Neonatal listeriosis in Scotland.

Thirty-one cases of neonatal listeriosis occurred in Scotland between 1 January 1987 and 31 August 1989. In each of these, Listeria monocytogenes was cultured from blood, cerebrospinal fluid or both. No case of neonatal listeriosis occurred between 1 September 1989 and 31 July 1990, a statistically significant difference in incidence (p less than 0.001). A possible explanation may be that pregnant women adjusted their diet in accordance with the advice given by the Chief Medical Officer in his letter to General Practitioners of February 1989 entitled 'Food and Listeriosis'. Full clinical features and outcome of nineteen of the thirty-one cases were obtained from the paediatricians responsible for their care. Of these, sixteen were early onset and three late onset cases. There were eight deaths, all early onset cases. Two severely asphyxiated infants could not be resuscitated and of the five infants who required assisted ventilation from birth, four died. Four early onset and three late onset cases presented with pyogenic meningitis and all seven recovered without sequelae. It is concluded that when neonatal listeriosis presents as an asphyxiated infant who, after resuscitation, requires assisted ventilation, a fatal outcome is probable. When neonatal listeriosis presents as pyogenic meningitis, recovery without sequelae is the usual outcome.