Listeria in Pregnancy: how to Manage Exposure to Recalled Foods

A few recalls have made headlines over concerns of fruit contaminated with the bacteria Listeria monocytogenes. This bacterium can cause infection listeriosis, which can have serious effects on a pregnant woman.

If a pregnant woman consumed food that was involved in a listeria recall but has no symptoms, no further testing needs to be done. She should be educated about the symptoms of listeria and be told that if she has any of these symptoms within 2 months of eating the food that was recalled, then she should notify her obstetric provider immediately as certain testing may be done.

These symptoms often resemble the flu and can include fever, muscle aches, backache, and headaches. Often diarrhea or other gastrointestinal symptoms will occur before these other symptoms appear. If you think that these symptoms seem very vague (or that every pregnant woman has them at some point!), you are correct. This is what can make the diagnosis tricky. What can be even harder is that some women with listeria show no symptoms at all.

If a woman was exposed to a recalled food and does have some of these mild symptoms but has no fever, she can be monitored expectantly as well. While there is no data to support this, some obstetric providers will draw blood work to look for listeria growing in the bloodstream in these women. Antibiotics may or may not be started while waiting for these blood cultures to return (again, there is no good data to make a recommendation either way).

However, if a woman has a fever (above 100.6 degrees Fahrenheit) with or without other symptoms of listeria, was exposed to a contaminated food, and has no other obvious source for the symptoms (such as appendicitis), then testing for listeria and treatment (until it is ruled out) for the infection should be done.  This is done to prevent the mother from becoming very ill and from having complications with her baby (such as preterm labor and stillbirth).

Testing would again include blood cultures (and cultures of the placenta if she delivers), and treatment would be in the form of intravenous antibiotics (usually ampicillin). The baby will usually be monitored, though there is no set regimen that is known to be best. Delivery would only be recommended in the setting of a very sick mother or if the monitoring of the baby was concerning enough.

If you are worried that you may have signs of listeria and were exposed to a recalled food, be sure to talk with your doctor or midwife. While the complications can be severe, the good news is that overall this is a rare occurrence in pregnancy.

Sources:

• The American Congress of Obstetricians and Gynecologists. Management of pregnant women with presumptive exposure to Listeria monocytogenes.

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