Yersinia enterocolitica O:3 Infections in Infants and Children, Associated with the Household Preparation of Chitterlings

Abstract

An epidemiological investigation of an outbreak of gastroenteritis in Georgia, USA, caused by Yersinia enterocolitica O:3 showed that the febrile diarrhoeal illnesses were strongly associated with the household preparation of chitterlings (the large intestines of pigs). All 15 patients were black, 14 were infants, and 11 were from low-income families. Preparation of chitterlings is time consuming, taking a median of 5 h over 1-4 days in these families. Although none of the infants had direct contact with the raw chitterlings, in nearly all cases the persons cleaning the pig intestines were also caring for the infants. Plasmid profiles of the isolates from the chitterlings (unopened and opened containers) were indistinguishable from those obtained from the patients. Pigs are known to be reservoirs in other countries. This report strengthens the link between pigs and Y. enterocolitica O:3 gastroenteritis, and suggests that indirect exposure to contaminated vehicles is important for infection. It also presents information indicating that serotype O:3 is replacing O:8 as the predominant serotype in the USA.newline˜Melody Greenwood ADDITIONAL ABSTRACT: An outbreak of gastroenteritis caused by Yersinia enterocolitica O:3 from November 1988 to January 1989 in Atlanta, Georgia, USA, is reported. All 15 patients were black, and 14 were infants (median age 3 months). The febrile, diarrhoeal illnesses were strongly associated with the household preparation of chitterlings, which are the large intestines of pigs. Although none of the infants had direct contact with the raw chitterlings, in nearly all cases the persons cleaning the pig intestines were also caring for the infants.