110211map.jpgAs of November 1, 2011, a total of 139 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes have been reported to CDC from 28 states. The number of infected persons identified in each state is as follows: Alabama (1), Arkansas (1), California (2), Colorado (39), Idaho (2), Illinois (3), Indiana (3), Iowa (1), Kansas (10), Louisiana (2), Maryland (1), Missouri (6), Montana (1), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (11), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4). Nevada and Utah have reported their first case each since the last CDC update. Among persons for whom information is available, reported illness onset ranges from July 31, 2011 through October 21, 2011. Ages range from <1 to 96 years, with a median age of 77 years. Most ill persons are over 60 years old. Fifty-seven percent of ill persons are female. Among the 134 ill persons with available information on whether they were hospitalized, 132 (99%) were hospitalized. State and local health departments in these and other states are investigating other listeriosis illnesses to determine if they are part of this outbreak.

Twenty-nine deaths have been reported: Colorado (8), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (2), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (1). Among persons who died, ages range from 48 to 96 years, with a median age of 81 years. In addition, one woman pregnant at the time of illness had a miscarriage.

Five of the illnesses were related to a pregnancy; two were diagnosed in newborns and three were diagnosed in pregnant women. One miscarriage has been reported. Other outcomes are being monitored.

It is expected that the “final” CDC report on the number of illnesses and deaths will come out this week. I have been asked frequently what I expect to be the final numbers. My educated assumption is that the number of dead will be over 30 and the number is sick above 140 that are officially linked to listeria-tainted cantaloupe.

However, there will be many illnesses, deaths and miscarriages that will never be counted. Some that are sick might not have received medical treatment (hopefully, because they were not too ill). Others, however – especially deaths and miscarriages – will never be counted. Many of the dead are the elderly and the deaths will be listed being caused by other co-morbid factors. As for miscarriages, well, I am simply not aware of how often tests for Listeria are given to the mother or the baby – I expect not often.