Skip to main content

Yersinia enterocolitica infections associated with improperly pasteurized milk products: southwest Pennsylvania, March–August, 2011

  • A. H. LONGENBERGER (a1) (a2), M. P. GRONOSTAJ (a1) (a3), G. Y. YEE (a3), L. M. JOHNSON (a4), J. F. LANDO (a3) (a5), R. E. VOORHEES (a3), K. WALLER (a2), A. C. WELTMAN (a2), M. MOLL (a2), S. B. LYSS (a6), B. L. CADWELL (a6), L. M. GLADNEY (a7) and S. M. OSTROFF (a2)...

In July 2011, a cluster of Yersinia enterocolitica infections was detected in southwestern Pennsylvania, USA. We investigated the outbreak's source and scope in order to prevent further transmission. Twenty-two persons were diagnosed with yersiniosis; 16 of whom reported consuming pasteurized dairy products from dairy A. Pasteurized milk and food samples were collected from this dairy. Y. enterocolitica was isolated from two products. Isolates from both food samples and available clinical isolates from nine dairy A consumers were indistinguishable by pulsed-field gel electrophoresis. Environmental and microbiological investigations were performed at dairy A and pasteurization deficiencies were noted. Because consumption of pasteurized milk is common and outbreaks have the potential to become large, public health interventions such as consumer advisories or closure of the dairy must be implemented quickly to prevent additional cases if epidemiological or laboratory evidence implicates pasteurized milk as the outbreak source.

Corresponding author
*Author for correspondence: A. H. Longenberger, PhD, Pennsylvania Department of Health, Room 933, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120-0701, USA. (Email:
Hide All
1.Scallan E, et al. Foodborne illness acquired in the United States – major pathogens. Emerging Infectious Diseases 2011; 17: 715.
2.Ostroff S. Yersinia as an emerging infection: epidemiologic aspects of yersiniosis. Contributions to Microbiology and Immunology 1995; 13: 510.
3.Tacket CO, et al. An outbreak of Yersinia enterocolitica infections caused by contaminated tofu (soybean curd). American Journal of Epidemiology 1985; 121: 705711.
4.Tauxe RV, et al. Yersinia enterocolitica infections and pork: the missing link. Lancet 1987; 1: 11291132.
5.Lee LA, et al. Yersinia enterocolitica O:3 infections in infants and children, associated with the household preparation of chitterlings. New England Journal of Medicine 1990; 322: 984987.
6.Ackers ML, et al. An outbreak of Yersinia enterocolitica O:8 infections associated with pasteurized milk. Journal of Infectious Diseases 2000; 181: 18341837.
7.Black RE, et al. Epidemic Yersinia enterocolitica infection due to contaminated chocolate milk. New England Journal of Medicine 1978; 298: 7679.
8.Greenwood MH, Hooper WL. Excretion of Yersinia spp. associated with consumption of pasteurized milk. Epidemiology and Infection 1990; 104: 345350.
9.Greenwood MH, Hooper WL, Rodhouse JC. The source of Yersinia spp. in pasteurized milk: an investigation at a dairy. Epidemiology and Infection 1990; 104: 351360.
10.Tacket CO, et al. A multistate outbreak of infections caused by Yersinia enterocolitica transmitted by pasteurized milk. Journal of the American Medical Association 1984; 251: 483486.
11.Ostroff SM, et al. Sources of sporadic Yersinia enterocolitica infections in Norway: a prospective case-control study. Epidemiology and Infection 1994; 112: 133141.
12.Oliver SP, Jayarao BM, Almeida RA. Foodborne pathogens in milk and the dairy farm environment: food safety and public health implications. Foodborne Pathogens and Disease 2005; 2: 115129.
13.Fukushima H, et al. Differentiation of Yersinia enterocolitica serotype O:5,27 strains by phenotypic and molecular techniques. Journal of Clinical Microbiology 1993; 31: 16721674.
14.Fearnley C, et al. Application of fluorescent amplified fragment length polymorphism for comparison of human and animal isolates of Yersinia enterocolitica. Applied and Environmental Microbiology 2005; 71: 49604965.
15.Rahman A, et al. Yersinia enterocolitica: Epidemiological studies and outbreaks. Journal of Pathogens 2011; 2011: 111.
16.Bhaduri S, Wesley IV, Bush EJ. Prevalence of pathogenic Yersinia enterocolitica strains in pigs in the United States. Applied and Environmental Microbiology 2005; 71: 71177121.
17.McNally A, et al. Comparison of the biotypes of Yersinia enterocolitica isolated from pigs, cattle and sheep at slaughter and from humans with yersiniosis in Great Britain during 1999–2000. Letters in Applied Microbiology 2004; 39: 103108.
18.Jayarao BM, et al. A survey of foodborne pathogens in bulk tank milk and raw milk consumption among farm families in Pennsylvania. Journal of Dairy Science 2006; 89: 24512458.
19.Fredriksson-Ahomaa M, Korkeala H. Low occurrence of pathogenic Yersinia enterocolitica in clinical, food, and environmental samples: a methodological problem. Clinical Microbiology Reviews 2003; 16: 220229.
20.Smith CM, Hill VR. Dead-end hollow-fiber ultrafiltration for recovery of diverse microbes from water. Applied and Environmental Microbiology 2009; 75: 52845289. Boer E. Isolation of Yersinia enterocolitica from foods. International Journal of Food Microbiology 1992; 17: 7584.
22.Doyle MP, Hugdahl MB. Improved procedure for recovery of Yersinia enterocolitica from meats. Applied and Environmental Microbiology 1983; 45: 127135.
23.Van Damme I, Habib I, De Zutter L. Yersinia enterocolitica in slaughter pig tonsils: enumeration and detection by enrichment versus direct plating culture. Food Microbiology 2010; 27: 158161.
24.Schiemann DA, Olson SA. Antagonism by gram-negative bacteria to growth of Yersinia enterocolitica in mixed cultures. Applied and Environmental Microbiology 1984; 48: 539544.
25.International Organization for Standardization. Microbiology of food and animal feedings stuffs–Horizontal method for the detection of presumptive pathogenic Yersinia enterocolitica (ISO10273:2003). Geneva, Switzerland: British Standard International Organization for Standardization, 2003.
26.Wauters G. Antigens of Yersinia enterocolitica. In: Bottone E, ed. Yersinia enterocolitica. Boca Raton: CRC Press, 1981, pp. 4153.
27.Wauters G, Kandolo K, Janssens M. Revised biogrouping scheme of Yersinia enterocolitica. Contributions to Microbiology and Immunology 1987; 9: 1421.
28.Wauters G, et al. Somatic and flagellar antigens of Yersinia enterocolitica and related species. Contributions to Microbiology and Immunology 1991; 12: 239243.
29.Food and Drug Administration. Grade A pasteurized milk ordinance, 2011 revision. Silver Spring, MD, USA: United States Department of Health and Human Services, Public Health Service, 2011.
30.Jones G. Cleaning and sanitizing milking equipment. Virginia Cooperative Extension, 2009, vol. 404-400.
31.Schiemann DA, Toma S. Isolation of Yersinia enterocolitica from raw milk. Applied and Environmental Microbiology 1978; 35: 5458.
32.Weagant SD, Feng P, Stanfield JT. Yersinia enterocolitica and Yersinia pseudotuberculosis, chapter 8. In: Bacteriological Analytical Manual, 8th edn, revision A. Silver Spring, MD, USA: United States Department of Health and Human Services, Food and Drug Administration, 1998. Revised August 2007.
33.Heesemann J, et al. Virulence of Yersinia enterocolitica is closely associated with siderophore production, expression of an iron-repressible outer membrane of polypeptide of 65,000 Da and pesticin sensitivity. Molecular Microbiology 1993; 8: 397408.
34.Fàbrega A, Vila J. Yersinia enterocolitica: pathogenesis, virulence and antimicrobial resistance. Enfermedades Infecciosas y Microbiología Clínica 2012; 30: 2432.
35.Carniel E, Guilvout I, Prentice M. Characterization of a large chromosomal ‘high-pathogenicity island’ in biotype 1B Yersinia enterocolitica. Journal of Bacteriology 1996; 178: 67436751.
36.Langer AJ, et al. Nonpasteurized dairy products, disease outbreaks, and state laws – United States, 1993–2006. Emerging Infectious Diseases 2012; 18: 385391.
37.Centers for Disease Control and Prevention. Outbreak of Listeria monocytogenes infections associated with pasteurized milk from a local dairy – Massachusetts, 2007. Morbidity and Mortality Weekly Report 2008; 57: 10971101.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 8
Total number of PDF views: 39 *
Loading metrics...

Abstract views

Total abstract views: 252 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th November 2017. This data will be updated every 24 hours.