  Listeriosis outbreaks have been associated with consumption of unpasteurized (raw) milk and contaminated soft cheeses, vegetables and ready-to-eat meats. The disease affects primarily pregnant women, newborns and people with weakened immune systems.

“This is a tragedy, which could have been avoided,” said State Epidemiologist Dr. Jeff Engel.  “Listeriosis can be prevented by avoiding unpasteurized milk and other potentially contaminated food, especially among vulnerable people.”

Although the cases occurred close together in time, data from molecular testing conducted at the State Laboratory of Public Health showed that different strains were involved. A single product does not seem to be the source of these cases, prompting public health officials to issue a general Listeria warning.

A person with listeriosis has fever, muscle aches and sometimes gastrointestinal symptoms such as nausea or diarrhea. If infection spreads to the nervous system, symptoms such as headache, stiff neck, confusion, loss of balance or convulsions can occur.

Listeria monocytogenes is found in soil and water. Vegetables can become contaminated from the soil or from manure used as fertilizer. Animals can carry the bacterium without appearing ill and can contaminate foods of animal origin such as meats and dairy products.

The bacterium has been found in a variety of raw foods, such as uncooked meats and vegetables, as well as in processed foods that become contaminated after processing, such as soft cheeses and cold cuts at the deli counter. Unpasteurized (raw) milk or foods made from unpasteurized milk are at increased risk to contain the bacterium.

General recommendations to avoid listeriosis include:

• Avoid unpasteurized (raw) milk or foods made from unpasteurized milk.
• Thoroughly cook raw food from animal sources.
• Wash raw vegetables before eating.
• Wash hands, knives and cutting board after handling uncooked foods.
• Consume perishable and ready-to-eat foods as soon as possible.

Recommendations for people at high risk, such as pregnant women and persons with weakened immune systems, in addition to the recommendations listed above include:

• Do not eat hot dogs, luncheon meats or deli meats, unless they are reheated until steaming hot.
• Avoid getting fluid from hot dog packages on other foods, utensils and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats.
• Do not eat soft cheeses such as feta, Brie and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk.
• Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten.
• Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked" or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.