EpidemicYersinia enterocoliticaInfection Due to Contaminated Chocolate Milk

Abstract

In September and October, 1976, an outbreak of illness due to chocolate milk contaminated with Yersinia enterocolitica resulted in hospitalization of 36 children, 16 of whom had appendectomies. Infection with Y. enterocolitica serotype 0:8 was demonstrated in 38 ill persons. Sixty-one per cent of the persons who were infected had a titer greater than 1:160 OH agglutinins to serotype 8 yersinia, whereas 48 per cent of the hospitalized children had a fourfold change in agglutinin titer. An epidemiologic investigation demonstrated that illness was associated with drinking of chocolate milk purchased in school cafeterias, and Y. enterocolitica 0:8 was subsequently isolated from the milk. The investigation suggested that the bacterium was introduced at the dairy during the mixing by hand of chocolate syrup with previously pasteurized milk.

Yersinia enterocolitica infection in children

“…A sporadic case has been reported in pediatrics. 17 We found it a complication in 10% of our children. The youngest child with arthritis in our series was 2 years of age, the other children were 7 years or older.…”

Excretion ofYersiniaspp. associated with consumption of pasteurized milk

“…In particular, an outbreak associated with the consumption of contaminated pasteurized chocolate milk occurred in the USA in 1976 [1], and a large multi-state outbreak of infection in the USA in 1982 was traced to pasteurized milk [2].…”

Human carriage of Yersinia spp.

“…The organisms may further be responsible for a wide variety of other clinical manifestations (Larson, 1979). Sporadic infection has been reported in many countries (Swaminathan et al, 1982) and several outbreaks of infection due to Y. enterocolitica have also been recorded (Asakawa et al, 1973;Black et al, 1978;Ratnam et al, 1982;Shayegani et al, 1983;Tacket et al, 1984). Despite the increasing number of reports of Y. enterocolitica isolations elsewhere, there is little published information concerning the incidence of this organism in Great Britain.…”