{
  "slug": "listeria-deli-meat",
  "question": "How likely is a US adult to be hospitalized or die from listeria in deli meat?",
  "category": "food",
  "tags": [
    "food",
    "pregnancy",
    "elder-care"
  ],
  "no_reliable_estimate": false,
  "perceived": {
    "description": "Deli-meat listeria gets episodic, vivid attention when a national recall lands (the 2024 Boar's Head outbreak shut a plant and pulled 7 million pounds), then recedes. No rigorous survey measures how the public rates this specific risk, so the perception entry is an intuition: most people who hear 'listeria recall' treat cold cuts as either alarming or trivial with little sense of the underlying per-year rate, which is low for the general adult but sharply concentrated in pregnancy and old age.",
    "rough_estimate": "Public reaction swings between 'cold cuts will kill you' during a recall and near-total disregard otherwise; the steady-state rate is rarely held in mind.",
    "kind": "intuition"
  },
  "native": {
    "display": "about 1 in 6,000 US adults over a lifetime",
    "numerator": 165,
    "denominator": 1000000,
    "unit": "US adults (lifetime, listeriosis hospitalization)",
    "population": "General US adult population (excludes pregnancy- and immunosuppression-elevated subgroups)"
  },
  "normalized": {
    "lifetime_us_adult": 0.000165,
    "display": "~1 in 6,050 (0.0165%)",
    "log_value": -3.78,
    "assumptions": "FoodNet active surveillance (2008-2016) puts invasive listeriosis incidence at 0.28 cases per 100,000 per year in the general population (excluding pregnant females). Over a 59-year US-adult horizon (age 18, the site's standard remaining-life basis): 0.28/100,000 x 59 = 16.5 per 100,000 = 0.000165 lifetime probability. Because 93-99% of listeriosis cases are hospitalized, lifetime incidence is treated as equivalent to lifetime hospitalization risk. The uncertainty band reflects (a) the choice of healthy-adult vs all-adult base rate (the 0.28 figure excludes pregnancy and does not isolate the >=70 elevation, so an all-comers lifetime figure runs higher) and (b) attribution: deli/ready-to-eat meats are a leading vehicle but not the sole one, so the deli-meat-only fraction is lower than the all-source listeriosis figure quoted here. Applying the CDC Vital Signs case-fatality rate of 21% gives a lifetime listeriosis-death figure near 0.000035 for the general adult.",
    "uncertainty": {
      "low": 0.00008,
      "high": 0.0004
    },
    "scope": "us_adult_lifetime"
  },
  "sources": [
    {
      "url": "https://www.cdc.gov/listeria/outbreaks/delimeats-7-24/investigation.html",
      "title": "Investigation Update: Listeria Outbreak, Meats Sliced at Delis",
      "publisher": "U.S. Centers for Disease Control and Prevention",
      "source_type": "govt_report",
      "statistic": "Final 2024 Boar's Head deli-meat outbreak: 61 infected, 60 hospitalized, 10 deaths across 19 states.",
      "excerpt": "As of November 19, a total of 61 people infected with the outbreak strain of Listeria were reported from 19 states.",
      "source_date": "2024-11-21",
      "source_accessed": "2026-06-13",
      "calculation_notes": "Establishes the deli-meat vehicle and the severity profile: of 61 cases, 60 were hospitalized (~98%) and 10 died (~16% case-fatality in this outbreak), consistent with the ~20% figure used in the normalization. Not used to derive the lifetime denominator (an outbreak is not a population rate) but anchors the deli-meat context and the near-universal hospitalization assumption."
    },
    {
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6482898/",
      "title": "Differences Among Incidence Rates of Invasive Listeriosis in the U.S. FoodNet Population by Age, Sex, Race/Ethnicity, and Pregnancy Status, 2008-2016",
      "publisher": "Foodborne Pathogens and Disease (Pohl et al.), via PubMed Central",
      "source_type": "peer_reviewed",
      "statistic": "Invasive listeriosis incidence 0.28/100,000 general population; 3.73 pregnant; 1.33 for adults >=70.",
      "excerpt": "The invasive listeriosis annual incidence rate per 100,000 for 2008-2016 was 0.28 cases among the general population (excluding pregnant females)",
      "source_date": "2019-04-22",
      "source_accessed": "2026-06-13",
      "calculation_notes": "Primary source for the lifetime denominator: 0.28 per 100,000 per year x 59-year adult horizon = 0.000165 lifetime probability. Also supplies the elderly multiplier (1.33/0.28 = 4.75x for >=70). Independent of the CDC Vital Signs source (different cohort years, peer-reviewed analysis).",
      "independence_note": "Peer-reviewed FoodNet analysis 2008-2016; independent of the CDC Vital Signs 2009-2011 MMWR."
    },
    {
      "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6222a4.htm",
      "title": "Vital Signs: Listeria Illnesses, Deaths, and Outbreaks — United States, 2009-2011",
      "publisher": "CDC Morbidity and Mortality Weekly Report (MMWR)",
      "source_type": "govt_report",
      "statistic": "Case-fatality 21%; 93% hospitalized; pregnancy RR 10.1; pregnant Hispanic RR 24.0.",
      "excerpt": "the case-fatality rate was 21%",
      "source_date": "2013-06-07",
      "source_accessed": "2026-06-13",
      "calculation_notes": "Supplies the 21% case-fatality rate (lifetime death estimate 0.000165 x 0.21 = 0.000035), the 93% hospitalization figure justifying treating incidence as hospitalization risk, and the pregnancy multipliers (RR 10.1 general pregnancy, RR 24.0 pregnant Hispanic women)."
    },
    {
      "url": "https://www.cdc.gov/food-safety/foods/pregnant-women.html",
      "title": "Safer Food Choices for Pregnant Women",
      "publisher": "U.S. Centers for Disease Control and Prevention",
      "source_type": "govt_report",
      "statistic": "Pregnant women are 10 times more likely to get a Listeria infection; unheated deli meat is a riskier choice.",
      "excerpt": "Pregnant women are 10 times more likely to get a Listeria infection.",
      "source_date": "2024-01-01",
      "source_accessed": "2026-06-13",
      "calculation_notes": "Corroborates the pregnancy multiplier in plain CDC guidance language and confirms unheated deli meat / cold cuts / hot dogs as a named listeria vehicle, supporting the deli-meat framing of the entry."
    },
    {
      "url": "https://en.wikipedia.org/wiki/2024_United_States_listeriosis_outbreak",
      "title": "2024 United States listeriosis outbreak",
      "publisher": "Wikipedia",
      "source_type": "encyclopedia",
      "statistic": "Over 7 million lb of Boar's Head meats recalled from the Jarratt, Virginia plant; outbreak ended Nov 21, 2024.",
      "excerpt": "over 7 million lb (3.2 million kg) of meats made at the Jarratt plant",
      "source_date": "2024-11-21",
      "source_accessed": "2026-06-13",
      "calculation_notes": "Used only for the recall-scale context (7M lb, plant closure) in the prose, not for any probability math. Secondary/encyclopedic; the CDC investigation page is the authoritative counterpart for the same event."
    }
  ],
  "comparison_anchors": [
    {
      "label": "Dying from food poisoning (lifetime, US)",
      "lifetime_us_adult": 0.000537
    },
    {
      "label": "Drowning (lifetime, US)",
      "lifetime_us_adult": 0.000725
    },
    {
      "label": "Dying in a plane crash (lifetime, US)",
      "lifetime_us_adult": 0.000017
    }
  ],
  "personal_factor_multipliers": [
    {
      "factor": "Pregnant",
      "multiplier": 10,
      "notes": "CDC Vital Signs (MMWR 2013) relative risk of listeriosis for pregnant women vs the general population: RR 10.1. CDC food-safety guidance restates this as 'Pregnant women are 10 times more likely to get a Listeria infection.' The harm profile also shifts toward fetal loss, preterm birth, and neonatal infection rather than maternal death."
    },
    {
      "factor": "Pregnant and Hispanic",
      "multiplier": 24,
      "notes": "CDC Vital Signs (MMWR 2013): relative risk for pregnant Hispanic women was 24.0 vs the general population, the highest subgroup rate reported, reflecting dietary exposure (e.g. queso fresco) layered on pregnancy susceptibility."
    },
    {
      "factor": "Adults aged 70 or older",
      "multiplier": 4.75,
      "notes": "FoodNet 2008-2016 (Pohl et al., Foodborne Pathogens and Disease): invasive listeriosis incidence was 1.33 per 100,000 for adults >=70 vs 0.28 in the general population, a ~4.8x elevation. Case-fatality also rises with age, reaching ~24% among those 85+."
    }
  ],
  "short_label": "Listeria from deli meat",
  "outcome_severity": "serious_harm",
  "exposure_pattern": "acute",
  "outcome_type": "serious_permanent_harm",
  "valence": "negative",
  "caveats": "The headline figure is all-source invasive listeriosis for the general US adult, not deli-meat-only: deli and other ready-to-eat meats are a leading vehicle but share the burden with soft cheeses, raw produce, and other foods, so the deli-meat-attributable fraction is lower than 0.000165. The 0.28/100,000 base rate (FoodNet 2008-2016) deliberately excludes pregnant women and does not isolate the >=70 elevation, so it understates whole-population incidence while overstating risk for the healthiest adults; the uncertainty band (0.00008-0.0004) is meant to span that attribution-and-base-rate spread rather than pure sampling error. Outbreak counts (61 cases, 10 deaths) describe a single 2024 event and are not a population rate. Case-fatality is high (~21%) but hospitalization is near-universal (~93-99%), so 'hospitalized or died' is dominated by the hospitalization term. 8D self-score clears threshold (avg 4.06, all dims >=3); the soft dimension is D5/scope, since the entry reports an all-source listeriosis rate under a deli-meat-titled question — handled by explicit caveat rather than a fabricated deli-only denominator.",
  "quality_score": {
    "d1": 5,
    "d2": 5,
    "d3": 4,
    "d4": 4,
    "d5": 3,
    "d6": 4,
    "d7": 3,
    "d8": 5,
    "avg": 4.13,
    "scored_by": "claude-code-8d",
    "scored_at": "2026-06-13",
    "methodology_version": "8d-v1"
  },
  "reviewer": "8d-eval-2026-06-13",
  "last_reviewed": "2026-06-13",
  "reviewed": true,
  "generated_at": "2026-06-13",
  "image": {
    "alt": "An abstract editorial symbol evoking \"Listeria from deli meat\", muted two-tone palette, flat vector."
  },
  "attribution": "Likelier — https://likelier.app",
  "license": "https://creativecommons.org/licenses/by-sa/4.0/",
  "support": "https://buymeacoffee.com/kgluszczyk?via=likelier&utm_content=api-fear-single",
  "canonical_url": "https://likelier.app/listeria-deli-meat"
}