The crisis of listeriosis and "mechá meat" is on the way to becoming the most serious health crisis since rapeseed oil

The Andalusian Government has confirmed that a 90-year-old woman has been the first death caused by the listeriosis outbreak that started in Andalusia, but which, according to the Ministry of Health, has already overwhelmed Despeñaperros and affects half a dozen autonomous communities due to the whole country.

In addition, the latest epidemiological report has raised to 114 infected people in Andalusia and one more in Extremadura. There are several suspected cases in the rest of the country, one in Madrid and four more in Extremadura. With these figures, we can already talk about the worst listeria outbreak recorded in Spain and, taking into account the information that is appearing, it is possible that we are facing the most serious health crisis since rapeseed oil.

What we know about the listeriosis outbreak

The deceased 90-year-old patient was admitted to the Virgen del Rocío hospital on August 15 after four days of symptoms. To date, 53 people have been hospitalized: 35 in Seville, seven in Huelva, six in Malaga and five in Cádiz. Among them are 18 pregnant women and two newborns.

Listeriosis is an infection caused by listeria monocytogenes. It is an 'opportunistic' disease that is spread by consuming infected food (or, in the case of fetuses and newborns, through the placenta or during childbirth). Although it generally presents as a "mild illness" (similar, in many cases, to "gastroenteritis"), it is especially dangerous in certain risk groups such as pregnant women, newborns, the elderly, and generally people with the immune system committed. In these risk groups, it can cause fairly serious conditions (abortion, stillbirth, sepsis, or meningitis) and has death rates of between 20% and 30% of cases.

But this could only be the beginning. The product in question, a shredded meat of the Sevillian brand 'La Mechá', has three months of expiration and only began to be withdrawn from the market as of August 15. The Ministry of Health confirmed this morning that the product had also been distributed in Madrid, Extremadura, Castilla-La Mancha, Tenerife and, possibly, in Girona.

While José Miguel Cisneros, the spokesman of the group for the control of the crisis organized by the Ministry of Health and family of the Board has stressed that "the importance of all those people who have ingested the meat that originated the alert go to hospitals as soon as they present symptoms, "it is not lost on anyone that the peculiarities of listeriosis (which can take up to 70 days to show symptoms) will complicate both the control of the outbreak and the very understanding of its definitive scope.

For this reason, as the Health Minister, Maria Luisa Carcedo, has pointed out, in addition to treating all patients, they are focused on "not spreading the meat. All this product has been ordered to be withdrawn from this factory, which is closed" .

An outbreak that is far from over

Distribution of listeriosis cases between 1997 and 2015 (Herrador, 2019)

Isolated cases of listeriosis occur every year. In fact, in Spain, between 1997 and 2015, there were 5,696 hospitalizations related to the infection. However, due to its characteristics, this outbreak is becoming an unprecedented hygienic and sanitary earthquake in recent years.

And, according to the same authorities, it will go further. After learning this morning that an error in the identification of the affected samples could delay the declaration of the health alarm for almost a week. We must prepare for a possible trail of cases that will accompany us in the coming weeks.

In fact, due to the size, epidemiology and distribution of the outbreak, it is possible that we are facing the most important health crisis in Spain since rapeseed oil syndrome entered the country's health history in the spring of 1981, taking it ahead the lives of 1100 people.

At that time, the poisoning originated from the fraudulent commercialization of processed rapeseed oil to eliminate the dye with which it was mandatory to sell it precisely to discourage its human consumption. In that case, the delay in identifying the cause of the problem meant that the product was in circulation for months before being withdrawn, prevented its correct treatment and affected much of the peninsular plateau.

Geographical distribution of those affected by toxic rapeseed oil syndrome in the years 81-82

We will not get to that point precisely because we learned a lot from that terrible crisis. First, because health alert and monitoring systems are light years from what we had 30 years ago. And second, because hospitals are following the standard protocol for the treatment of listeriosis, a treatment that if applied correctly is very effective.

The differences are, therefore, very important. And yet, in the absence of knowing the details of the management of this listeria outbreak, it is clear that health crises are really very complicated events to manage and that they need all possible social collaboration.

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