In English and Spanish (turn over for Spanish )

Preventing Listeriosis 

In Pregnant Hispanic Women in the U.S.

 Community Educatorʼs Guide Community Educatorʼs Guide 

To A Serious Foodborne Risk
Statistics Tell The Story

• Recent serious listeriosis outbreaks 

were reported in California, Washington 

and North Carolina, where 12 cases 

of infected individuals – all Hispanic 

– were linked to eating contaminated, 

homemade Queso Fresco1. 

• In the most recent listeriosis outbreak, 

eleven victims were non-English 

speaking women and ten were pregnant. 

The infections resulted in fi ve stillbirths, 

three premature deliveries, and two 

infected newborns. 

 1 U.S. Food and Drug Administration

Dear Community Educator,

We need your help. You can play a critical role in preventing the listeriosis 

disease in your community. This foodborne illness is caused by Listeria bacteria, 

and eating foods that contain this bacteria can lead to serious illness – and even 

death. The youngest victim of listeriosis is the unborn baby – who can become 

infected even though the mother doesnʼt feel sick! The message for pregnant 

women is simple: never eat dairy products made with unpasteurized milk. 

Pregnant women should only eat cheese that is labeled “made from pasteurized 

milk” and purchased in stores. 

• All pregnant women are at serious risk for listeriosis – in fact, they are 20 times more likely to become 

infected than other healthy adults. Thatʼs because their immune systems are suppressed during pregnancy, 

so they are less able to fi ght off the infection.

• Hispanic pregnant women are at even greater risk of listeriosis because of traditional dietary habits.

• If a pregnant woman has listeriosis, her unborn baby can become ill – and even die.

The risk to Hispanic women is much higher than it is for the general 

population because of the cultural tradition of eating Mexican-style 

soft cheeses like Queso Fresco, which, in many Latin American soft cheeses like Queso Fresco, which, in many Latin American 

countries, are often made from “raw” (unpasteurized) milk. Most 

women are simply unaware that cheese made with unpasteurized women are simply unaware that cheese made with unpasteurized 

milk can harbor these deadly bacteria! milk can harbor these deadly bacteria!

Thatʼs why this Thatʼs why this Preventing Listeriosis Community Educatorʼs 

Guide was created. It will make it easier for you to spread this 

important health message throughout your community. The guide important health message throughout your community. The guide 

includes a variety of handouts and tools to be reproduced and 

distributed – along with background information for you regarding 

the disease, its symptoms, and how to prevent it.

Thank you for alerting women in your community about this 

potentially fatal condition. Pregnant women need to know that they 

could be putting their unborn babies at risk.

 Sincerely yours,

 Center for Food Safety and Applied Nutrition

 Food and Drug Administration

 Table of Contents

Using this Toolkit ..................................................................... .....................................................................3

Getting Started .........................................................................4

Q&A: Common Questions from Pregnant Women ..............5-6

Background for Educators ...................................................7-9

Consumer Brochure reproducible .....................................10-11

Fotonovela reproducible ...................................................12-15

Community Flyer reproducible ..............................................16

About This Program

Pregnant Hispanic women 

in the U.S. are at critical 

risk for become infected 

by Listeria. 

YOU can help keep these 

women and their babies safe!

2
Community Educatorʼs Guide 

• This self-contained manual includes background information, common questions and 

answers, and a set of reproducible materials to help you notify your community about 

this critical health risk

• The reproducibles may be used in a variety of settings, including:

 — Group presentations

 — Home visits

 — Displays at community gathering points (see Getting Started on page 4 for 

 location ideas)

Community Flyer: 

Page 16

This reproducible is printed 

on one 8 1⁄2 x 11” page.

Photocopy the fl yer – 

no folding required.

You may choose to 

photocopy English on one 

side and Spanish on the 

reverse for use with 

bi-lingual audiences.

Consumer Brochure

A folding handout that gives the basic 

facts about Listeriosis: what it is, 

how to avoid it, and what to do if you 

think youʼre infected.

Fotonovela — Maribelʼs Story

Everyone loves fotonovelas, and this 

8-page story is designed to capture 

the attention of your audiences 

through a compelling, beautifullyillustrated story. Add your local 

contact information to the inside 

front cover.

Community Flyer

This detailed one-page fl yer can 

be used at community health 

fairs, posted on clinic walls, 

and placed in local OB/GYNsʼ 

waiting rooms. 

Q&A – Questions from 

Pregnant Women

You may also photocopy this 

section and distribute it as a 

handout during your presentations 

or home visits.

Consumer Brochure:

Pages 10 - 11

This reproducible is printed 

on two 8 1⁄2 x 11” pages.

1. Photocopy the pages 

back-to-back and 

top-to-top. 

2. Fold in half.

Finished 

brochures will 

be 5 1⁄2 x 8 1⁄2

Assembling Your Handout Materials

Fotonovela: 

Pages 12 – 15

This reproducible is printed on four 

8 1⁄2 x 11” pages.

1. Photocopy pages back-to-back

and top-to-top. 

2. Place sheets in order. 

3. Fold pages in half to make 

the booklet. Finished 

fotonovelas will be 8 pages 

long, sized at 5 1⁄2 x 8 1⁄2. 

Using This Toolkit

3

How eating Queso Fresco 

harmed her unborn baby.

Maribel’s Story Donʼt Eat Cheeses Made from Donʼt Eat Cheeses Made from 

Unpasteurized Milk

Keep Your 

Unborn Baby Safe Unborn Baby Safe

In English and Spanish (turn over for Spanish )

Preventing Listeriosis In Pregnant Hispanic Women in the U. In Pregnant Hispanic Women in the U.S.

 Community Educatorʼs Guide 

To A Serious Foodborne Risk

U.S. Food and Drug 

 Administration

U.S. Department of Health 

and Human Services

Cheeses made from raw or “unpasteurized” milk 

can contain bacteria that might make your baby sick 

— even before heʼs born. 

You can help keep your baby safe by avoiding 

cheeses made from unpasteurized milk. Hereʼs what 

you need to know:

• “Queso Fresco” is a Mexican-style soft cheese that 

is sometimes made with unpasteurized milk. Many 

types of cheeses can be made “Queso Fresco” style 

— including Queso Fresco, Panela, Asadero, and 

Queso Blanco. 

• Unpasteurized cheeses are 

 often sold door-to-door, at fl ea often sold door-to-door, at flea 

 markets, from the back of markets, from the back of 

trucks, or brought into the U.S. 

from Mexico or Central America. from Mexico or Central America.

• Before eating any of these soft Before eating any of these soft 

 Mexican-style cheeses, read

 the label to make sure it says 

 “Made from Pasteurized Milk,” “Made from Pasteurized Milk,”

or “Pasteurized.” If it doesnʼt or “Pasteurized.” If it doesnʼt 

 — do not eat the cheese.

• If you think you may have 

eaten contaminated cheese 

while pregnant, while pregnant, call your 

doctor or clinic.

What Does 

“Pasteurized” Mean?

• Pasteurized means that a 

food, like milk, is heated 

at a processing plant to 

kill bacteria.

• Unpasteurized (raw) milk has 

not been heated at a processing

plant, and may contain 

dangerous bacteria that can 

hurt or kill your unborn baby 

– even if you donʼt feel sick!

Some Cheeses Could Harm Your Unborn Baby!

Help Keep Your Unborn Baby Safe. Help Keep Your Unborn Baby Safe. 

Do not eat Queso Fresco-style cheeses made 

with unpasteurized milk! 

♥ ♥ ♥ ♥ ♥ ♥ ♥ Attention Pregnant Women ♥ ♥ ♥ ♥ ♥ ♥ ♥ 

Eating Unpasteurized

Cheeses Can Cause Listeriosis

• This dangerous disease can 

cause birth defects and other 

serious problems — even 

the death of your baby.

Unpasteurized Cheese 

Can Cause Other Diseases, Too

These have been known to 

include:

• Tuberculosis 

• Salmonellosis

• Brucellosis

♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ 

Donʼt eat Queso Fresco, Panela, Asadero or Queso Blanco 

unless youʼre sure it is pasteurized.

Poster — 17 x 22”, full color

• This Call-to-Action is a great springboard for alerting pregnant women about the 

health risk of Listeriosis

• If possible, place copies of the Consumer Brochure, Fotonovela or Community Flyer 

near the poster so the community can easily get more information on the topic

Handout Materials (reproducibles):

page

3

page

5

cover

inside spread

Cristina: Oh look, they have Queso Fresco here. But it doesnʼt 

taste the same as the kind we used to eat in Mexico. Remember 

how our mothers would buy the milk fresh from the dairy farm and 

make the cheese at home?

Rosario: Yes, I remember. But eating Queso Fresco like we used 

to isnʼt worth the risk – especially after the tragedy that happened 

to my neighbor Maribel.

 A tragedy? What happened?

 Oh, itʼs so sad – I thought you heard. Maribel ate Queso 

Fresco she bought from a vendor selling cheese door to door . . .

3

cover

page

7

How eating Queso Fresco 

harmed her unborn baby.

Cristina:

Rosario: Oh, itʼs so sad – I thought you heard. Maribel ate Queso M

Fresco she bought from a vendor selling cheese door to door . . .

aribel’s Story

Donʼt Eat Cheeses Made from Donʼt Eat Cheeses Made from 

Unpasteurized Milk

Keep Your 

Unborn Baby Safe Unborn Baby Safe

If You Are Pregnant . . .

Eating Certain Cheeses Could 

Harm Your Baby! Harm Your Baby!

Visit 

www.cfsan.fda.gov www.cfsan.fda.gov

for more information. for more information.

Cheeses made from unpasteurized milk can Cheeses made from unpasteurized milk can 

contain bacteria called Listeria. It can make 

your baby sick – even before he is born even before he is born.

U.S. Food and Drug 

 Administration

U.S. Department of Health 

and Human Services

Made from

PASTEURIZED MILK

Queso Fresco

10 oz

• Don’t eat Mexican-style soft cheese • Don’t eat Mexican-style soft cheese 

like Queso Fresco, Panela, Asadero like Queso Fresco, Panela, Asadero 

or Queso Blanco unless the 

label states that it is made 

from pasteurized milk. 

• Do not buy or eat Queso Fresco • Do not buy or eat Queso Fresco 

sold door-to-door.

• If you have eaten cheese made from 

unpasteurized milk, call your doctor 

or clinic.

Q. What is listeriosis? Q. What is listeriosis?

A. Itʼs a serious illness caused by eating food contaminated with Itʼs a serious illness caused by eating food contaminated with Listeria

bacteria. These germs can affect you and your unborn baby, newborns, bacteria. These germs can affect you and your unborn baby, newborns, 

and other people with immune systems weakened by cancer, diabetes and and other people with immune systems weakened by cancer, diabetes and 

other diseases.

Q. How can I get listeriosis? Q. How can I get listeriosis? 

A. By eating foods that are contaminated with By eating foods that are contaminated with Listeria monocytogenes. 

These dangerous bacteria have been found in Queso Fresco-style soft These dangerous bacteria have been found in Queso Fresco-style soft

cheeses and other foods made from unpasteurized milk. cheeses and other foods made from unpasteurized milk. 

Q. Why am I at risk during pregnancy? Q. Why am I at risk during pregnancy? 

A. During pregnancy, parts of your immune system are suppressed. Thatʼs During pregnancy, parts of your immune system are suppressed. Thatʼs 

why pregnant women are 20 times more likely than other healthy adults why pregnant women are 20 times more likely than other healthy adults 

to get listeriosis. Approximately one third of all cases occur in pregnant to get listeriosis. Approximately one third of all cases occur in pregnant 

women; also at high risk are newborns and fetuses. women; also at high risk are newborns and fetuses.

Q. Iʼm Latina. Am I at greater risk for listeriosis? Q. Iʼm Latina. Am I at greater risk for listeriosis?

A. From a biological standpoint, no. Latinas are not more From a biological standpoint, no. Latinas are not more susceptible to 

listeriosis. But from a dietary standpoint, Latinas have a higher chance listeriosis. But from a dietary standpoint, Latinas have a higher chance 

of getting listeriosis than a non-Hispanic pregnant woman because of 

their food choices. Latinas are more likely to purchase and eat homemade their food choices. Latinas are more likely to purchase and eat homemade 

Mexican-style soft cheeses from local vendors – and these cheeses are Mexican-style soft cheeses from local vendors – and these cheeses are 

often made with unpasteurized milk. Many cases of listeriosis within 

Hispanic communities have been linked to eating homemade cheeses.

Q. Iʼve never known anyone that had this happen. Why should I worry?

A. Itʼs very possible that someone you know has lost a baby because of 

listeriosis, and it just wasnʼt diagnosed or recorded. The Food and Drug 

Administration and the Centers for Disease Control and Prevention 

(CDC) are tracking the incidence of listeriosis in the United States, 

and they have linked the high incidence of the disease among Hispanic 

pregnant women to eating Queso Fresco-style cheese made with 

unpasteurized milk.

Common Questions and Answers Common Questions and Answers 

From Pregnant Women About Listeriosis From Pregnant Women About Listeriosis 

Common Questions and Answers 

From Pregnant Women About Listeriosis 
Attention 

Pregnant Women: regnant Women:

Some Cheeses Could 

Harm Your Unborn Baby!

• Don’t eat Queso Fresco, 

Panela, Asadero or 

Queso Blanco unless 

you’re sure it is made 

from pasteurized milk!

• If you think you may 

have eaten contaminated 

cheese and you are 

pregnant – call your 

doctor or clinic.

Get Your Community Involved!

Use local organizations or groups to help you get 

the word out. Drop off copies of the materials at:

• Churches

• Clinics

• Community Based Organizations 

• Pharmacies

• Local Mercados

• WIC Centers

• La Leche League offi ces

• School nurse offi ces

• Head Start and Early Head Start Centers

Speak out in the community 

Vendors and local suppliers must understand the 

danger of selling soft cheeses made with 

unpasteurized milk. If made with unpasteurized 

milk, the Queso Fresco-style cheeses they are 

providing to their community may be endangering 

the life of an unborn child. 

Be Prepared for Some Doubt

Itʼs common for any of us to be unsure about this new 

Listeria information. After all, if someone has never 

heard of this risk before – or it never happened to anyone 

they knew back home, where eating cheese made with 

unpasteurized milk was even more common – itʼs human 

nature to conclude that the risk is not real.

Remind them of these points:

• The risk is real – and could be deadly. Itʼs very 

possible that it has happened to someone they know 

and that Listeria just wasnʼt diagnosed as the cause.

• Ever since the U.S. government became aware of this 

risk, they have been closely tracking outbreaks of 

listeriosis and the causes. The FDA and the Centers for 

Disease Control and Prevention (CDC) are making 

doctors more aware of the risks from listeriosis. You 

may start hearing more about this from your doctor 

or clinic. 

Here are some ideas for getting the conversation 

going when speaking with a group. Note: When 

visiting a home and speaking one-on-one, the 

Fotonovela makes an ideal introduction to the topic.

• Say “Cheese”: Pick up several varieties of Queso 

Fresco-style cheeses to show to the group. In 

addition to store-bought brands that are labeled 

as “made from pasteurized milk,” try to locate a 

home-made variety without the proper labeling. 

Use these to open the discussion about types of 

traditional cheese and the importance of 

pasteurization and proper labeling.

• Make it Personal: Generate a discussion about 

how cheese was made in Latin American 

countries and how itʼs made in the U.S. Explain 

why eating cheese made with unpasteurized milk 

is so dangerous. Get participants to relay stories 

about vendors, people they know, and their own 

experiences.

• Share Statistics: Check with local public health 

authorities, hospitals or community clinics to see 

if there are any local statistics regarding listeriosis 

among pregnant women. Use these statistics to 

underscore the reality of the threat.

Getting Started

Presentation Starter Ideas

• Consider a Guest Participant: In one community, 

a woman who had suffered a miscarriage due to 

listeriosis was willing to talk to others and warn 

them of this critical health risk. Stay tuned into the 

health news and local conversations to see if there 

is anyone willing to share her story.

 

4
Q. What is listeriosis? Q. What is listeriosis?

A. Itʼs a serious illness caused by eating food contaminated with Itʼs a serious illness caused by eating food contaminated with Listeria

bacteria. These germs can affect you and your unborn baby, newborns, bacteria. These germs can affect you and your unborn baby, newborns, 

and other people with immune systems weakened by cancer, diabetes and other people with immune systems weakened by cancer, diabetes 

and other diseases.

Q. How can I get listeriosis? Q. How can I get listeriosis? 

A. By eating foods that are contaminated with By eating foods that are contaminated with Listeria monocytogenes. 

These dangerous bacteria have been found in Queso Fresco-style soft These dangerous bacteria have been found in Queso Fresco-style soft

cheeses and other foods made from unpasteurized milk. cheeses and other foods made from unpasteurized milk. 

Q. Why am I at risk during pregnancy? Q. Why am I at risk during pregnancy? 

A. During pregnancy, parts of your immune system are suppressed. Thatʼs During pregnancy, parts of your immune system are suppressed. Thatʼs 

why pregnant women are 20 times more likely than other healthy adults why pregnant women are 20 times more likely than other healthy adults 

to get listeriosis. Approximately one third of all cases occur in pregnant to get listeriosis. Approximately one third of all cases occur in pregnant 

women; also at high risk are newborns and fetuses. women; also at high risk are newborns and fetuses.

Q. Iʼm Latina. Am I at greater risk for listeriosis? Q. Iʼm Latina. Am I at greater risk for listeriosis?

A. From a biological standpoint, no. Latinas are not more From a biological standpoint, no. Latinas are not more susceptible to 

listeriosis. But from a dietary standpoint, Latinas have a higher chance listeriosis. But from a dietary standpoint, Latinas have a higher chance 

of getting listeriosis than a non-Hispanic pregnant woman because of 

their food choices. Latinas are more likely to purchase and eat homemade their food choices. Latinas are more likely to purchase and eat homemade 

Mexican-style soft cheeses from local vendors – and these cheeses are Mexican-style soft cheeses from local vendors – and these cheeses are 

often made with unpasteurized milk. Many cases of listeriosis within 

Hispanic communities have been linked to eating homemade cheeses.

Q. Iʼve never known anyone that had this happen. Why should I worry?

A. Itʼs very possible that someone you know has lost a baby because of 

listeriosis, and it just wasnʼt diagnosed or recorded. The Food and Drug 

Administration and the Centers for Disease Control and Prevention 

(CDC) are tracking the incidence of listeriosis in the United States, 

and they have linked the high incidence of the disease among Hispanic 

pregnant women to eating Queso Fresco-style cheese made with 

unpasteurized milk.

Common Questions and Answers Common Questions and Answers 

From Pregnant Women About Listeriosis From Pregnant Women About Listeriosis 

5
Common Questions and Answers Common Questions and Answers 

From Pregnant Women About Listeriosis From Pregnant Women About Listeriosis (contʼd)

Q. What are the symptoms of listeriosis? Q. What are the symptoms of listeriosis?

A. You may experience fever, chills, muscle aches, nausea and You may experience fever, chills, muscle aches, nausea and 

diarrhea, or upset stomach. Or, you may not feel sick at all — yet diarrhea, or upset stomach. Or, you may not feel sick at all — yet 

the infection can still severely affect your unborn baby. Listeriosis the infection can still severely affect your unborn baby. Listeriosis 

can lead to miscarriage, stillbirth, premature labor, the delivery of can lead to miscarriage, stillbirth, premature labor, the delivery of 

a low-birth-weight infant, a wide range of health problems for a a low-birth-weight infant, a wide range of health problems for a 

newborn, or even infant death. If infection spreads to your nervous newborn, or even infant death. If infection spreads to your nervous 

system, headaches, stiff neck, confusion, loss of balance, 

or convulsions can occur. In extreme cases, death can occur. or convulsions can occur. In extreme cases, death can occur.

Q. How long does it take to get symptoms?

A. The symptoms can take a few days or even weeks to appear. If you The symptoms can take a few days or even weeks to appear. If you 

think you may have eaten contaminated cheese while pregnant, you think you may have eaten contaminated cheese while pregnant, you 

should see a doctor immediately. A doctor may perform a blood test should see a doctor immediately. A doctor may perform a blood test 

to see if you have it.

Q. How can listeriosis be treated? Q. How can listeriosis be treated? 

A. Your doctor may prescribe antibiotics that are safe to use during Your doctor may prescribe antibiotics that are safe to use during 

pregnancy. Antibiotics may also be given to your baby if he/she is pregnancy. Antibiotics may also be given to your baby if he/she is 

born with listeriosis.

Q. How can I prevent listeriosis? Q. How can I prevent listeriosis?

A. The most important thing to do is to avoid eating Mexican-style The most important thing to do is to avoid eating Mexican-style 

Queso Fresco cheese, including Queso Fresco, Panela, Asadero, or Queso Fresco cheese, including Queso Fresco, Panela, Asadero, or 

Queso Blanco made from unpasteurized milk. Do not eat this type Queso Blanco made from unpasteurized milk. Do not eat this type 

of cheese unless it is commercially processed and the label says of cheese unless it is commercially processed and the label says 

that it is made with pasteurized milk. Never buy cheese sold 

door-to-door or from an unlicensed street vendor – chances are 

it is made from raw (unpasteurized) milk.

6
7

I. About Listeria and Listeriosis

Listeriosis is a Foodborne Illness

Listeriosis is a serious disease caused by eating foods that are contaminated with the Listeria monocytogenes (“Listeria”) 

bacterium. 

• This germ is commonly found in soil, water, decaying vegetation, and the intestinal tract of animals. 

• It can also be found in:

 — Soft cheeses or other products made from unpasteurized milk

 — Processed foods that become contaminated — such as deli meats 

• Unlike many other foodborne bacteria, Listeria grows in the refrigerator.

Heat processes like pasteurization destroy Listeria. For pregnant women, the key is to avoid cheeses and other 

foods made from unpasteurized milk. If a pregnant woman contracts listeriosis, she can suffer severe consequences 

– including pre-term labor or the loss of her baby. 

Symptoms of Listeriosis

Listeriosis is tricky to detect. Sometimes it causes symptoms. Sometimes 

a mother may be passing it to her unborn baby without even knowing it

because she doesnʼt feel sick at all.

• Listeriosis can cause fever, chills, muscle aches, nausea and diarrhea, 

or upset stomach. If infection spreads to the nervous system, it can lead 

to headaches, stiff neck, confusion, loss of balance, or convulsions. In 

extreme cases, death can occur.

• Even if there are no symptoms, the disease can still severely affect 

the unborn baby. It can lead to miscarriage, stillbirth, premature 

labor, the delivery of a low-birth-weight infant, a wide range of health 

problems for a newborn, or even infant death. 

Symptoms can occur within a few days or even weeks after eating the 

contaminated cheese.

Treating Listeriosis

Pregnant women (and other people who have weakened immune systems) who believe they have eaten contaminated 

cheese should seek medical attention immediately. A doctor may need to prescribe antibiotics. A newborn baby may also 

be given antibiotics if he/she is born with listeriosis.

Background Information for Educators

What You Need To Know
Alert for Pregnant Women:

Donʼt Buy Homemade Cheese 

Sold Door-to-Door

Sometimes, Latino entrepreneurs 

have been known to purchase 

raw milk and use it to make 

homemade cheese, then sell it 

door-to-door or from an ice chest 

in their communities. Unlicensed 

vendors also sell it from carts. 

Remind women not to purchase 

or eat this cheese. It could harm 

their unborn child!

1 Centers for Disease Control and Prevention, 2001

II. Educating about Mexican-style Soft Cheeses

Eating Unpasteurized Cheese Puts Women and their Babies At Risk

Flavors in foods that are like those from home can be a comfort to a person coming to the U.S. from another country. 

But in the case of Mexican-style soft cheeses made from “raw” (unpasteurized) milk, the results can be tragic. 

• As Hispanics emigrate to the U.S., their search for authentic tastes from home unknowingly puts them at risk for 

listeriosis. The most common cause is the eating of Mexican-style soft cheeses like Queso Fresco that have been 

made with “raw” unpasteurized milk. 

• Many types of cheeses can be made in this style, including: Queso Fresco, Panela, Asadero and Queso Blanco.

These soft, white, moist cheeses are a staple in many Hispanic diets. Many feel that these 

cheeses taste much better made the traditional way with unpasteurized milk. However, 

what many people probably donʼt realize is that this taste preference puts them at risk 

– because unless the milk is pasteurized fi rst, it can carry the bacteria that cause 

listeriosis! 

What You Need To Know (contʼd)

Looking At The Statistics: Pregnant Hispanic Women and Listeriosis

Listeriosis affects people of all races and genders – but pregnant women are 

20 times more likely than other healthy adults to get listeriosis. Hormonal changes 

that occur during pregnancy affect the motherʼs immune system, which leads to 

greater susceptibility to listeriosis. 

• One-third of all listeriosis cases in the U.S. occur in pregnant women 1. 

Studies have also revealed that Pregnant U.S. Hispanic women are more likely 

to get listeriosis due to eating homemade Mexican-style soft cheeses made with 

unpasteurized milk. Thatʼs why itʼs critical to get preventive information out to 

these women.

Other Risks with Queso Fresco-style Cheeses That Affect All Consumers

Recent illnesses in New York have linked cheese made with unpasteurized milk to 

Tuberculosis. In California, illnesses have linked cheese made with unpasteurized 

milk to Brucellosis. 

For more information on these threats, visit the FDAʼs Web site: www.cfsan.fda.gov.

8
 

For More Information

Visit www.cfsan.fda.gov (Spanish and English) 

or call 1-800-SAFEFOOD (English only).

Other On-line Sources:

www.foodsafety.gov

U.S. Partnership for Food Safety Education – www.fi ghtbac.org

Centers for Disease Control and Prevention – www.cdc.gov

United States Department of Agriculture – www.usda.gov

4. Chill 

• Your refrigerator should register at 40° F (4° C) or below. Place a refrigerator 

thermometer in the refrigerator and check the temperature periodically. 

• Store perishable foods that are pre-cooked or ready-to-eat in your refrigerator and eat 

them as soon as possible.

1. Clean

• Before, during, and after food preparation, wash hands and kitchen surfaces often with hot 

water and soap. 

• Listeria can grow at refrigerator temperatures, so clean your refrigerator regularly and wipe 

up spills inside immediately. Use hot water and a mild liquid dishwashing detergent, then 

rinse thoroughly and dry with a clean cloth or paper towel.

2. Separate

• Keep raw meats separate from other foods, 

such as fruits and vegetables. 

3. Cook

• Thoroughly cook and reheat food to a safe 

internal temperature before eating. Thoroughly 

cook meat, poultry, and seafood.

9

4 Simple Steps to Prevent Foodborne Illness

In addition to avoiding cheese that may have been made from unpasteurized milk, these four simple steps can further 

reduce the likelihood of getting listeriosis and other foodborne illnesses:

III. Preventing Listeriosis

The single most important thing a pregnant Hispanic woman can do to prevent listeriosis is to avoid eating cheese 

made from unpasteurized milk. In addition, there are some general food safety guidelines that can further aid in 

preventing infection.

What You Need To Know (contʼd)
Pregnant Women: Pregnant Women:

Do not eat these Mexicanstyle soft cheeses unless youʼre sure they are made from pasteurized milk:

• Asadero

• Panela

• Queso Blanco

• Queso Fresco

Read the Label!

Donʼt Eat Cheeses Made from 

Unpasteurized Milk

Keep Your 

Unborn Baby Safe

U.S. Food and Drug 

 Administration

U.S. Department of Health 

and Human Services

www.cfsan.fda.gov
• “Queso Fresco” is a Mexican-style soft 

cheese that is sometimes made with unpasteurized milk. Many types of cheeses are made “Queso Fresco”-style. These include Queso Fresco, Panela, Asadero, and Queso Blanco. 

• These unpasteurized cheeses are often

sold door-to-door, sold by unlicensed street vendors, or brought into the U.S. from Mexico or Latin America.

• Before eating any of these soft 

Mexican-style cheeses, check the label to make sure it says “Made from Pasteurized Milk.” If it doesnʼt – do not eat it.

Eating Cheese from Unpasteurized Milk

Can Cause Listeriosis and Other Diseases

• Listeria is a bacteria that causes a disease called listeriosis. 

It can cause birth defects and other serious problems — even the death of your baby.

• Other diseases caused by cheese made from unpasteurized • Other diseases caused by cheese made from unpasteurized 

milk include: — Tuberculosis— Salmonellosis— Brucellosis

• Symptoms of listeriosis 

can include:— fever— chills— muscle aches— upset stomach— nausea and/or  diarrhea

Or, there may be no symptoms at all!

Many women donʼt realize that they are putting their 

unborn babies at risk. If you eat Mexican-style soft 

cheeses made from unpasteurized milk while you are 

pregnant, you could harm your baby!

Made from

Queso Fresco

PASTEURIZED MILK

10 oz

What does “Unpasteurized” Mean?

• Pasteurized milk is heated at a processing plant to kill bacteria.• Unpasteurized (raw) milk can contain dangerous bacteria that 

can hurt or kill your unborn baby – even if you donʼt feel sick!

If Youʼre Concerned That Youʼve Eaten 

Contaminated Cheese While Pregnant:

• Call your doctor or clinic right away• Your doctor may prescribe antibiotics that are 

safe to take during pregnancy

Some Cheeses Could Harm 

Your Unborn Baby!

Cheeses made from raw or “unpasteurized” milk can contain 

bacteria that might make your baby sick — even before he is born. 
a M

How eating Queso Fresco 

harmed her unborn baby.

r bi els’ Story

Cristina: Maribelʼs story makes me so sad. But one important thing we can do is tell other people about this – especially friends who are pregnant, and their families. Rosario: Thatʼs right. Hector and Maribel have been spreading the word, too. They believe that one good thing that can come from this terrible tragedy is to prevent it from happening to anyone else.Cristina: You can count on me to help spread the word . . .

Rosario: I know. But what happened to Maribel and Hector doesnʼt always happen. You can usually treat listeriosis with antibiotics that help the mother and the unborn baby. Your doctor can give you a blood test to see if you have it – so women who have eaten cheese made with unpasteurized milk can go to the 

doctor and get checked out. But in Maribelʼs case it was too late. 

Some Cheeses Could 

Harm Your Unborn Baby!

• Don’t eat Queso Fresco, Panela, Asadero or 

Queso Blanco unless you’re sure it is made 

from pasteurized milk!

• If you think you may have eaten contaminated 

cheese and you are 

pregnant – call your doctor or clinic.

8
U.S. Food and Drug Administration

5100 Paint Branch Parkway

College Park, MD 20740

For questions about the information in this publication, contact:

Cristina Rosario

Hector Maribel

Introducing

Rosario: Unfortunately, like many Latina women who crave the taste of Queso Fresco from home, Maribel didnʼt know to look for the “pasteurization” label – and because of that, her unborn baby got sick and died. Dr. Nieves said that the symptoms of listeriosis can include fever, chills, muscle aches, upset stomach, nausea and/or diarrhea. But then, Dr. Nieves also said that itʼs very common for a pregnant woman to have listeriosis and not even know it because she doesnʼt feel sick. Thatʼs why itʼs so important to avoid eating cheese made from unpasteurized milk or cheese made from unknown sources.Cristina: Wow – that is scary. Poor Maribel and Hector. 

7

Do not eat ʻQueso Frescoʼ-style Cheese:Queso Fresco, Panela, Queso Blanco or Asadero, if made from unpasteurized milk.

Dr. Nieves: Iʼm sorry, Mr. and Mrs. Sanchez. Your baby was stillborn. She died from an infection called listeriosis. You passed this infection onto your baby without even knowing it. You can get infected with the Listeria bacteria from eating Queso Fresco made from unpasteurized milk. There are several types of queso fresco-style cheeses that might be unpasteurized, and pregnant women shouldnʼt eat them.

www.cfsan.fda.gov
4

Maribel: Wow – Queso Fresco just like in Mexico! Gonzalo - Vendor: I make it myself – like my dad used to make back home. I get raw milk straight from a local farmer. Thereʼs nothing like it in the stores in the U.S.Maribel: I crave the taste of homemade Queso Fresco like I remember from home. Iʼll take two packages. Thank you!

Rosario: Maribel didnʼt know to ask, but the cheese she bought was not made with pasteurized milk.Cristina: What does this mean, “pasteurized”?Rosario: When cheese is made from pasteurized milk, it means that the milk used to make the cheese has been processed to kill bacteria. See, look at this label – “Made from Pasteurized Milk.” 

5

Rosario: Unfortunately, this Unfortunately, this was not the case with the cheese Maribel bought. It hadnʼt been pasteurized to kill bacteria. All she wanted was to eat cheese that tasted like the kind made in Mexico – but instead, the Queso Fresco she bought from the door-to-door vendor was contaminated with bacteria called Listeria.

Made from

Queso Fresco

PASTEURIZED MILK

10 oz
Rosario: For awhile, Maribel felt fi ne. But then, she started to 

feel sick ...

Maribel: Hey, Papi, Iʼm not feeling great. Hey, Papi, Iʼm not feeling great.Hector: Mi amor, donʼt worry – go to bed, and get some rest.

Rosario: But several days passed and Maribel didnʼt feel any better. Her husband Hector started to worry. Finally, one night he convinced her to go to the hospital.Cristina: What happened?Rosario: She lost her baby. It turns out that she had gotten an infection called listeriosis and she passed it to her baby without knowing it.Cristina: Oh, no. She lost the baby because of bacteria from the cheese?

6

Cristina: Oh look, they have Queso Fresco here. But it doesnʼt taste the same as the kind we used to eat in Mexico. Remember how our mothers would buy the milk fresh from the dairy farm and make the cheese at home?Rosario: Yes, I remember. But eating Queso Fresco like we used to isnʼt worth the risk – especially after the tragedy that happened to my neighbor Maribel.Cristina: A tragedy? What happened?Rosario: Oh, itʼs so sad – I thought you heard. Maribel ate Queso Fresco she bought from a vendor selling cheese door to door . . .

3
U.S. Food and Drug 

 Administration

U.S. Department of Health 

and Human Services

Cheeses made from raw or “unpasteurized” milk 

can contain bacteria that might make your baby sick 

— even before heʼs born. 

You can help keep your baby safe by avoiding 

cheeses made from unpasteurized milk. Hereʼs what 

you need to know:

• “Queso Fresco” is a Mexican-style soft cheese that 

is sometimes made with unpasteurized milk. Many 

types of cheeses can be made “Queso Fresco” style 

— including Queso Fresco, Panela, Asadero, and 

Queso Blanco. 

 • Unpasteurized cheeses are 

 often sold door-to-door, at fl ea 

 markets, from the back of markets, from the back of 

trucks, or brought into the U.S. 

from Mexico or Central America. from Mexico or Central America.

• Before eating any of these soft 

 Mexican-style cheeses, read

 the label to make sure it says 

 “Made from Pasteurized Milk,” “Made from Pasteurized Milk,”

or “Pasteurized.” If it doesnʼt or “Pasteurized.” If it doesnʼt 

 — do not eat the cheese.

• If you think you may have 

eaten contaminated cheese 

while pregnant, while pregnant, call your 

doctor or clinic.

What Does 

“Pasteurized” Mean?

• Pasteurized means that a 

food, like milk, is heated 

at a processing plant to 

kill bacteria.

• Unpasteurized (raw) milk has 

not been heated at a processing

plant, and may contain 

dangerous bacteria that can 

hurt or kill your unborn baby 

– even if you donʼt feel sick!

Some Cheeses Could Harm Your Unborn Baby!

Help Keep Your Unborn Baby Safe. 

Do not eat Queso Fresco-style cheeses made 

with unpasteurized milk! 

♥ ♥ ♥ ♥ ♥ ♥ ♥ Attention Pregnant Women Attention Pregnant Women ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ 

Eating Cheeses Made From

Unpasteurized Milk

Can Cause Listeriosis

• This dangerous disease can 

cause birth defects and other 

serious problems — even 

the death of your baby.

Cheese Made From

Unpasteurized Milk Can

Cause Other Diseases, Too

These have been known to 

include:

• Tuberculosis 

• Salmonellosis

• Brucellosis

♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ 

Donʼt eat Queso Fresco, Panela, Asadero or Queso Blanco 

unless youʼre sure it is made from pasteurized milk.

www.cfsan.fda.gov