Infection with Yersinia enterocolitica results in a number of clinical syndromes which are dependent on the host’s age. Possible clinical presentations include enterocolitis, acute mesenteric lymphadenitis or terminal ileitis.
Enterocolitis - this is characterised by fever, diarrhoea and severe abdominal pain. This condition may be mistaken for acute appendicitis. Serological tests showing a rising titre of Y. enterocolitica antibodies is strongly suggestive of acute yersinosis but this result is generally only available after recovery. This condition is normally self-limiting. Treatment with antibiotics (e.g. tetracycline) is controversial and is based on clinical judgement.
This is infection with a member of the Yersinia species. There are three major human pathogens;
- Yersinia pestis, which causes plague
- Yersinia pseudotuberculosis which causes mesenteric lymphadenitis
- Yersinia enterocolitica which causes enterocolitis
Summary: Yersinia pseudotubercolosis and Yersinia entercolitica
Cause:
- Yersinia enterocolitica and Yersinia pseudotuberculosis
Reservoir:
- Asymptomatic carriage in the gastrointestinal tract of wild and domesticated animals and birds, particularly pigs for Y. enterocolitica
Epidemiology:
- most commonly seen in those less than 15 years of age
- seasonal variation occurs - Y. pseudotuberculosis is more common in winter and Y. enterocolitica is more common from June to November
Transmission:
- Faecal-oral:
- consumption of contaminated food or water, particularly pork or pork products. A wide variety of foodstuffs have been implicated in cases and outbreaks
- person-to-person: particularly within nurseries, schools and healthcare settings
- direct contact with animals
- Via contaminated blood products
Incubation period:
- Y. enterocolitica: usually 3-7 days with extremes of 1-12 days reported
- Y. pseudotuberculosis: range of 2-25 days reported (median 5-8 days)
Common clinical features:
- Y. enterocolitica:
- watery diarrhoea, abdominal pain, fever
- duration: 2 days to 6 weeks
- complications: reactive arthritis, erythema nodosum, septicaemia - Y. pseudotuberculosis:
- mesenteric adenitis, fever, abdominal pain often mimicking appendicitis
- duration: 1-37 days (average 18 days)
- complications: reactive arthritis, erythema nodosum, acute renal failure
Infectivity:
- excretion of the organism in stool may persist for several months after infection but infectivity decreases substantially after the first 4 days or so
Reference:
- PHE (2019). Recommendations for the Public Health Management of Gastrointestinal Infections