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Journal of Clinical Microbiology, May 2005, p. 2350-2355, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2350-2355.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Microbiological Aspects of the Investigation That Traced the 1998 Outbreak of Listeriosis in the United States to Contaminated Hot Dogs and Establishment of Molecular Subtyping-Based Surveillance for Listeria monocytogenes in the PulseNet Network

Lewis M. Graves,1* Susan B. Hunter,1 Anna Rae Ong,1 Diana Schoonmaker-Bopp,2 Kelley Hise,1 Laura Kornstein,3 Wallis E. DeWitt,1 Peggy S. Hayes,1 Eileen Dunne,1 Paul Mead,1 and Balasubramanian Swaminathan1

Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333,1 New York State Public Health Laboratory, New York, New York 12208,2 New York City Department of Health, New York, New York 100163

Received 20 September 2004/ Returned for modification 28 October 2004/ Accepted 27 December 2004

A multistate outbreak of listeriosis occurred in the United States in 1998 with illness onset dates between August and December. The outbreak caused illness in 108 persons residing in 24 states and caused 14 deaths and four miscarriages or stillbirths. This outbreak was detected by public health officials in Tennessee and New York who observed significant increases over expected listeriosis cases in their states. Subsequently, the Centers for Disease Control and Prevention (CDC) began laboratory characterization of clinical isolates of Listeria monocytogenes by serotyping and restriction fragment length polymorphism analysis using pulsed-field gel electrophoresis (PFGE). For the purpose of this investigation, outbreak-related isolates were defined as those that had a specific AscI-PFGE pattern and indistinguishable or highly similar (no more than 2 band difference in 26 bands) ApaI-PFGE patterns when their DNA was restricted by AscI and ApaI restriction enzymes. Timely availability of molecular subtyping results enabled epidemiologists to separate outbreak cases from temporally associated sporadic cases in the same geographic areas and facilitated the identification of contaminated hot dogs manufactured at a single commercial facility as the source of the outbreak. During the investigation of this outbreak, a standardized protocol for subtyping L. monocytogenes by PFGE was developed and disseminated to public health laboratories participating with CDC's PulseNet network; these laboratories were requested to begin routine PFGE subtyping of L. monocytogenes.

* Corresponding author. Mailing address: Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop CO3, Atlanta, GA 30333. Phone: (404) 639-3334. Fax: (404) 639-3333. E-mail: lmg2{at}cdc.gov.

Journal of Clinical Microbiology, May 2005, p. 2350-2355, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2350-2355.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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