Yersinia enterocolitica: A rare but important food safety concern for young children and immune-compromised individuals

HYG-5574
Family and Consumer Sciences
Date: 
11/09/2011
Written by Lydia Medeiros, Jeffery Lejeune, and Michele Williams

Yersinia enterocolitica causes foodborne illness in this country and has the most serious public health significance. Yersinia pseudotuberculosis causes gasteroenteritis but foodborne cases have only been recorded in Japan. A third type, Yersinia pestis, causes the plague but is not transferred to people through food. Animals (pigs, birds, beavers, cats, and dogs) carry Yersinia enterocolitica and can cause contamination of soil and water, which in turn can contaminate foods of all types. Infection with Yersinia enterocolitica is called yersiniosis.

Symptoms of illness

Yersiniosis causes gastroenteritis with vomiting and diarrhea, but the characteristic symptoms are abdominal pain and fever. This infection can be confused with appendicitis, sometimes resulting in unnecessary surgery. Crohn's disease has also been misdiagnosed when Yersinia enterocolitica is the cause of symptoms. Long-term, 2–3% of infections from this pathogen can cause a type of arthritis called reactive arthritis.

Public health consequences

The exact number of yersiniosis cases that occur each year is hard to determine because many people attribute their illness to a virus or flu. The local Health Department and Centers for Disease Control and Prevention (CDC) cannot record the number of cases accurately unless the ill person seeks medical care, which is unusual in mild cases. The CDC has calculated an estimate of the number of cases of yersiniosis cases based on corrections for underreporting, misdiagnosis, and the number of cases that are not caused by contaminated food.

The CDC estimates that there are over 97,000 cases of Yersinia enterocolitica infection each year in this country, and that 90% of the cases are caused by eating contaminated food. More than 530 cases will be severe enough to require hospitalization; 29 deaths are possible each year.

Most cases occur in young children less than 5 years old (1.9 cases/100,000 population), but the age group that has the most severe illnesses requiring hospitalization, and perhaps causing death, are the elderly over the age of 60 years (0.4 cases/100,000 population). Young children are susceptible due to their immature immune systems. Likewise, the elderly are susceptible because of aging and also because of the incidence of other chronic diseases that affect the immune system.

Foods implicated

Yersinia enterocolitica is associated with animal foods (meat, poultry, or unpasteurized milk) and seafood. Yersinia bacteria are found in soil and water and cross-contamination during food handling is the main reason these bacteria are transferred through the food supply. Seafood from polluted water may be contaminated with Yersinia species bacteria. Cleaning and sanitizing while handling meat, poultry, or seafood will prevent cross-contamination. The bacteria can be destroyed by cooking to safe temperatures.

How to control this pathogen in your home

1. Use a thermometer to make sure that meat and poultry (including ground) are cooked to safe temperatures, at least 160 degrees F (71 degrees C).

  1. The only way to be sure meat and chicken are done is to check with a food thermometer.
  2. Follow the safe cooking advice on packages.
  3. The thermometer should go into the thickest part of the meat or poultry.
  4. Cook meat or poultry until the food thermometer says at least 160 degrees F (71 degrees C).

2. Knives, cutting boards, and food preparation surfaces should be washed with hot water and soap after contact with raw poultry, meat, and seafood.

  1. Clean sinks and counters with paper towels or clean cloths and hot, soapy water before and after cooking food.
  2. Keep foods that are ready to eat away from raw meat, poultry, or seafood.
  3. Wash knives, cutting boards, and counters with hot water and soap after you work with raw meat, poultry, or seafood.
  4. Scrub your cutting board with dish soap. If your cutting board is not made of wood, you can put it into the dishwasher.
  5. Wash your hands with soap and warm water after working with raw meat, poultry, or seafood.
  6. Put thawing meat, poultry, or seafood in a dish in the refrigerator to keep juices from leaking onto the food below.
  7. Keep pets away from food preparation areas.

3. Drink only pasteurized milk.

  1. Children and the elderly are very susceptible to foodborne illness and should not drink raw milk.
  2. Only buy cheeses made with pasteurized milk, or that have been aged at minimum of 60 days.

4. Wash hands with warm, soapy water before and after handling raw foods.

  1. First, wet your hands.
  2. Add soap to your hands.
  3. Rub both sides for at least 20 seconds.
  4. Rinse thoroughly.
  5. Air dry, or dry your hands with a clean towel or paper towel.
  6. Always wash your hands after using the toilet, after changing a baby's diaper, after touching pets or other animals, and after sneezing or coughing.

References

Centers for Disease Control and Prevention. Yersinia. cdc.gov/nczved/divisions/dfbmd/diseases/yersinia/. Accessed: February 14, 2011.

Centers for Disease Control and Prevention. Vital signs: Incidence and trends of infection with pathogens transmitted commonly through food—foodborne diseases active surveillance network, 10 U.S. sites, 1996–2010. Morbidity and Mortality Weekly 2011; 60 (22):749–755.

Hillers, V.N., Medeiros, L.C., Kendall, P., Chen, G., & DiMascola, S. Consumer food handling behaviors associated with prevention of 13 foodborne illnesses. Journal of Food Protection 2003; 66:1893–1899.

Scallan, E., Hoekstra, R.M., Angulo, F.J., Tauxe, R.V., Widdowson, M.A., Roy, S.L., Jones, J.L., & Griffin, P.M. Foodborne illness acquired in the United States—major pathogens. Emerging Infectious Diseases 2011; 17:7–15.

U.S. Food and Drug Administration. Yersinia enterocolitica. The Bad Bug Book. fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm070040.htm. Accessed: August 12, 2011.

For more information about food safety, visit Foodsafety.osu.edu.

Ohioline http://ohioline.osu.edu