Local and tribal health department: Please forward to hospitals, clinics, urgent care centers, emergency departments, and convenience clinics in your jurisdiction.
Hospitals, clinics and other facilities: Please distribute to infection preventionists, internists, infectious disease doctors, OB-GYN physicians, family physicians, emergency department staff and all other health care providers who might see patients with bacteremia or meningitis.
Health care providers:
•Consider listeriosis in patients who present with compatible symptoms (listed below), especially among individuals who ate or may have eaten at China Buffet restaurant in Alexandria.
•Be aware that two cases of listeriosis have been identified in Minnesotans who ate at China Buffet in Alexandria on February 15; one was a previously healthy teenager.
•Report all cases with positive Listeria monocytogenes results (including both culture and culture-independent tests) to MDH at 1-877-676-5414 (toll-free) or 651-201-5414, and forward clinical specimens to the MDH Public Health Laboratory per normal reportable disease surveillance procedures.
Approximately 8 cases of listeriosis (invasive Listeria monocytogenes disease) are reported each year in Minnesota (range, 2 to 19 cases). Recently, two cases were identified with the same strain (0 allele difference by whole genome sequencing, indicating that they had a common source). Both reported eating at China Buffet in Alexandria on February 15, 2020.
Public health officials are investigating the source, which may extend beyond the restaurant, and working with the restaurant on interventions. 
Those at highest risk for listeriosis include pregnant women and their newborns, older adults, and the immunocompromised. 
Symptoms of Listeria monocytogenes infection:
•muscle aches
•stiff neck
•loss of balance
Symptoms of invasive disease are sometimes preceded by diarrhea or other gastrointestinal symptoms. Infected pregnant women may experience only a mild illness; however, infections during pregnancy can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. Symptoms of listeriosis begin from 3 to 70 days after consuming the bacteria.