1995. Outbreak in the Upper Valley of Vermont and
New Hampshire. This outbreak likely resulted from
post-pasteurization contamination of milk. Dairy
pigs were the most likely source of contamination.
Milk bottles were also likely contaminated by rinsing
with untreated well water prior to filling.PrecautionsPoor sanitation and improper sterilization tech-
niques by food handlers, including improper storage,
are important factors contributing to contamination.
To prevent yersinia outbreaks, the Center for Disease
Control (CDC) offers the following preventive
advice:
Avoid eating raw or undercooked pork.
Consume only pasteurized milk or milk products.
Wash hands with soap and water before eating and
preparing food, after contact with animals, and after
handling raw meat.
After handling raw chitterlings, clean hands and fin-
gernails scrupulously with soap and water before
touching infants or their toys, bottles, or pacifiers.
A person other than the foodhandler should care for
children while chitterlings are being prepared.
Prevent cross-contamination in the kitchen by using
separate cutting boards for meat and other foods,
and carefully cleaning all cutting boards, counter-tops, and utensils with soap and hot water after
preparing raw meat.
Dispose of animal feces in a sanitary manner.Interactions
As long as the bacteria continues to be excreted,
yersiniosis can be transmitted to others and accord-
ingly requires strict attention to personal hygiene.
People with yersiniosis should stay off work or school
while they have symptoms. Those in high risk groups
or occupations (infants, children, school pupils, stu-
dents, food workers, child-care workers, teachers, and
health care practitioners) can only return to work after
being completely free of symptoms for two days.Aftercare
Uncomplicated cases ofY. enterocoliticadiarrhea
usually resolve on their own without antibiotic treat-
ment. However, in more severe or complicated infec-
tions, antibiotics may be required. Diarrhea is a
symptom that is not only uncomfortable, but also
dangerous to health, because it can result in the body
loosing too much fluid (dehydration) and the salts and
minerals(electrolytes) required to maintain health.
Medicines that stop diarrhea are not recommended
because diarrhea helps to purge the pathogen. To
prevent dehydration and replenish lost electrolytes, a
bland diet should be followed. Typically, it involves:
Day 1: Drinking clear liquids at room temperature
such as sports drinks (Powerade/Gatorade), weak
tea (decaffeinated), non-caffeinated sodas;
Day 2: Slowly adding bland foods in small amounts as
can be tolerated during the day. Examples are: oat-
meal or cream of wheat made with water, dry cereal
(without milk), plain rice or pasta (no butter, oil, or
sauces), crackers or pretzels, gingersnaps, plain toast
(no butter or jelly), mashed potatoes (no skins), ripe
bananas, applesauce, chicken noodle soup.
Day 3: Gradually adding more variety of foods in
small, more frequent meals evenly spaced throughout
the day. Examples are: soft boiled eggs or scrambled
eggs, plain baked potato, fish or chicken (no skin)
well-cooked, baked or grilled (not fried), plain yogurt,
cottage cheese, cooked carrots or green beans, milk
(skim or low-fat after diarrhea has stopped).Complications
The major complication of yersiniosis is the per-
formance of unnecessary appendix removals (appendec-
tomies) since one of the main symptoms of yersinia
infections is abdominal pain of the lower right abdomen.Yersinia enterocolitica bacteria causes most cases of the
food-borne disease yersiniosis in the United States.(Scimat/
Photo Researchers, Inc. Reproduced by permission.)Yersinia