Clinical and microbiological follow-up of an outbreak of Yersinia pseudotuberculosis serotype Ib

Yersinia pseudotuberculosis, a food-borne pathogen, causes infection that commonly presents as gastroenteritis and mesenteric lymphadenitis. Post-infectious complications include erythema nodosum, reactive arthritis and, less commonly, uveitis and nephritis. Six serotypes of Y. pseudotuberculosis have been identified, and post-infectious complications have been identified following infection with some, but not all, serotypes. The first recognized outbreak of Y. pseudotuberculosis serotype lb occurred in British Columbia in November 1998. We documented the incidence of post-infectious complications and the effect of antibiotic use on the clinical course. Four months after the outbreak, a standardized questionnaire asking about symptoms and antibiotic use was administered by telephone to laboratory-confirmed cases. Stool samples were collected to examine for chronic carriage of Y. pseudotuberculosis and 59 of 74 eligible cases participated. The most common post-infectious symptoms were rash (8/59) and joint pain (7/59). Microbiological analysis, at follow-up, revealed 0/36 stools positive for Y. pseudotuberculosis. Seventy-eight percent of cases had taken antibiotics during their acute illness. There was no significant difference in the frequency of post-infectious symptoms between cases who had or had not taken antibiotics. The post-infectious pathogenicity of Y. pseudotuberculosis serotype lb is lower than that documented for other serotypes. Antibiotic use did not significantly alter the reported clinical course of illness.