Summary about Disease
Yersinia enterocolitica* enteritis is an infection of the small intestine caused by the bacterium *Yersinia enterocolitica*. It is a zoonotic disease, meaning it can be transmitted from animals to humans. The infection typically causes gastrointestinal symptoms, such as diarrhea, abdominal pain, and fever. It's more common in young children, particularly in the winter months. In some cases, it can mimic appendicitis, especially in older children and young adults.
Symptoms
Common:
Diarrhea (often bloody in young children)
Abdominal pain (may be severe and mimic appendicitis, particularly in the lower right abdomen)
Fever
Vomiting
Headache
Less Common/Complications:
Reactive arthritis (joint pain), particularly in adults; may occur weeks after the initial infection.
Erythema nodosum (painful red nodules under the skin), usually on the shins
Bacteremia (bloodstream infection), rare but can occur in immunocompromised individuals.
Causes
Primary Cause: Infection with the bacterium Yersinia enterocolitica*.
Transmission:
Consumption of contaminated food, especially raw or undercooked pork products.
Unpasteurized milk.
Contaminated water.
Direct contact with infected animals, particularly pigs.
Person-to-person transmission is less common, but possible, especially among young children.
Medicine Used
Mild Cases: Often, no antibiotic treatment is necessary. Focus on supportive care, such as rest and hydration (oral rehydration solutions).
Severe Cases or High-Risk Individuals (e.g., immunocompromised):
Antibiotics may be prescribed. Commonly used antibiotics include:
Ciprofloxacin
Trimethoprim-sulfamethoxazole (TMP-SMX)
Doxycycline
Aminoglycosides (e.g., gentamicin, tobramycin) - often used in severe cases requiring hospitalization.
Is Communicable
Yes, Yersinia enterocolitica* enteritis *is* communicable, although person-to-person transmission is not as common as foodborne transmission. It can spread through:
Fecal-oral route (e.g., poor hygiene after using the toilet)
Contaminated surfaces
Precautions
Food Safety:
Cook pork thoroughly. Use a food thermometer to ensure it reaches a safe internal temperature.
Avoid consuming unpasteurized milk or dairy products.
Wash raw vegetables and fruits thoroughly.
Prevent cross-contamination in the kitchen. Use separate cutting boards for raw meat and other foods.
Hygiene:
Wash hands thoroughly with soap and water after using the toilet, before preparing food, and after contact with animals.
Water Safety:
Drink safe, treated water.
Avoid contact with animals:
Avoid contact with farm animals, pets and especially pigs.
How long does an outbreak last?
The duration of an outbreak can vary depending on the source and extent of contamination. Localized outbreaks might be relatively short-lived (a few weeks) if the contaminated food source is quickly identified and removed. Larger outbreaks, especially those involving widespread contamination, could last several weeks or even months. Individual cases typically resolve within 1-3 weeks without treatment.
How is it diagnosed?
Stool Culture: The most common diagnostic test. A stool sample is collected and sent to a laboratory to identify the presence of Yersinia enterocolitica* bacteria.
Blood Culture: May be performed if bacteremia (bloodstream infection) is suspected.
Clinical Evaluation: A doctor will consider the patient's symptoms, medical history, and potential exposure to risk factors (e.g., consumption of raw pork) to aid in diagnosis.
Imaging Studies: In cases where appendicitis is suspected, imaging studies such as ultrasound or CT scan may be used to rule out other causes of abdominal pain.
Timeline of Symptoms
Incubation Period: Typically 1-10 days after exposure to the bacteria.
Acute Phase:
Symptoms usually last 1 to 3 weeks.
Diarrhea: Can start within a few days of exposure and persist for up to several weeks.
Abdominal Pain: Can develop alongside diarrhea and may be severe.
Fever: Can appear in the initial days of the illness.
Post-Infectious Phase:
Reactive arthritis or erythema nodosum can develop weeks after the initial gastrointestinal symptoms have resolved.
Important Considerations
Differential Diagnosis: Yersinia* enteritis can mimic other conditions, such as appendicitis, inflammatory bowel disease (IBD), and other bacterial infections. Accurate diagnosis is crucial for appropriate management.
Vulnerable Populations: Young children, the elderly, and immunocompromised individuals are at higher risk of severe complications.
Antimicrobial Resistance: Resistance to certain antibiotics is possible, so susceptibility testing should be performed when antibiotics are necessary.
Public Health Reporting: Yersinia infections are often reportable to public health authorities to track outbreaks and implement control measures.
Prevention is Key: Emphasize food safety and hygiene practices to prevent infection.