Canada in 2008; improperly handled cantaloupe was implicated in both the outbreak of listeriosis from Jensen Farms in Colorado in 2011, and a similar listeriosis outbreak across eastern Australia in early 2018. 35 people died across these two outbreaks. The Australian company GMI Food Wholesalers was fined A$236,000 for providing L. monocytogenes-contaminated chicken wraps to the airline Virgin Blue in 2011. Caramel apples have also been cited as a source of listerial infections which hospitalized 26 people, of whom five died. In 2019, the United Kingdom experienced nine cases of the disease, of which six were fatal, in an outbreak caused by contaminated meat (produced by North Country Cooked Meats) in hospital sandwiches. In 2019, two people in Australia died after probably eating smoked salmon and a third fell ill but survived the disease. In September 2019, three deaths and a miscarriage were reported in the Netherlands after the consumption of listeria-infected deli meats produced by Offerman. Prevention Preventing listeriosis as a foodborne illness requires effective sanitation of food contact surfaces. Ethanol is an effective topical sanitizer against Listeria. Quaternary ammonium can be used in conjunction with alcohol as a food-contact safe sanitizer with increased duration of the sanitizing action. Keeping foods in the home refrigerated below 4 °C (39 °F) discourages bacterial growth. Unpasteurized dairy products may pose a risk. Cooking all meats (including beef, pork, poultry, and seafood) to a safe internal temperature, typically 73 °C (165 °F), will kill the food-borne pathogen. Treatment Non-invasive listeriosis: bacteria are retained within the digestive tract. Symptoms are mild, lasting only a few days and requiring only supportive care. Muscle pain and fever can be treated with over-the-counter pain relievers; diarrhea and gastroenteritis can be treated with over-the-counter medications. Invasive listeriosis: bacteria have spread to the bloodstream and central nervous system. Treatment includes intravenous delivery of high-dose antibiotics and hospital in-patient care of (probably) not less than two weeks stay, depending on the extent of the infection. Ampicillin, penicillin, or amoxicillin are typically administered for invasive listeriosis; gentamicin may be added in cases of patients with compromised immune systems. In cases of allergy to penicillin, trimethoprim-sulfamethoxazole, vancomycin, and fluoroquinolones may be used. For effective treatment the antibiotic must penetrate the host cell and bind to penicillin-binding protein 3 (PBP3). Cephalosporins are not effective for treating listeriosis. In cases of pregnancy, prompt treatment is critical to prevent bacteria from infecting the fetus;