Actions requested
- BE AWARE that during an ongoing listeriosis outbreak investigation, listeria bacteria (Listeria monocytogenes)was detected in milkshakes sold at a Frugals drive-in restaurant in Tacoma. The strain of listeriadetected in Frugals milkshakes has been linked to an outbreak that caused six severe infections and three deaths among Washington residents since February.
- BE AWARE that people aged 65 and older, as well as immunocompromised people, are at risk for developing an invasive listeriosis infection after consuming foods contaminated with L. monocytogenes. Invasive infections can include sepsis, meningitis, and meningoencephalitis as the bacteria spreads beyond the intestines.
- BE AWARE that listeriosis infection in pregnancy can result in miscarriage, stillbirth, preterm labor, and sepsis or meningitis in neonate. Pregnant people often experience mild, flu-like symptoms when infected or can even be asymptomatic.
- Older children or adults with normal immune function can experience mild symptoms, have no symptoms, and hardly ever develop an invasive disease.
- BE ALERT for possible cases of listeriosis infection in these high-risk individuals who consumed milkshakes from Frugals between May 29 and Aug. 7. Symptoms of listeriosis typically appear in two to three weeks, but incubation can take up to 70 days.
- REVIEW the CDC framework for patient management of high-risk individuals who may have been exposed to food contaminated with monocytogenes.
- REPORT any suspected and confirmed cases to Kitsap Public Health District by calling 360-728-2235.
Background
The Washington State Department of Health announced that from Feb. 27 to July 22, 2023, six Washington residents (five from Pierce County and one from Thurston County) reported severe illness, which was linked to infection with Listeria bacteria (or listeriosis). All infected residents had weakened immune systems. Three residents died.
Whole genome sequencing (or genetic fingerprinting) of the bacteria showed the same food most likely made all six people sick. The ill residents were in their 40s, 60s, and 70s.
Two of the six infected residents reported consuming milkshakes from the Frugals in Tacoma at 10727 Pacific Ave. S. before becoming sick. Milkshakes and ice cream have been associated with Listeria outbreaks in the past. As a part of the ongoing investigation, Tacoma-Pierce County Health Department gathered milkshake samples from Frugals on Aug. 8. On Aug. 18, all flavors of Frugals milkshakes were found to be contaminated with the same strain of Listeria that infected the other residents and caused the outbreak.
Since, Frugals has discontinued the use of its two machines and will keep them out of service until the health department confirms they are free of contamination.
Additional resources
- Framework for patient management of high-risk individuals with Listeria, CDC
- Symptoms summary of invasive illness linked to Listeria, CDC
- Opinion on management of pregnant women with likely exposure to L. monocytogenes, American College of Obstetrics and Gynecology
- Background on the outbreak with tips around preventing Listeria, Washington State Department of Health (DOH)
Contacting the health district
- Call: 360-728-2235 and leave a message. Includes reporting notifiable conditions 24 hours a day, 7 days a week. Leave the patient’s name, date of birth and disease.
- Fax: 360-813-1168.
This advisory is also posted on the health advisory page of our Provider Resources website, providers.kitsappublichealth.org.
EDIT: Please take note we issued an updated version of this advisory and corrected the errors here. The sentences containing our mistakes have been bolded to ensure the correct information is emphasized. We apologize for any inconvenience.