Yersinia enterocolitica Agent Information Sheet

Boston University
Research Occupational Health Program (ROHP)
617-414-7647

Agent

Yersinia enterocolitica is a gram negative rod-shaped to ovoid bacilli member of the enterbacteriacae family. Some strains produce a heat-stabile enterotoxin (ST).

Disease/Infection

Only a few strains of Y. enterocolitica cause illness in humans. Yersinia eterocolitica can cause yersiniosis, enterocolitis, or pseudotuberculosis.

Pathogenicity

Based on data from the Foodborne Diseases Active Surveillance Network, which measures the burden and sources of specific diseases over time, approximately one culture-confirmed Y. enterocolitica infection per 100,000 persons occurs each year.

    • Special Populations at Risk
      Higher case fatality rate in immunocompromised individuals

    Biosafety Information

    Risk Group/BSL
    Risk Group 2
    Biosafety Level 2

    Modes of Transmission
    Transmission from person to person is very rare. Fecal-oral transmission by contact with infected persons or animals or by eating and drinking fecal contaminated food and water; nosocomial transmission has been reported; transmission by infected blood products has been reported.

    Transmission
    Skin Exposure (Needlestick, bite, or scratch):Yes
    Mucous Membrane Splash to Eye(s), Nose or Mouth:Yes
    Inhalation:No
    Ingestion:Yes

    Host Range/Reservoir
    Y. enterocolitica has been recovered from a wide variety of animals without signs of disease.

    Symptoms
    Symptoms typically develop 4 to 7 days after exposure and may last 1 to 3 weeks or longer. Acute enteric disease is manifested by watery or bloody diarrhea, fever and abdominal pain. A skin rash, called “erythema nodosum,” may also appear on the legs and trunk; this is more common in women. In older children and adults, right-sided abdominal pain and fever may be the predominant symptoms, and may be confused with appendicitis. In a small proportion of cases, complications such as skin rash, joint pains, or spread of bacteria to the bloodstream can occur.

    Incubation Period
    The incubation period for the infection is 3-7 days, generally under 10 days.

    Viability
    Susceptible to many disinfectants – 1% sodium hypochlorite, 70% ethanol, 2% glutaraldehyde, iodines, phenolics, formaldehyde.

    Survival Outside Host
    Water – 20 days; beets – 1 to 2 days; linen – 18 hours; seawater – up to 105 days (winter); soil – 540 days.

    Information for Lab Workers

    Laboratory PPE

    Personal protective equipment includes but is not limited to laboratory coats or gowns, disposable gloves, and safety glasses.

    Containment

    Biosafety level 2 practices, containment equipment and facilities for activities with cultures or potentially infectious clinical materials; ABSL-2animal biosafety level 2 practices and facilities for activities involving infected animals

    In Case of Exposure/Disease

    • For lab exposures (needle sticks, bite, cut, scratch, splash, etc…) involving animals or infectious agents, or for unexplained symptoms or illness call the ROHP 24/7 hour number (1-617-414-ROHP (7647); or, 4-ROHP (7647) if calling from an on-campus location) to be connected with the BU Research Occupational Health Program (ROHP) medical officer. ROHP will refer you to the appropriate health care location.
    • For injuries in the lab which are major medical emergencies (heart attacks, seizures, etc…):
      • Medical Campus: call or have a coworker call the Control Center at 4–4144.
      • Charles River Campus: call or have a coworker call campus security at 617-353-2121.
        You will be referred to or transported to the appropriate health care location by the emergency response team.
    • Under any of these scenarios, always inform the physician of your work in the laboratory and the agent(s) that you work with.
    • Provide the wallet-size agent ID card to the physician.

    Vaccination

    No vaccine is available

    Information for First Responders/Medical Personnel

    Public Health Issues

    Person to person transmission has been documented. Communicable via fecal shedding at least as long as symptoms exist; untreated cases may excrete organism for 2 to 3 months; chronic carrier state exists. Standard precautions should be used.

    Diagnosis/ Surveillance

    Y. enterocolitica infections are generally diagnosed by detecting the organism in the stools. Many laboratories do not routinely test for Y. enterocolitica, so it is important to notify laboratory personnel when infection with this bacterium is suspected so that special tests can be done. PCR based methods also exist for isolation for Y. enterocolitica and tend to be more sensitive than culture. The organism can also be recovered from other sites, including the throat, lymph nodes, joint fluid, urine, bile, and blood.

    First Aid/Post Exposure Prophylaxis

    Perform one of the following actions:

    Skin Exposure (Needlestick or scratch):Immediately go to the sink and thoroughly wash the wound with soap and water for 15 minutes. Decontaminate any exposed skin surfaces with an antiseptic scrub solution.
    Mucous Membrane Splash to Eye(s), Nose or Mouth:Exposure should be irrigated vigorously.
    Splash Affecting Garments:Remove garments that may have become soiled or contaminated and place them in a double red plastic bag.

    Treatment

    Uncomplicated cases of diarrhea due to Y. enterocolitica usually resolve their own without antibiotic treatment. However, in more severe or complicated infections, antibiotics such as tetracyclines, trimethoprim-sulfamethoxazole, or fluoroquinolones may be useful.

    References

    Public Health Agency of Canada; http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/yersinia-enterocolitica-eng.php

    CDC: https://www.cdc.gov/yersinia/

    CDC BMBL: http://www.cdc.gov/biosafety/publications/bmbl5/BMBL.pdf

    Mandell, G. L., J. E. Bennett, et al. (2010). Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia, PA, Churchill Livingstone/Elsevier.

    Control of Communicable Diseases Manual. David L. Heymann. Washington DC, USA: American Public Health Association Press, 19th edition, 2008

    Revised: 7/17/2012

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