Yersinia enterocolitica gastroenteritis: a prospective study of clinical, bacteriologic, and epidemiologic features

A prospective study was performed to estimate the frequency of gastroenteritis due to Yersinia enterocolitica in Montreal children and their families. Evidence of bacterial infection was correlated with clinical features and serologic responses. YE was isolated from the stools of 181 (index cases) of 6,364 children with gastroenteritis over a 15-month period; Salmonella was isolated from 280 and Shigella from 68. Median ages were 24, 30, and 41 months, respectively. All but 18 YE isolates were biotype 4, serotype 0:3. YE was not found in the stools of 545 children without gastrointestinal symptoms. Clinical manifestations of the index cases with YE biotype 4, serotype 0:3 (n = 57) included diarrhea (98%), fever (88%), abdominal pain (64.5%), and vomiting (38.5%) with mean durations of 14, 3.9, 7.7, and 2.4 days, respectively. The duration of excretion of YE in the stool ranged from 14 to 97 days (mean 42). Spread of YE occurred in 27 of 57 families studied, involving 15 of 41 children and 19 of 117 adult contacts; approximately one-third of infected contacts developed diarrhea. Agglutination titers of greater than or equal to 200 were demonstrated in all index cases infected with serotype 0:3, with the exception of two very young infants. YE is a frequent cause of bacterial gastroenteritis in Montreal children. The illness is characterized by persistent diarrhea and abdominal pain, prolonged YE excretion in the stools, and moderate communicability.