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Pregnant women from ethnic minority groups at higher risk of listeria food poisoning

HPA studies show that neighbourhood deprivation also a major risk factor

There is a higher incidence of listeriosis in pregnant women from ethnic minority groups and, overall, in people living in more deprived areas, research from the Health Protection Agency (HPA) has revealed.

Listeriosis is a rare but severe food-borne disease, caused by infection with listeria bacteria. It mainly affects the elderly and those with weakened immune systems, but can also pose a significant risk to pregnant women, their unborn babies and newborns. Early symptoms may include a self-limiting flu-like illness and an upset stomach, but the infection can cause more severe illness such as septicaemia or meningitis and can lead to abortion and stillbirth in unborn babies. Uncomplicated listeriosis can be treated effectively with antibiotics.

Between 2001 and 2008 there were 1510 cases of listeriosis, 181 of which were in pregnant women. Of these, almost 40 per cent (66 individuals out of 181) were women from an ethnic minority which was established from the first and surname of the patient. The proportion of pregnant women with listeriosis from an ethnic minority increased from less than a quarter of the cases in 2001 to over half of the cases in 2008, with the greatest increase being from 2006-8. This increase was over and above what could be expected given changes in the population structure of England and Wales during this time.

Dr. Iain Gillespie, Head of Listeria Surveillance at the HPA said: “During pregnancy women are advised to avoid certain foods that may be contaminated with listeria. These include undercooked ready meals, soft cheeses, cold cuts of meat and pâtés. This HPA study suggests that these food safety messages may not be reaching, or may not be heeded by, all pregnant women, particularly those from ethnic minorities.

“It is important that all pregnant women know what foods should be avoided for the sake of their own health and that of their babies, so food safety messages for preventing listeriosis in pregnancy may need to be targeted more clearly to those that appear to be more at risk, including women from ethnic minority groups.”

In an additional study, HPA surveillance data on all cases of listeriosis between 2001 and 2007 were compared with population data and indicators of deprivation. For all patient groups, it was found that there were more cases of listeriosis in the most deprived areas of England compared to the most affluent.

Additional analyses showed that as a whole, listeriosis cases in deprived areas were more reliant on convenience stores and local shops (e.g. butchers, bakers, etc) for their food shopping than the general population, and that patients’ risk behaviours with food changed with increasing deprivation.

Dr. Gillespie said: “This study suggests that deprivation is an important risk factor for listeriosis, especially in older people and in pregnant women. Our evidence suggests that people living in deprived areas rely more on smaller local shops and convenience stores to do their shopping. Smaller premises have been linked to a lower microbiological standard of food in many studies, so UK Government food safety policy should continue to focus on small food businesses for this reason.

“In addition, risk behaviour with food has been found to be a factor and this emphasises the importance of access to advice on how to avoid listeria infection. Food safety advice on avoiding listeria infection must be tailored to the most vulnerable groups and communicated effectively.”

The two HPA studies were published in a recent edition of Eurosurveillance.

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