Gram-positve 
  bacilli capable of forming endospores (see WebLinked 
  image)
	
  Naturally 
  occuring in environment: soil, water, vegetation, intestinal tract of mammals 
  and birds, fish, insects
	
  Healthy 
  adults and children can be asymptomatic carriers 
	
  Transmitted 
  to man via direct contact with environmental sources or ingestion of contaminated 
  food products, including milk, cheese, cole slaw, fish, chicken, beef, pork, 
  vegetables, etc.
	
  Primarily 
  infection of neonates and older adults
	
  Three 
  clinical manifestations dependent on : 
	
  Organisms 
  passed from mother to fetus either: 
	
  If 
  infection occurs during delivery, disease presents in one of two clinical forms: 
  
	
  Facultative 
  intracellular pathogen that invades and grows in variety of mammalian cells, 
  including: 
	
  Normal 
  macrophages readily phagocytose extracellular organisms that have been opsonized 
  with complement or antibody, but these organisms can then survive intracellularly. 
  Once internalized via phagocytosis, organisms are capable of breaking down phagolysosome 
  membrane, multiplying in the cytoplasm, and passing directly into a new host 
  cell, via pseudopod extensions and actin filaments 
	
  Antibodies, 
  i.e., humoral immune response and extracellular bactericidal factors are ineffective 
  against these organisms 
	
  Cell-mediated 
  immune response dependent on macrophage activation by lymphokines (T cell response) 
  eventually are effective at clearing organisms 
  
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