794 YERSINIA ENTEROCOLITICA GASTROENTERITIS IN CHILDREN

Abstract

Y. enterocolitica (YE) is the second commonest cause of bacterial gastroenteritis (GE) in children in the Montreal area. The purpose of this study is to define prospectively the incidence of YE GE, duration of carriage, serological response, communicability in households, and effect of antimicrobial therapy. Clinical, bacteriologic and serologic surveillance was performed on index cases (IC) and their family members until all members of the family had 3 consecutive negative stools. During the first 6 mo of the study 96 IC were identified from 2531 ill children. In 31 IC whose clinical and epidemiologic data were available, diarrhea (100%), fever (71%) and abdominal pain (61%) were major symptoms with mean duration (D) of 16, 4 and 9 days respectively. D of excretion of YE was 4.5 wks (range 2-9). Paired sera were available from 25 IC; all but 2 (both under age 4.5 mo) showed a serologic response. The geometric mean titer of the 1st serum from those ≥1 yr (18) was 635, compared to 100 for those ≥1 yr (7). Intrafamilial spread was documented by at least 2 of 3 criteria (clinical, bacteriologic, or serologic) in 7 of 25 families, involving 4 of 13 children and 3 of 53 adult household contacts. It is too early to evaluate the effect of therapy. Our findings indicate that (1) YE is a frequent cause of GE in children; (2) YE GE is followed by “O” type-specific antibody response in children ≥1 yr of age; and (3) intrafamilial spread is often asymptomatic.