Spain’s health ministry has issued an international alert over what is being called the biggest ever listeriosis outbreak to hit Spain.

Who has been affected?

The number of people confirmed to have been infected has reached 186 with dozens having been hospitalized, including 31 pregnant women.

But more than 500 other cases are suspected of being linked to the outbreak, confirmed the Ministry of health in a statement.

A 90-year-old woman became the first fatality linked to the outbreak, after she passed away in Seville's Virgen del Rocio hospital on Tuesday and on Friday a 72-year-old man, who was in palliative care suffering from pancreatic cancer, died after contracting listeriosis.

Among those who have fallen ill are at least 23 pregnant women, at least two of whom suffered miscarriages suspected to have been caused by the infection, said the Junta de Andalusia, one losing a baby in the 18th week of gestation, and another in her third trimester.

Ten members of the same family were being treated after they all shared a meal of contaminated meat during the fiesta on August 15th. Among them are a pregnant woman and two young girls.

What is listeria?

The listeria monocytogenes under the microscope.

Listeria is a commonly found bacteria and most people who consume foods that contain it do not become ill.

But for elderly people, pregnant women or those with serious conditions like diabetes or cancer, it poses a serious threat.

Listeriosis begins with flu-like symptoms including chills, fever and muscle aches. It can take up to six weeks after consuming contaminated foods for symptoms to occur.

The infection is caused by the bacteria listeria monocytogenes, which can grow in foods, especially soft cheese, unpasteurised milk, and smoked fish, which is why pregnant women are advised to avoid these. It can also grow on other food products, including salads, and can continue to replicate even when food is refrigerated at cold temperatures.

A recent report revealed that an average of 70 people die from Listeriosis each year in Spain.

Where has it been detected?

Most confirmed cases – 161 so far –  have been recorded in the southern region of Andalusia, where the packaged pork plant linked to the outbreak is situated.

But there have been other cases confirmed in Extremadura, Castile-Leon, Madrid, Aragon and as far away as Asturias and Catalonia.

Authorities have expressed concern over possible infection among tourists who may not suffer symptoms until they return home.

As well as issuing a national alert over the outbreak, Spain’s health ministry said it had issued alerts to EU authorities and the World Health Organization.

What's the source? 

The regional government of Andalusia warned last Thursday that meatloaf or pre-cooked meat, known as carne mechada was to blame. The source has been traced to contaminated meat sold under the commercial name “la Mecha” made by Seville-based company Magrudis. 

The entire batch of that particular product has been recalled from shops, the health ministry said, but consumer watchdog Facua warned that smaller stores may not have heeded the recall or that contaminated products could already have been bought and are in households awaiting consumption.

On  Wednesday, health authorities widened the recall to all the products manufactured in the Magrudis factory since May 1st and have closed the plant entirely.

“Obviously there was a failure to follow the established procedures,” acting health minister Maria Luisa Carcedo told reporters. “Now we need to carry out the inspections and investigations to figure out exactly where this failure took place.”

Further products were added to the list of possible contaminated meat, all from the Magrudis factory, that ceased manufactoring on August 15th when the outbreak came to light.

These include packets from the Magrudis brand labelled; Crema de carne mechada, Manteca colorá, Pringá estilo casero, Zurrapa de hígado, Zurrapa lomo blanca and Zurrapa lomo roja.

Controversy

Questions are being asked as to why it took so long to raise the alarm over the outbreak and for the contaminated meat to be recalled.

Regional health authorities in Andalucia admit that it was first detected on August 5th but wasn’t until August 15th that a health alert was issued.

Rubén Sánchez, head of Facua, has called for the immediate dismissal of Jesús Aguirre, Andalusia’s regional health minister, for his “disastrous mismanagement” of the outbreak.

READ MORE: What is it that makes living in Spain so healthy?