The genus Yersinia is comprised of Gram negative, facultative anaerobic bacteria that are rod-shaped. They are oxidase positive and catalase negative. They belong to the order Enterobacteriaceae and have 11 species.
Symptoms of Yersinia include diarrhea, vomiting and fever. Most people recover without antibiotic treatment. Drink plenty of fluids to prevent dehydration.
Diarrhea
A common symptom of Yersinia infection is diarrhea. Infections from this group of bacteria may also cause other digestive symptoms such as abdominal pain, vomiting and fever. Yersiniosis is usually caused by Yersinia enterocolitica or Yersinia pseudotuberculosis, although other members of this family can also cause disease. This family of facultative anaerobic gram-negative coccobacilli contains bacteria that are resistant to most first-generation cephalosporins and penicillins. Yersiniosis typically results from eating contaminated food, especially raw or undercooked pork products.
Yersinia is found in many animals, including pigs, and it can be spread by eating or drinking contaminated food or water that contains the germs. Infants can become infected after their caretakers handle contaminated raw pork intestines (chitterlings). Yersiniosis can also be spread by passing the germs from soiled fingers or a contaminated object to the mouth of another person, particularly in settings where hygiene standards are poor.
Infection with Yersinia can lead to bowel inflammation and bloody diarrhea. Its ability to cause these symptoms is due to the organism’s invasive properties. Yersinia invading cells destroy tissue, produce toxins and inhibit the body’s immune response. It does this by impairing phagocytosis, inhibiting phagocytic killing and apoptosis, and preventing the release of inflammatory cytokines such as interleukin-12, gamma interferon and tumor necrosis factor alpha (TNF-a).
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When Yersinia enters the gastrointestinal tract, it can infect small intestine Peyer’s patches and disseminate to the mesenteric lymph nodes and liver [3].
Diarrhea from Yersinia is frequently accompanied by abdominal pain, which can be difficult to differentiate from appendicitis. The diagnosis is made by stool culture. The Yersinia strains that cause disease are non-lactose fermenting and oxidase negative; they can be identified by isolating them from stool, rectal swab, blood, wound, bile, throat swab, mesenteric lymph node or cerebrospinal fluid. The laboratory should be notified if Yersinia is suspected; the specimens should be grown on cefsulodin-irgasan-novobiocin (CIN) agar or a similar selective medium. Radioimmunoassays and enzyme-linked immunosorbent assays can be used to detect antibodies against the organism. Imaging studies, such as ultrasound or computed tomography (CT), are rarely useful in diagnosing Yersinia infections but can be helpful in differentiating true from false appendicitis.
Vomiting
The genus Yersinia consists of Gram-negative facultative anaerobic bacteria ovoid or rod-shaped in appearance. There are only three primary members of this genus that are pathogenic to humans: Yersinia pestis (plague), Yersinia enterocolitica, and Yersinia pseudotuberculosis (pseudoappendicitis). These bacteria can be found in the intestinal tracts of many mammals and can cause illness ranging from mild diarrhea to a life-threatening invasive infection in some patients. The mainstay of management is usually hydration, although antibiotics are required in some cases. Most infections are preventable by strict handwashing and avoidance of raw pork products.
The most common symptom of Yersinia is watery diarrhoea, sometimes with blood in the stool and severe stomach pain. The incubation period is typically 4 to 7 days and most people recover quickly without treatment. Rarely, Yersinia can lead to mesenteric adenitis, a condition which mimics appendicitis. It can also cause terminal ileitis.
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When infected with Yersinia, your immune system responds by producing inflammatory molecules known as cytokines. These molecules are responsible for stimulating cells to become activated, proliferate, and differentiate into specialized cell types that attack the invading bacteria. They can also trigger the release of enzymes that destroy bacterial cell walls.
Infection with Yersinia can be difficult to diagnose, as it can present with a wide variety of symptoms. If you suspect you have this infection, notify your doctor so that a stool sample can be sent to the laboratory for Yersinia culture. This method is more reliable than relying on a patient history or symptoms to make a diagnosis. Yersinia can be isolated from stool, blood, bile, wounds, throat swabs, cerebrospinal fluid, mesenteric lymph nodes, or peritoneal fluid.
If you are ill with Yersinia, stay home from nursery, school, or work until your faeces test negative for Yersinia and you no longer have any diarrhoea or vomiting. You should also refrain from preparing food and providing care for others until you have been symptom free for 48 hours. This helps to ensure that you do not infect anyone else with the bacteria. Similarly, it is important to wash your hands carefully after preparing food and before touching infants or toddlers.
Fever
The germs that cause Yersiniosis are the bacteria Yersinia enterocolitica and Yersinia pseudotuberculosis (note that these are different from the bacterium Yersinia pestis that causes the plague). Fever is usually the first symptom of these infections in young children. Older children and adults may experience right-sided abdominal pain that can mimic appendicitis. Infections with these bacteria are very common and often resolve on their own without antibiotic treatment, especially in mild cases.
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People are most likely to become infected with Yersiniosis from eating contaminated food, especially pork products, or drinking water and unpasteurized milk that contain the wastes of infected animals. People can also be infected by catching the germ from person to person, though this happens rarely. Yersiniosis is contagious during the time that diarrhea lasts, and some people continue to be infectious for weeks or months after their symptoms have ended.
Yersinia bacteria have a very strong affinity for lymphoid tissue and the reticuloendothelial cells of the gastrointestinal tract, and can grow within the intestines. The bacterial cells secrete a protein called yersiniabactin that can bind iron in depleted host tissues and allow the bacteria to thrive. Infections with Yersinia can be complicated by the fact that the bacteria can suppress host immunity. In particular, the bacteria can interfere with phagocytosis and inhibit the production of cytokines, such as interleukin-12, gamma interferon, tumor necrosis factor alpha, and others that normally help to develop specific protective immunity [1].
When people are exposed to Yersinia, the immune system responds by increasing the number of cells in the intestinal mucosa to protect against infection. Yersinia, however, has evolved to counter these responses. Infection with Yersinia can lead to the development of a form of arthritis known as reactive arthropathy. This occurs in the weight-bearing joints of the lower extremities, and is most commonly seen in patients who carry the herpes B virus and the human leukocyte antigen HLA-B27.
People can reduce their risk of getting Yersiniosis by eating only thoroughly cooked meat, drinking pasteurized milk and other dairy products, and washing hands before and after handling food. Food handlers can reduce their risk by preparing food in a clean environment and wearing rubber gloves.
Muscle Pain
Yersinia is a genus of facultatively anaerobic (can grow without oxygen) and pleomorphic Gram-negative bacteria that belong to the family Enterobacteriaceae. Yersinia species are pathogenic in humans, with Yersinia pestis causing plague and Yersinia enterocolitica causing yersiniosis. Infection with the latter species usually results in diarrhea and abdominal pain, though symptoms may vary depending on the virulence of the strain and age of the person infected. Symptoms in young children can mimic appendicitis, and in rare cases of severe infection, joint pains (reactive arthritis) and skin rash (erythema nodosum) may also occur.
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Infection with Yersinia can be caused by eating or drinking contaminated food and water, most commonly through faecal-oral transmission or through consumption of raw or improperly cooked meat and dairy products such as cheese, milk, yogurt or ice cream. Yersinia enterocolitica can multiply rapidly at 4 degC, such as in a refrigerator. During major foodborne Yersiniosis outbreaks in the EU, raw or medium-cooked pork and raw or inappropriately heated dairy products have been implicated as vehicles of infection.
Typically, symptoms begin in the gastrointestinal tract and last 1 to 3 weeks. Infections with Yersinia enterocolitica are typically sporadic rather than occurring in epidemics, and most people recover without antibiotic treatment. Nevertheless, some individuals develop more serious complications such as joint pains and a skin rash, called erythema nodosum.
The occurrence of joint pain and a skin rash as symptoms of yersiniosis is very uncommon, but if they do present, these symptoms can be a serious complication of the infection that needs to be evaluated by a physician immediately. Joint symptoms are more likely to develop in the legs than in the arms, and the joints affected tend to be larger ones. In a case-control study that involved questionnaires for both cases and controls, those who reported yersiniosis were asked if they had developed any new-onset joint symptoms during the time that they had gastrointestinal illness with Yersinia. The control group was similarly questioned about their experience with joint symptoms. The results indicate that the incidence of yersiniosis in those who had joint symptoms is approximately twice as high as that in those who did not.
