Pregnant women are usually warned not to eat deli meats while pregnant. Is eating a hot dog or a slice of bologna while pregnant really that dangerous?The precaution to avoid deli meat is due to the risk of a type of food poisoning called Listeria. This is a bacteria that can cause listeriosis, a gastrointestinal (GI) illness characterized by fever, abdominal cramps and some diarrhea. Normally, this is a mild and short-term condition but for some reason, this bacteria behaves far worse during pregnancy and has been linked to premature birth and even intrauterine fetal death.
Listeria breakouts usually make the news, but food product recalls also occur where no illness is reported, yet the bacteria was detected in food and lead to a recall. Listeria has been reported in ricotta and other “white” cheese, cantaloupes, caramel apples, Mexican-style cheese, a wide range of deli meats, beef and smoked fish (lox).
The CDC estimates that approximately 1600 illnesses and 260 deaths due to listeriosis occur annually in the United States (1). This is a case-fatality rate of 20%.
In 1985, 86 cases of Listeria infection were identified in Southern California. This was the - now infamous - Jalisco Mexican cheese outbreak. This was a pasteurized, manufactured and packaged product. It had nothing to do with “raw” milk. Fifty-eight of the cases were among mother-infant pairs. Twenty-nine deaths occurred: eight neonatal deaths, thirteen stillbirths, and eight non-neonatal deaths. This is the event that to this day still causes fear and concern among pregnant women about avoiding certain cheeses.
In 2011, infected cantaloupes from Jensen farms resulted in 33 confirmed deaths and 147 illnesses from Listeria in 28 states (1).
In 2012, Frescolina Ricotta Salata cheese contaminated by Listeria was recalled. Twenty illnesses in 12 states were reported, but no deaths.
In April, 2013, 468,000 pounds of deli-type meat were recalled. This included ham, turkey breast, pork, ham shanks, head cheese, corned beef, pastrami, and roast beef. There were no reported illnesses.
In February, 2013, 1,500 packages of Nova smoked salmon (lox) were recalled. There were no reported illnesses.
In January, 2015, Bidart Farms of Bakersfield was the source of a Listeria outbreak in caramel apples. Thirty-two people in 11 states were infected, and at least 7 deaths were reported including one fetal loss.
In March, 2015 Rio Tex Wholesale Meats, a Mercedes, Texas establishment, is recalling approximately 58,180 pounds of ready-to-eat beef products that may be contaminated with Listeria monocytogenes, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced.
In January 2016, according to the CDC, 15 people infected with the outbreak strain of Listeria have been reported from eight states since July 5, 2015. All fifteen (100%) ill people reported being hospitalized, including one person from Michigan who died as a result of listeriosis. One of the illnesses reported was in a pregnant woman. Of eight ill people who were asked about packaged salad, all eight reported eating a packaged salad. Four ill people who were able to specify the brands of packaged salad eaten reported various varieties of Dole brand packaged salad and the outbreak was eventually traced to the Dole processing facility in Springfield, Ohio. There was a massive recall of these products.
In summary, Listeria has been found in: white cheese, deli meats, ham, turkey breast, pork, corned beef, pastrami, roast beef, bologna, hot dogs, smoked salmon, caramel candy apples, cantaloupes and packaged salad.
Recommendations for pregnant women include:
- Do not eat hot dogs, luncheon meats, cold cuts, other deli meats (e.g., bologna), or fermented or dry sausages unless they are heated to an internal temperature of 165°F or until steaming hot just before serving.
- Avoid getting fluid from hot dog and lunch meat packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats.
- Pay attention to labels. Do not eat refrigerated pâté or meat spreads from a deli or meat counter or from the refrigerated section of a store.
- Foods that do not need refrigeration, like canned or shelf-stable pâté and meat spreads, are safe to eat. Refrigerate after opening.
- Do not eat soft cheese such as feta, queso blanco, queso fresco, Brie or Camembert unless it is labeled as made with pasteurized milk.
- Make sure the label says, "MADE WITH PASTEURIZED MILK."
- Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole, or unless it is a canned or shelf-stable product.
- Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna, and mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." These fish are typically found in the refrigerator section or sold at seafood and deli counters of grocery stores and delicatessens.
- Canned and shelf stable tuna, salmon, and other fish products are safe to eat.
- Consumers and food preparers should wash their hands with warm water and soap for at least 20 seconds before and after handling any whole melon, such as cantaloupe, watermelon, or honeydew.
- Scrub the surface of melons, such as cantaloupes, with a clean produce brush under running water and dry them with a clean cloth or paper towel before cutting. Be sure that your scrub brush is sanitized after each use, to avoid transferring bacteria between melons.
- Promptly consume cut melon or refrigerate promptly. Keep your cut melon refrigerated at, or less than 40 degrees F (32-34 degrees F is best), for no more than 7 days.
- Discard cut melons left at room temperature for more than 4 hours.