The supplier, Greenyard Frozen UK, reported to the UKs Food Standards Agency that the factory in which the food was processed had been shut down by the Hungarian Food Chain Safety Office, after which the European Food Safety Authority and the European Centre for Disease Prevention and Control issued updates stating that at least five EU member states (UK, Austria, Denmark, Finland and Sweden) were affected. Between June 2015 and July 2018, 9 people had reportedly died as a result of listeriosis, of a total of 47 confirmed cases.In an update on the EFSA website, it was stated that the contamination had supposedly been present since at least 2015, and as a result the Hungarian Food Chain Safety Office had prohibited the marketing of all affected frozen vegetables and frozen vegetable packs produced by the plant in Baja between August 2016 and June 2018. This followed a previous study that found the majority of L. monocytogenes isolates had been found in a 2017 sample of various frozen vegetables, with a minority found in a 2016 sample and a small number found in a 2018 sample. The study suggested that the strain identified (L. monocytogenes serogroup IVb, multi-locus sequence type 6 (ST6)) was likely persisting through standard cleaning operations and disinfection procedures, and that since common production lines were in operation, cross-contamination was an additional concern. 2017–18 South African listeriosis outbreak
In early December 2017 an outbreak of listeriosis was reported by the South African Department of Health.
If the mobility of the stapes is reduced due to otosclerosis, then stapedius muscle contraction does not significantly decrease the admittance. When acoustic reflex testing is conducted, the acoustic reflex thresholds (ART) cannot be determined when attempting to measure on the affected side. Also, a conductive pathology will attenuate the test stimuli, resulting in either elevated reflex thresholds or absent reflexes when the stimulus is presented in the affected ear and measured in the other ear. CT imaging
Imaging is usually not pursued in those with uncomplicated conductive hearing loss and characteristic clinical findings. Those with only conductive hearing loss are often treated medically or with surgery without imaging. The diagnosis may be unclear clinically in cases of sensorineural or mixed hearing loss and may become apparent only on imaging. Therefore, imaging is often performed when the hearing loss is sensorineural or mixed.A high-resolution CT shows very subtle bone findings. However, CT is usually not needed prior to surgery.Otosclerosis on CT can be graded using the grading system suggested by Symons and Fanning. Grade 1, solely fenestral;
Grade 2, patchy localized cochlear disease (with or without fenestral involvement) to either the basal cochlear turn (grade 2A), or the middle/apical turns (grade 2B), or both the basal turn and the middle/apical turns (grade 2C); and
Grade 3, diffuse confluent cochlear involvement (with or without fenestral involvement). Treatment
Medical
Earlier workers suggested the use of calcium fluoride; now sodium fluoride is the preferred compound. Fluoride ions inhibit the rapid progression of disease.