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Yersinia entercolitica

June 10, 2008 - 7:30am
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Yersinia entercolitica

Y. enterocolitica is a bacterium that causes yersiniosis, a gastrointestinal disease linked to contaminated food. It is often isolated from clinical specimens such as wounds, feces, sputum and mesenteric lymph nodes. However, it is not part of the normal human system. Y. pseudotuberculosis has been isolated from the diseased appendix of humans. Both organisms have often been isolated from such animals as pigs, birds, beavers, cats, and dogs. Only Y. enterocolitica has been detected in environmental and food sources, such as ponds, lakes, meats, ice cream, and milk. Most isolates have been found not to be pathogenic.

Y. enterocolitica and Y. pseudotuberculosis cause gastroenteritis. To date, no foodborne outbreaks caused by Y. pseudotuberculosis have been reported in the United States, but human infections transmitted via contaminated water and foods have been reported in Japan.

What are the symptoms of yersiniosis?

Yersiniosis is frequently characterized by such symptoms as gastroenteritis with diarrhea and/or vomiting. However, fever and abdominal pain are the hallmark symptoms. Yersinia infections mimic appendicitis and mesenteric lymphadenitis, but the bacteria may also cause infections of other sites such as wounds, joints and the urinary tract.

How is yersiniosis diagnosed?

Diagnosis of yersiniosis begins with isolation of the organism from the infected person's feces, blood, or vomit, and sometimes at the time of appendectomy. Diarrhea is reported to occur in about 80% of cases. Abdominal pain and fever are the most reliable symptoms. Because of the difficulties in isolating yersiniae from feces, several countries rely on blood analyses. Yersiniosis has been misdiagnosed as Chord's disease (regional enteritis) as well as appendicitis.

What foods are associated with yersiniosis?

Strains of Y. enterocolitica can be found in meats (pork, beef, lamb, etc.), oysters, fish, and raw milk. The exact cause of the food contamination is unknown. However, the prevalence of this organism in the soil and water and in animals such as beavers, pigs, and squirrels, offers ample opportunities for it to enter our food supply. Poor sanitation and improper sterilization techniques by food handlers, including improper storage, cannot be overlooked as contributing to contamination.

How frequently does yersiniosis occur?

Yersiniosis does not occur frequently. It is rare unless a breakdown occurs in food processing techniques. CDC estimates that about 17,000 cases occur annually in the USA. Yersiniosis is a far more common disease in Northern Europe, Scandinavia, and Japan.

What complications can result from yersiniosis?

The major "complication" is the performance of unnecessary appendectomies , since one of the main symptoms of infections is abdominal pain of the lower right quadrant. Both Y. enterocolitica and Y. pseudotuberculosis have been associated with reactive arthritis , which may occur even in the absence of obvious symptoms. The frequency of such postenteritis arthritic conditions is about 2-3%. Another complication is bacteremia (entrance of organisms into the blood stream), in which case the possibility of a disseminating disease may occur. This is rare, however, and fatalities are also extremely rare.

Who is most susceptible to yersiniosis?

The most susceptible populations for the main disease and possible complications are the very young, the debilitated, the very old and persons undergoing immunosuppressive therapy. Those most susceptible to postenteritis arthritis are individuals with the antigen HLA-B27 (or related antigens such as B7).


Food and Drug Administration

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.



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