NUORTI JP, MIKKOLA J, HALLANVUO S, SIITONEN A, LYYTIKAINEN O, WILKMAN C, RUUTU P; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 693 (abstract no. 2215).
Natl. Publ. Health Inst., Helsinki, FINLAND.
BACKGROUND: The source for Y. pseudotuberculosis (YP) infections has remained unknown in previous outbreaks. Clinical microbiology laboratories routinely report YP isolations to the Finnish Infectious Disease Registry. In October 1998, reported YP, serotype O3 (YP-O3) infections increased markedly.METHODS: Cases with culture-confirmed YP-O3 infection and illness onsets from October 15 through November 6, 1998 were identified through national, laboratory-based surveillance. We conducted a population-based, telephone interview case-control study in three southern administrative districts where the majority of cases occurred. Healthy community controls identified through the Population Registry were matched on age, sex and postal code. YP-O3 isolates were subtyped by pulsed-field gel electrophoresis (PFGE).RESULTS: We identified a total of 47 YP-O3 cases (age range, 2-77 years; median, 19 years); 53% were female. One patient with bacteremia died; 5 were operated for pseudoappendicitis. We enrolled 39 cases and 78 controls in the case-control study. Case-patients were more likely than controls to report having eaten iceberg lettuce in the 2 weeks before illness onset (71% vs. 42%; matched OR, 3.9; 95% CI, 1.3-9.6). No other fresh produce, or meat product was associated with illness. All 27 case isolates tested had indistinguishable PFGE patterns. Geographically dispersed clusters of cases were identified in two schools and two companies where iceberg lettuce had been served in lunch cafeterias. The lettuce was distributed to all of these cafeterias by the same wholesale company and was traced back to a domestic producer.CONCLUSIONS: An epidemiologic association of YP infections with a specific vehicle has not been confirmed before. Laboratory-based surveillance and serotyping of isolates helped in rapid detection of the outbreak. Sporadic cases of yersiniosis may be due to unrecognized outbreaks caused by contaminated fresh produce.
Publication Types:
Keywords:
- Acute Disease
- Case-Control Studies
- Communicable Diseases
- Disease Outbreaks
- Electrophoresis, Gel, Pulsed-Field
- Female
- Finland
- Humans
- Lettuce
- Serotyping
- Tuberculosis
- Yersinia pseudotuberculosis Infections
Other ID:
UI: 102246276
From Meeting Abstracts