Ongoing High Incidence and Case-Fatality Rates for Invasive Listeriosis, Germany, 2010–2019

L isteria monocytogenes infections are primarily food- borne and cause gastrointestinal disease or invasive syndromes among infected persons (1). Because L. monocytogenes is an intracellular pathogen and because invasive listeriosis is the primary manifestation in diagnosed listeriosis, persons with defi cient cell-mediated immunity are at increased risk for its symptoms, including sepsis and meningitis. In addition, infection during pregnancy can lead to chorioamnionitis and fetal infection that can result in miscarriage and stillbirth even 2 months after the mother is exposed. One study found that 44% of patients with non-pregnancyassociated (NPA) listeriosis in Germany had received immunosuppressive therapy 3 months before illness onset and another 28% had a coexistent immunocompromising illness, such as diabetes (2). Testing for bacteria in blood cultures or cerebrospinal fl uid (CSF) is recommended for diagnosis.