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January 27, 1984, Vol 251, No. 4 >
ARTICLE | January 27, 1984

A Multistate Outbreak of Infections Caused by Yersinia enterocolitica Transmitted by Pasteurized Milk FREE

Carol O. Tacket, MD; Jai P. Narain, MD, MPH; Richard Sattin, MD; John P. Lofgren, MD; Charles Konigsberg, Jr, MD, MPH; Robert C. Rendtorff, ScD, MD; Alfio Rausa, MD; Betty R. Davis, MS; Mitchell L. Cohen, MD
[+] Author Affiliations

Reprint requests to the Enteric Diseases Branch, Centers for Disease Control, Bldg 1, Room 5428, 1600 Clifton Rd NE, Atlanta, GA 30333 (Dr Tacket).


JAMA. 1984;251(4):483-486. doi:10.1001/jama.1984.03340280033023
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References

In June and July 1982, a large interstate outbreak of Yersinia enterocolitica infections caused by an unusual serotype occurred in Tennessee, Arkansas, and Mississippi. Eighty-six percent of cases had enteritis characterized by fever, abdominal pain, and diarrhea. In three separate case-control studies, drinking milk pasteurized by plant A was statistically associated with illness. In a survey of randomly chosen households, 8.3% of persons who recalled having drunk milk from plant A during the suspect period experienced a yersiniosislike illness. Inspection of the plant and cultures of the available raw and pasteurized milk did not reveal the source or mechanism of contamination or a breach in normal pasteurizing technique. Although outbreaks of enteric disease caused by pasteurized milk are rare in the United States, the ability of Y enterocolitica to grow in milk at refrigeration temperatures makes pasteurized milk a possible vehicle for virulent Y enterocolitica. The extent to which milk is responsible for sporadic cases of yersiniosis is unknown.

(JAMA 1984;251:483-486)

REFERENCES

1 +
Hurvell B:  Zoonotic Yersinia enterocolitica infection: Host range, clinical manifestations, and transmission between animals and man , in Bottone EJ (ed): Yersinia enterocolitica . Boca Raton, Fla, CRC Press Inc, 1981;, pp 145-159.
2 +
Harvey S, Greenwood JR, Pickett MJ, et al:  Recovery of Yersinia enterocolitica from streams and lakes of California . Appl Environ Microbiol 1976;;32:352-354.
3 +
Black RE, Jackson RJ, Tsai T, et al:  Epidemic Yersinia enterocolitica infection due to contaminated chocolate milk . N Engl J Med 1978;;298:76-79.
4 +
 Outbreak of yersiniosis in Washington state . MMWR 1982;;31:562-564.
5 +
Schiemann DA:  Association of Yersinia enterocolitica with the manufacture of cheese and occurrence in pasteurized milk . Appl Environ Microbiol 1978;;36:274-277.
6 +
Vidon DJM, Delman CL:  Incidence of Yersinia enterocolitica in raw milk in eastern France . Appl Environ Microbiol 1981;;41:355-359.
7 +
Schiemann DA, Toma S:  Isolation of Yersinia enterocolitica from raw milk . Appl Environ Microbiol 1978;;35:54-58.
8 +
Morris GK, Feeley JC, Martin WT, et al:  Isolation and identification of Yersinia enterocolitica . Public Health Lab 1977;;35:217-235.
9 +
De Grace M, Laurin M-F, Belanger C, et al:  Yersinia enterocolitica gastroenteritis outbreak—Montreal . Can Dis Weekly Rep 1976;; 2:41-44.
10 +
Hughes D:  Isolation of Yersinia enterocolitica from milk and a dairy farm in Australia . J Appl Bacteriol 1979;;46:125-130.
11 +
Francis DW, Spaulding PL, Lovett J:  Enterotoxin production and thermal resistance of Yersinia enterocolitica in milk . Appl Environ Microbiol 1980;;40:174-176.
12 +
 Salmonella gastroenteritis associated with milk—Arizona . MMWR 1979;;28:117-120.
13 +
Galbraith NS, Forbes P, Clifford C:  Communicable disease associated with milk and dairy products in England and Wales 1951-1980 . Br Med J Clin Res 1982;;284:1761-1765.
14 +
Wormser GP, Keusch GT:  Yersinia enterocolitica: Clinical observations , in Bottone EJ (ed): Yersinia enterocolitica . Boca Raton, Fla, CRC Press Inc, 1981;, pp 83-93.
15 +
Kohl S, Jacobson JA, Nahmias A:  Yersinia enterocolitica infections in children . J Pediatr 1976;;89:77-79.
16 +
Portnoy DA, Falkow S:  Virulence-associated plasmids for Yersinia enterocolitica and Yersinia pestis . J Bacteriol 1981;;148:877-883.
17 +
Olsovsky Z, Olsakova S, Chorot S, et al:  Mass occurrence of Yersinia enterocolitica in two establishments of collective care of children . J Hyg Epidemiol Microbiol Immunol 1975;;19:22-29.
18 +
Asakawa Y, Akanane S, Kagata N, et al:  Two community outbreaks of human infection with Yersinia enterocolitica . J Hyg 1973;;71:715-723.
19 +
Shayegani M, Morse D, DeForge I, et al: Foodborne outbreak of Yersinia enterocolitica in Sullivan County, New York, with pathologic studies of the isolates , abstract C175. Atlanta, American Society of Microbiology, 1982;.

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1 +
Hurvell B:  Zoonotic Yersinia enterocolitica infection: Host range, clinical manifestations, and transmission between animals and man , in Bottone EJ (ed): Yersinia enterocolitica . Boca Raton, Fla, CRC Press Inc, 1981;, pp 145-159.
2 +
Harvey S, Greenwood JR, Pickett MJ, et al:  Recovery of Yersinia enterocolitica from streams and lakes of California . Appl Environ Microbiol 1976;;32:352-354.
3 +
Black RE, Jackson RJ, Tsai T, et al:  Epidemic Yersinia enterocolitica infection due to contaminated chocolate milk . N Engl J Med 1978;;298:76-79.
4 +
 Outbreak of yersiniosis in Washington state . MMWR 1982;;31:562-564.
5 +
Schiemann DA:  Association of Yersinia enterocolitica with the manufacture of cheese and occurrence in pasteurized milk . Appl Environ Microbiol 1978;;36:274-277.
6 +
Vidon DJM, Delman CL:  Incidence of Yersinia enterocolitica in raw milk in eastern France . Appl Environ Microbiol 1981;;41:355-359.
7 +
Schiemann DA, Toma S:  Isolation of Yersinia enterocolitica from raw milk . Appl Environ Microbiol 1978;;35:54-58.
8 +
Morris GK, Feeley JC, Martin WT, et al:  Isolation and identification of Yersinia enterocolitica . Public Health Lab 1977;;35:217-235.
9 +
De Grace M, Laurin M-F, Belanger C, et al:  Yersinia enterocolitica gastroenteritis outbreak—Montreal . Can Dis Weekly Rep 1976;; 2:41-44.
10 +
Hughes D:  Isolation of Yersinia enterocolitica from milk and a dairy farm in Australia . J Appl Bacteriol 1979;;46:125-130.
11 +
Francis DW, Spaulding PL, Lovett J:  Enterotoxin production and thermal resistance of Yersinia enterocolitica in milk . Appl Environ Microbiol 1980;;40:174-176.
12 +
 Salmonella gastroenteritis associated with milk—Arizona . MMWR 1979;;28:117-120.
13 +
Galbraith NS, Forbes P, Clifford C:  Communicable disease associated with milk and dairy products in England and Wales 1951-1980 . Br Med J Clin Res 1982;;284:1761-1765.
14 +
Wormser GP, Keusch GT:  Yersinia enterocolitica: Clinical observations , in Bottone EJ (ed): Yersinia enterocolitica . Boca Raton, Fla, CRC Press Inc, 1981;, pp 83-93.
15 +
Kohl S, Jacobson JA, Nahmias A:  Yersinia enterocolitica infections in children . J Pediatr 1976;;89:77-79.
16 +
Portnoy DA, Falkow S:  Virulence-associated plasmids for Yersinia enterocolitica and Yersinia pestis . J Bacteriol 1981;;148:877-883.
17 +
Olsovsky Z, Olsakova S, Chorot S, et al:  Mass occurrence of Yersinia enterocolitica in two establishments of collective care of children . J Hyg Epidemiol Microbiol Immunol 1975;;19:22-29.
18 +
Asakawa Y, Akanane S, Kagata N, et al:  Two community outbreaks of human infection with Yersinia enterocolitica . J Hyg 1973;;71:715-723.
19 +
Shayegani M, Morse D, DeForge I, et al: Foodborne outbreak of Yersinia enterocolitica in Sullivan County, New York, with pathologic studies of the isolates , abstract C175. Atlanta, American Society of Microbiology, 1982;.

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