Research – Forgotten but not gone: Yersinia infections in England, 1975 to 2020


Yersiniosis, most often caused by  is one of the most common bacterial food-borne zoonoses in Europe with reported overall incidence of 1.8 cases per 100,000 population in 2020 [1]. There is, however, marked variation among countries, with the highest numbers of cases per 100,000 population reported in Denmark and Finland (7.1 and 7.0, respectively) and the lowest in Romania and Bulgaria (0.03 and 0.06, respectively) [1]. Transmission is primarily faecal–oral via food or water contaminated with animal faeces [2]. Yersiniosis has been associated with the consumption of pork meat (raw or undercooked), occupational exposure to pigs, untreated drinking water, milk, vegetables, juices, ready-to-eat and other foods [36]. The incidence of yersiniosis in Europe is higher in males and in children under 5 years, and no clear seasonal pattern has been reported over the last decade [1,3]. Yersiniosis commonly presents as diarrhoea, abdominal pain and fever, and can manifest as acute mesenteric lymphadenitis and terminal ileitis. Although it is usually self-limiting with a low case fatality rate (0.05%), symptoms often persist for several weeks [3,6].

The reported incidence of  infections in the United Kingdom (UK) is well below the European average (0.2 cases per 100,000 in 2019) [3]. Routine testing for  is not currently recommended in the UK, unless there is a clinical suspicion (e.g. appendicitis, mesenteric lymphadenitis, terminal ileitis or reactive arthritis) [7]. The aim of this study was to describe the changing incidence and epidemiology of diagnosed  infections in England between 1975 and 2020 and to estimate the potential under-ascertainment of  due to the lack of routine testing.

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