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Yersiniosis 

Yersiniosis
Chapter:
Yersiniosis
DOI:
10.1093/med/9780198729228.003.0125
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date: 26 June 2019

Yersiniosis is a zoonotic infection, caused by Yersinia enterocolitica or Yersinia pseudotuberculosis. The main reservoir is the gastrointestinal tract of a large range of animals, including pigs, cattle, cats, and dogs. The majority of human infections are caused by Y. enterocolitica, pigs being the main reservoir. Sixty per cent of cases occur in infants and young children. Yersiniosis is commoner in Scandinavia and Northern Europe, but relatively uncommon in the United Kingdom and United States. Patients with iron overload are particularly susceptible to infection. The source of infection is usually inadequately cooked meat or unpasteurized dairy products. Yersinia can survive for several weeks at +4°C, so meat refrigerated for long periods or blood transfusions may be the source of infection. The incubation period for Y. enterocolitica infection is 3–10 days, and for Y. pseudotuberculosis 7–21 days. The majority of Y. enterocolitica infections present as acute terminal ileitis or acute enteritis. Y. pseudotuberculosis commonly presents as mesenteric adenitis, mimicking acute appendicitis. Bacteraemia may occur, especially in infants under 3 months of age, patients with haemolytic anaemias, thalassaemia, sickle-cell anaemia, and diabetes mellitus. Complications include intussusception, extraintestinal infections, and reactive arthritis (especially if HLA-B27-positive). Inform the laboratory if yersiniosis is suspected, since isolation from faeces requires selective media and cold enrichment. The majority of cases are self-limiting. Immunocompromised or ill children with Y. enterocolitica infection may be treated with fluoroquinolones or aminoglycosides. Y. pseudotuberculosis is generally susceptible to penicillin or ampicillin. Prevention requires good hygiene in food preparation, thorough cooking of meat, washing salads, and handwashing before eating. There are no vaccines.

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