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Tuesday, October 4, 2011

“I Had Listeria”

by Daniel J. DeNoon

Why am I — and the rest of the media — making such a big deal out of the ongoing Listeria outbreak in cantaloupe?

The main reason is that it really is a big deal: The biggest outbreak of this frightening foodborne illness in over a decade. As I write, the death toll is rising.

And for me, it’s personal. Last month my friend Bud nearly died of listeriosis — the disease Listeria causes when it worms its way out of the gut and into the blood.

Bud (not his real name) was one of the lucky ones. Some 20% of people with listeriosis die from meningitis, encephalitis, or other complications. Many others are permanently disabled. Pregnant women infected with Listeria usually don’t get very ill themselves — but they often have a miscarriage, stillbirth, or preterm birth.

People at high risk of serious Listeria disease may be transplant patients or others taking immunity-suppressing drugs. Others may have predisposing conditions, such as HIV infection or diabetes.

Bud was a healthy, lean, 69-year-old outdoorsman. His only risk factor was simply being an older adult. Bud likes cantaloupe, but hadn’t eaten any in the weeks before his illness. He’s not a part of the current Listeria outbreak, and still doesn’t know how he was infected.

Bud had been taking care of his very young grandchildren. When he got mild diarrhea, he simply assumed he’d caught a little bug from the kids. He would have thought no more about it, except for what happened next.

In the first week of July, Bud invited a neighbor with two small kids to visit him in the mountains, where he and his wife have a second home. Just after the guests arrived, Bud started feeling sick to his stomach. Apologizing that he “just had the 24-hour flu,” he stayed in bed all day while his guests hiked in the woods.

Bud is not the kind of guy to take to his bed, even when he’s ill. So when he admitted to feeling worse that night, his guests suggested getting medical help. As luck would have it, a retired emergency-room doctor lived nearby.

The doctor took Bud’s temperature — he had a fever — and examined him. On his leg, Bud had what looked like a tick bite. The doctor suggested that it might be some tick-borne illness, gave him a dose of antibiotics, and told him he’d come by in the morning.

“The next morning I had begun to lose control of my arms,” Bud recalls. “I was not cogent. My guest put the phone in my hands to call my wife, and it was weird. I could not remember how to dial.”

It got worse. The doctor arrived, and immediately told Bud they were going to the local hospital.

Bud could not move his arms. He doesn’t remember that he could not dress himself, but does remember the doctor asking him to get in the car.

“I stood by the door and I couldn’t get my arms to move to the doorknob. I didn’t even know what I was supposed to do,” he says. “They pushed me into the car. And at that point I blacked out.”

Misinformed that there was no need for her to hurry, Bud’s wife Amy (not her real name), got to the hospital a day later. She was met by a doctor.

“The doctor came out and told me it was meningitis,” Amy says. “The nurse with him was a friend of ours, and when I saw her face I knew she thought Bud was going to die.”

By evening, Bud’s family had gathered around him. Then, 18 hours after he’d blacked out, he came to.

“The first coherent thing he did is he looked up with half lidded eyes and said ‘Hi’ to our son,” Amy says.

Fortunately, the doctor who had taken Bud to the hospital insisted that he get a spinal tap. Culture of the spinal fluid showed he had listeriosis. Doctors began treatment with two powerful intravenous antibiotics.

But Bud wasn’t out of the woods. He developed pneumonia, and then his heart began to beat abnormally fast. There was no cardiologist at the rural hospital, so he was taken by ambulance to a university hospital.

Finally, after 10 days in the hospital, Bud was released. That’s when I first saw him, looking lean and wan and wearing a device that pumped antibiotics into his body 24 hours a day.

Amy had to learn to change the dressing and re-insert the needle once a day.

“It took me 45 minutes to an hour every day,” she says. “It seemed like 30 steps with swabs of this and swabs of that. That was nerve wracking, but at least I didn’t have to worry any more that Bud would suffer the consequences they warned me might happen, like deafness or permanent memory loss.”

Three months after he fell ill, and after getting over a terrible bout of pinkeye, Bud says he’s “still a little weak.” But he’s out in the woods taking vigorous 3-mile hikes and chopping firewood.

Yes, listeriosis is relatively rare. But it’s a nasty bug even when it isn’t deadly. The cantaloupe outbreak is a reminder that food safety remains a major issue.

Posted by: Daniel DeNoon at 9:54 am

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