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"It occurs in people whose B12 deficiency is caused by pernicious anemia," explains vitamin B12 expert and researcher Ralph Green, MD, PhD, a Distinguished Professor at the UC Davis School of Medicine

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Key virulence factors include internalin-mediated host cell adhesion and invasion, flagella-driven motility, the positive regulatory factor A (PrfA)-regulated transcriptional control of major virulence genes, the listeriolysin O-induced disruption of phagosomal membranes, the phospholipase-mediated evasion of host defense mechanisms, actin polymerization-dependent intracellular and intercellular spread, sigma factor-driven stress responses, biofilm formation and the development of resistance to antimicrobial agents