A Multistate Outbreak of Infections Caused by Yersinia enterocolitica Transmitted by Pasteurized Milk

In June and July 1982, a large interstate outbreak ofYersinia enterocoliticainfections caused by an unusual serotype occurred in Tennessee, Arkansas, and Mississippi. Eighty-six percent of cases had enteritis characterized by fever, abdominal pain, and diarrhea. In three separate case-control studies, drinking milk pasteurized by plant A was statistically associated with illness. In a survey of randomly chosen households, 8.3% of persons who recalled having drunk milk from plant A during the suspect period experienced a yersiniosislike illness. Inspection of the plant and cultures of the available raw and pasteurized milk did not reveal the source or mechanism of contamination or a breach in normal pasteurizing technique. Although outbreaks of enteric disease caused by pasteurized milk are rare in the United States, the ability ofY enterocoliticato grow in milk at refrigeration temperatures makes pasteurized milk a possible vehicle for virulentY enterocolitica. The extent to which milk is responsible for sporadic cases of yersiniosis is unknown. (JAMA1984;251:483-486)