A 35-year-old gravida 4 para 3 presents with a fever and diarrhea in the setting of exposure to raw and unpasteurized foods. Symptoms are consistent with listeriosis and a local outbreak of Listeria monocytogenes is identified. The patient is managed inpatient with empiric high-dose amoxicillin for 14 days while awaiting blood culture results, along with fetal monitoring and supportive care to prevent dehydration and electrolyte imbalance. L. monocytogenes causes the clinical disease listeriosis and about 16% of cases occur in pregnant women. Increased susceptibility to listeriosis is partly due to reduced T cell immunity. Symptoms can range from asymptomatic to severe disease with neurological symptoms. Transplacental infection can occur with neonatal disease even in the absence of maternal symptoms. Maternal, perinatal, and neonatal morbidity and mortality are high. The best strategy is primary prevention by avoiding high-risk foods such as deli meat and soft cheeses, along with raw and unpasteurized foods. Safe food storage and preparation techniques also have a role in decreasing infection from cross contamination. Individual decision-making and a discussion of risks should guide individual food related decisions.

Currently 7.8 billion people live on Earth, and by 2100 there will be 11.2 billion. As developing countries urbanize, their populations eat more meat and dairy. But if everyone on Earth eats the amount of animal products that we do in the US and Europe, we will need two Earths to feed us all. We are rapidly cutting down rainforests for agriculture, cattle farming, and palm oil production, which is not sustainable. Chronic diseases (heart disease, diabetes, stroke) are closely related to the foods we eat and are also the most common causes of premature death around the world. To reduce chronic diseases and feed a growing world population, many of us should transition to a healthier and more sustainable, plant-based diet. Additionally, new infectious diseases will be an even greater risk in the coming decades with so many people eating a meat-heavy diet due to increased interactions with wildlife – as we destroy their homes in the forests to grow the many animal products humans want to eat. To prevent both chronic and infectious diseases and agriculturally induced climate change, it is absolutely necessary that we transition to a more environmentally sustainable and healthy diet.