Outbreak of Yersinia pseudotuberculosis O:1 infection associated with raw milk consumption, Finland, spring 2014

Author:

Pärn Triin12,Hallanvuo Saija3,Salmenlinna Saara1,Pihlajasaari Annika4,Heikkinen Seija5,Telkki-Nykänen Hanna6,Hakkinen Marjaana3,Ollgren Jukka1,Huusko Sari1,Rimhanen-Finne Ruska1

Affiliation:

1. National Institute for Health and Welfare (THL), Department of Infectious Diseases Surveillance and Control, Helsinki, Finland

2. European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

3. Finnish Food Safety Authority Evira, Research and Laboratory Department, Food and Feed Microbiology Unit, Helsinki, Finland

4. Finnish Food Safety Authority Evira, Control Department, Food Hygiene Unit, Helsinki, Finland

5. City of Porvoo, Environmental Health Department, Porvoo, Finland

6. City of Porvoo Health Center, Finland

Abstract

In March 2014, a Yersinia pseudotuberculosis (YP) outbreak was detected by a municipal authority in southern Finland. We conducted epidemiological, microbiological and traceback investigations to identify the source. We defined a case as a person with YP infection notified to the National Infectious Disease Registry between February and April 2014, or their household member, with abdominal pain and fever ≥ 38 °C or erythema nodosum. Healthy household members were used as household-matched controls. We identified 43 cases and 50 controls. The illness was strongly associated with the consumption of raw milk from a single producer. The odds ratio of illness increased with the amount of raw milk consumed. Also previously healthy adults became infected by consuming raw milk. Identical YP strains were identified from cases’ stool samples, raw milk sampled from a case’s refrigerator and from the milk filter at the producer’s farm. The producer fulfilled the legal requirements for raw milk production and voluntarily recalled the raw milk and stopped its production. We advised consumers to heat the raw milk to 72 °C for 15 s. Current legislation for raw milk producers should be reviewed and public awareness of health risks linked to raw milk consumption should be increased.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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