Deli meats include ready to eat hot dogs, lunch meat, and cold cuts. They are a common and popular ingredient in our everyday quick meals and sandwiches.
It is recommended that pregnant women avoid eating deli meats to prevent the risk of developing Listeriosis, a food borne illness that can be detrimental to both mother and child. The safest course of action would be to stay away from deli meats until after pregnancy, or cook your deli meats to a safe temperature to kill any potential food borne pathogen.
This article will explain what exactly deli meat is and enumerate examples of foods classified as deli meats. Then, the danger of Listeriosis from consumption of contaminated ready-to-eat (RTE) deli foods will be discussed based on current evidences. Finally, the safety of eating deli meat and the recommendations during pregnancy will be presented.
What is Deli Meat?
Deli meats are fresh or canned meats that are pre-cooked and ready to serve. They are usually loaves or sausages made from pork, ham or beef, which have been sliced for sandwiches and other light dishes. They are also called sandwich meat, lunch(eon) meat, cold cuts, or sliced meats.
Deli meats are becoming one of the most popular food products, and can be found anywhere from grocery stores, food chains and local delis. The following are examples of different types of deli meats:
- Chorizo – cured Spanish sausage that is made from pork, garlic, black pepper and smoked paprika (responsible for its red color)
- Pancetta – considered the Italian version of bacon, it is made from pork belly, dry cured in salt and spices (nutmeg, pepper, fennel), and aged for a minimum of three months
- Prosciutto – made from pork leg, it is also dry cured in salt and aged in a cold environment for 9 to 18 months
- Ham – pork leg cured with salt
- Pepperoni – cured, spicy sausage made from pork or beef, pepper and spices, and is a favorite topping for pizza
- Mortadella – largest of all sausages, it is a type of cooked salami made from mixed minced pork, pork fat and peppercorns, olives or pistachios
- Salami – cured sausage made from pork, beef or veal, seasoned with garlic, herbs and spices
- Learn more about eating Salami while pregnant
- Beef pastrami – a popular sandwich meat, it is made from smoked corned beef coated with pepper and spices
- Chicken roll – made from mixed chicken meat and seasonings, then pressed into a roll before being baked
- Chicken breast supreme – made from pressed chicken breast fillets that have been steamed
- Turkey breast – turkey breast meat that has been roasted in the oven
- Roast beef – roast beef that has been roasted in the oven, then sliced thinly or shaved
Listeriosis During Pregnancy
Listeria monocytogenes is among the most dangerous bacterial food borne pathogens worldwide. It causes the infection Listeriosis, which can lead to severe human disease. In 2010 alone, Listeriosis resulted in more than 23 thousand illnesses and more than 5 thousand deaths, of which 20.7 percent occurred perinatally (Maertens de Noordhout et al., 2014).
Listeriosis has a high case fatality rate (Hilliard et al., 2018), and causes 19 percent of deaths from all food borne illnesses in the United States. Hospitalization rate in the general population can be over 95 percent (Scallan et al., 2011). According to the Centers for Disease Control and Prevention (CDC), there is an estimated 1,600 people in the United States who develop Listeriosis and become seriously ill each year, while there are 260 people who die from this disease.
L. monocytogenes is widely distributed in the environment. The difficulty in preventing its contamination in food lies in its ability to grow at refrigerator temperatures and even as low as 0 degrees Celsius (Rocourt et al., 2000).
Listeriosis in humans occurs mainly through consumption of contaminated food (Hilliard et al., 2018). L. monocytogenes is killed by pasteurization and by cooking, but RTE foods, including hot dogs and deli meats, can still be contaminated after factory processing.
Most common identified sources of infection include processed meats, dairy products and seafood (Mead et al., 2006). Foods that were implicated with the largest number of Listeriosis cases per year are pre-cooked meat and sausages (EFSA Panel on Biological Hazards et al, 2018).
In 2006, Mead et al. reported the second largest outbreak of Listeriosis in the United States, with more than 100 cases of infection and 14 deaths. The outbreak was linked to consumption of contaminated frankfurters and deli meats that came from a single facility.
Even “cooked” RTE products have been found to contain L. monocytogenes. In 2012, Lambertz et al. examined more than 500 samples of heat-treated RTE products in Sweden. Their results showed the presence of L. monocytogenes in 61 percent of cooked ham, 12 percent of turkey, 9 percent of roast beef, and 7 percent of sausages.
In 2013, Kramarenko et al. made a 10-year survey of all RTE foods in Estonia. They found that contamination with L. monocytogenes was significantly higher in RTE raw meat products (18.7%), compared to raw mixed salads, raw milk and raw fish products.
In 2014, Leong et al. tested RTE meat samples from 2013 to 2014 from different food processing facilities. The study’s results showed that 62 percent of these facilities were linked to contaminated food products with a general prevalence of 4.6 percent. In South Africa, the largest documented outbreak of Listeriosis happened from 2017 to 2018 and was associated with consumption of an RTE meat product (Matle et al., 2020).
Specific populations are at a higher risk of being infected with Listeriosis. These include (Maertens de Noordhout et al., 2014):
- The elderly
- Pregnant women
- Unborn babies
- People with immunodeficiencies – persons with acquired immunodeficiency syndrome (AIDS) or cancer or who have undergone organ transplants
The risk for Listeriosis was highest for the pregnant population and the elderly. As much as 41 percent of the cases occurred in pregnant women (EFSA Panel on Biological Hazards et al, 2018). Pregnant women are, on average, 20 times more likely to develop Listeriosis than the general population. In addition, about 17 percent of all cases of Listeriosis occurs during pregnancy.
Listeriosis in pregnant women is generally characterized by flu-like symptoms that may or may not be accompanied by gastrointestinal complaints (Doganay, 2003). However, pregnant women also have a 17-fold increased risk of being infected with the invasive form of this disease (Mateus et al., 2013).
Invasive Listeriosis presents most commonly as bloodstream infection followed by meningitis. Overall case fatality rate ranged from 12.7 to 20.5 percent per year (EFSA Panel on Biological Hazards et al, 2018), and can reach as high as 30 percent (Leong et al., 2014).
Listeriosis infection in pregnancy most commonly occurs in the third trimester. It has a low incidence but high fatality rate (Mateus et al., 2013). It can cause symptoms of gastroenteritis, still births and miscarriages in pregnant women (Amir et al., 2020; Matle et al., 2020).
In the fetus or newborn, L. monocytogenes causes a life-threatening invasive infection (Mead et al., 2006). It can result in severe consequences, including premature delivery, pneumonia, meningitis (Indrawattana et al., 2011), neonatal septicemia (Mateus et al., 2013), and infant death (Amir et al., 2020).
Safety of Eating Deli Meat During Pregnancy
Prevention of Listeriosis during pregnancy can be as simple as avoiding possibly contaminated foods, such as unpasteurized dairy, deli meats, salads, hot dogs, and raw vegetables (Jackson et al., 2010).
During pregnancy, the recommendations from the CDC include the following:
- Do not eat hot dogs, luncheon meats, cold cuts, or other deli meats, unless they are heated to an internal temperature of 165 degrees Fahrenheit or until steaming hot.
- Do not eat refrigerated pâté or meat spreads from a deli or meat counter.
- Do not eat soft cheese unless labeled as made from pasteurized milk.
- Do not eat refrigerated smoked seafood, unless contained in a cooked dish.
Moreover, pre-cooked or RTE foods should be consumed as soon as possible. The U.S. Department of Agriculture (USDA) refrigerator storage time guidelines are as follows:
- For hot dogs – an opened package should be stored not longer than 1 week, while an unopened package should be stored not longer than 2 weeks in the refrigerator
- For luncheon and deli meats – unopened and factory sealed packages should be stored not longer than 2 weeks, while store opened packages and meat sliced at deli shops should be stored not longer than 3 to 5 days in the refrigerator
Listeriosis is a serious infection that can result in death. It is particularly risky for pregnant women and their unborn babies. Newborns suffer the most devastating effects of Listeriosis infection in pregnancy.
Therefore, taking the necessary precautions to ensure the prevention of this infection is of prime significance during pregnancy. Accordingly, pregnant women should not eat deli meats, unless reheated to an appropriate internal temperature that could kill any potential food borne pathogen.
Pregnant women should also always involve their health care practitioners regarding their food options and choices.