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Abstract

In March 2014, a (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.

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/content/10.2807/1560-7917.ES.2015.20.40.30033
2015-10-08
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2015.20.40.30033
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References

  1. Galindo CL, Rosenzweig JA, Kirtley ML, Chopra AK. Pathogenesis of Y. enterocolitica and Y. pseudotuberculosis in human yersiniosis. J Pathogens. 2011;2011:182051.  https://doi.org/10.4061/2011/182051  PMID: 22567322 
  2. Heymann DL. Control of communicable diseases manual. 19th ed. Washington: American Public Health Association; 2008.
  3. Rimhanen-Finne R, Niskanen T, Hallanvuo S, Makary P, Haukka K, Pajunen S, et al. Yersinia pseudotuberculosis causing a large outbreak associated with carrots in Finland, 2006. Epidemiol Infect. 2009;137(3):342-7.  https://doi.org/10.1017/S0950268807000155  PMID: 18177523 
  4. National Institute for Health and Welfare (THL). Infectious diseases in Finland 2013. Helsinki: THL; 2014. Available from: https://www.julkari.fi/bitstream/handle/10024/125566/URN_ISBN_978-952-302-194-5.pdf?sequence=1
  5. Nuorti JP, Niskanen T, Hallanvuo S, Mikkola J, Kela E, Hatakka M, et al. A widespread outbreak of Yersinia pseudotuberculosis O:3 infection from iceberg lettuce. J Infect Dis. 2004;189(5):766-74.  https://doi.org/10.1086/381766  PMID: 14976592 
  6. Inoue M, Nakashima H, Ueba O, Ishida T, Date H, Kobashi S, et al. Community outbreak of Yersinia pseudotuberculosis. Microbiol Immunol. 1984;28(8):883-91.  https://doi.org/10.1111/j.1348-0421.1984.tb00744.x  PMID: 6503742 
  7. David HW, Stanley L. Applied Logistic Regression. 2nd ed. New York: John Wiley and Sons, Inc; 2000.
  8. Antikainen J, Kantele A, Pakkanen SH, Lääveri T, Riutta J, Vaara M, et al. A quantitative polymerase chain reaction assay for rapid detection of 9 pathogens directly from stools of travelers with diarrhea. Clin Gastroenterol Hepatol. 2013;11(10):1300-1307.e3.  https://doi.org/10.1016/j.cgh.2013.03.037  PMID: 23639597 
  9. Lambertz ST, Nilsson C, Hallanvuo S, Lindblad M. Real-time PCR method for detection of pathogenic Yersinia enterocolitica in food. Appl Environ Microbiol. 2008;74(19):6060-7.  https://doi.org/10.1128/AEM.00405-08  PMID: 18708521 
  10. Lambertz ST, Nilsson C, Hallanvuo S. TaqMan-based real-time PCR method for detection of Yersinia pseudotuberculosis in food. Appl Environ Microbiol. 2008;74(20):6465-9.  https://doi.org/10.1128/AEM.01459-08  PMID: 18757572 
  11. International Organization for Standardization (ISO). ISO/TS 13136:2012. Microbiology of food and animal feed – Real-time polymerase chain reaction (PCR)–based method for the detection of food-borne pathogens – Horizontal method for the detection of Shiga toxin-producing Escherichia coli (STEC) and the determination of O157, O111, O26, O103 and O145 serogroups. Geneva: ISO; 2012.
  12. International Organization for Standardization (ISO). ISO/WD 10237:2014. Microbiology of the food chain -- Horizontal method for the detection of pathogenic Yersinia enterocolitica. Geneva: ISO; 2014.
  13. Weagant SD, Feng P. Bacteriological Analytical Manual: Yersinia enterocolitica. Silver Spring: US Food and Drug Administration; 2007. Available from: http://www.fda.gov/Food/FoodScienceResearch/LaboratoryMethods/ucm072633.htm
  14. International Organization for Standardization (ISO). ISO 10272-1:2006. Microbiology of food and animal feeding stuffs – Horizontal method for detection and enumeration of Campylobacter spp. – Part 1: Detection method. Geneva: ISO; 2006.
  15. Halkilahti J, Haukka K, Siitonen A. Genotyping of outbreak-associated and sporadic Yersinia pseudotuberculosis strains by novel multilocus variable-number tandem repeat analysis (MLVA). J Microbiol Methods. 2013;95(2):245-50.  https://doi.org/10.1016/j.mimet.2013.09.007  PMID: 24050949 
  16. Centers for Disease Control and Prevention (CDC). Standard operating procedure for PulseNet PFGE of Campylobacter jejuni. Atlanta: CDC; 2013. Available from: http://www.cdc.gov/pulsenet/PDF/campylobacter-pfge-protocol-508c.pdf
  17. Public law. Maa- ja metsätalousministeriön asetus raakamaidon tuotannon ja luovutuksen elintarvikehygieniasta. [Decree of the Ministry of Agriculture and Forestry on food hygiene in the production and supply of raw milk]. Pub. L. No. 699-2013; 26 Sept 2013. Finnish. Available from: http://www.finlex.fi/fi/laki/alkup/2013/20130699#Pidm1839328
  18. Gregg M, Dicker R, Goodman R. Field Epidemiology. 1st ed. New York: Oxford University Press; 1996.
  19. Newkirk R, Hedberg C, Bender J. Establishing a milkborne disease outbreak profile: potential food defense implications. Foodborne Pathog Dis. 2011;8(3):433-7.  https://doi.org/10.1089/fpd.2010.0731  PMID: 21114422 
  20. Oliver SP, Jayarao BM, Almeida RA. Foodborne pathogens in milk and the dairy farm environment: food safety and public health implications. Foodborne Pathog Dis. 2005;2(2):115-29.  https://doi.org/10.1089/fpd.2005.2.115  PMID: 15992306 
  21. Denny J, Bhat M, Eckmann K. Outbreak of Escherichia coli O157:H7 associated with raw milk consumption in the Pacific Northwest. Foodborne Pathog Dis. 2008;5(3):321-8.  https://doi.org/10.1089/fpd.2007.0072  PMID: 18564912 
  22. Perkiomäki J, Leimi A, Tuominen P. Suomessa tuotetun raakamaidon biologiset vaarat – riskiprofiili. [Biological hazards of raw milk produced in Finland – risk profile]. Helsinki: Finnish Food Safety Authority Evira; 2012. Finnish. Available from: http://www.evira.fi/portal/fi/tietoa+evirasta/julkaisut/?a=view&productId=317
  23. Hoogenboom-Verdegaal AM, de Jong JC, During M, Hoogenveen R, Hoekstra JA. Community-based study of the incidence of gastrointestinal diseases in The Netherlands. Epidemiol Infect. 1994;112(3):481-7.  https://doi.org/10.1017/S0950268800051189  PMID: 8005214 
  24. Centers for Disease Control and Prevention (CDC). Raw (unpasteurized) milk. Atlanta: CDC; 2014. Available from: http://www.cdc.gov/features/rawmilk/
  25. Jalava K, Hakkinen M, Valkonen M, Nakari UM, Palo T, Hallanvuo S, et al. An outbreak of gastrointestinal illness and erythema nodosum from grated carrots contaminated with Yersinia pseudotuberculosis. J Infect Dis. 2006;194(9):1209-16.  https://doi.org/10.1086/508191  PMID: 17041846 
  26. Felming D, Hunt D. Biological safety principles and practices. 4th ed. Washington: ASM Press; 2006.
  27. Bottone EJ, Bercovier H, Mollaret HH. Bergey’s Manual of Systematic Bacteriology. 2nd ed. New York: Springer; 2005.
  28. European Food Safety Authority (EFSA). Scientific opinion on the public health risks related to the consumption of raw drinking milk. Parma: EFSA; 2015. Available from: http://www.efsa.europa.eu/en/efsajournal/doc/3940.pdf
  29. McAuley CM, McMillan K, Moore SC, Fegan N, Fox EM. Prevalence and characterization of foodborne pathogens from Australian dairy farm environments. J Dairy Sci. 2014;97(12):7402-12.  https://doi.org/10.3168/jds.2014-8735  PMID: 25282417 
  30. Quigley L, McCarthy R, O’Sullivan O, Beresford TP, Fitzgerald GF, Ross RP, et al. The microbial content of raw and pasteurized cow milk as determined by molecular approaches. J Dairy Sci. 2013;96(8):4928-37.  https://doi.org/10.3168/jds.2013-6688  PMID: 23746589 
  31. Ruusunen M, Salonen M, Pulkkinen H, Huuskonen M, Hellström S, Revez J, et al. Pathogenic bacteria in Finnish bulk tank milk. Foodborne Pathog Dis. 2013;10(2):99-106.  https://doi.org/10.1089/fpd.2012.1284  PMID: 23373473 
Outbreak of Yersinia pseudotuberculosis O:1 infection associated with raw milk consumption, Finland, spring 2014
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Triin+P%C3%A4rn&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pärn Triin</a>, <a href="/search?value1=Saija+Hallanvuo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hallanvuo Saija</a>, <a href="/search?value1=Saara+Salmenlinna&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Salmenlinna Saara</a>, <a href="/search?value1=Annika+Pihlajasaari&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pihlajasaari Annika</a>, <a href="/search?value1=Seija+Heikkinen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Heikkinen Seija</a>, <a href="/search?value1=Hanna+Telkki-Nyk%C3%A4nen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Telkki-Nykänen Hanna</a>, <a href="/search?value1=Marjaana+Hakkinen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hakkinen Marjaana</a>, <a href="/search?value1=Jukka+Ollgren&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ollgren Jukka</a>, <a href="/search?value1=Sari+Huusko&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Huusko Sari</a>, <a href="/search?value1=Ruska+Rimhanen-Finne&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rimhanen-Finne Ruska</a></span>. Outbreak of Yersinia pseudotuberculosis O:1 infection associated with raw milk consumption, Finland, spring 2014. <a href="/content/ecdc">Euro Surveill.</a> 2015;20(40):pii=30033. <a href="https://doi.org/10.2807/1560-7917.ES.2015.20.40.30033" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2015.20.40.30033</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 31 Dec 2014;&nbsp;&nbsp; <span class="generated">Accepted</span>: 04 Jun 2015 </span> </p>
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