In September and October, 1976, an outbreak of illness due to chocolate milk contaminated with Yersinia enterocolitica resulted in hospitalizaron of 36 children, 16 of whom had appendectomies. Infection with Y. enterocolitica serotype 0:8 was demonstrated in 38 ill persons. Sixty-one per cent of the persons who were infected had a titer greater than 1:160 OH agglutinins to serotype 8 yersinia, whereas 48 per cent of the hospitalized children had a fourfold change in agglutinin titer. An epidemiologic investigation demonstrated that illness was associated with drinking of chocolate milk purchased in school cafeterias, and Y. enterocolitica 0:8 was subsequently isolated from the milk. The investigation suggested that the bacterium was introduced at the dairy during the mixing by hand of chocolate syrup with previously pasteurized milk. (N Engl J Med 298:76–79, 1978) HUMAN illness caused by Yersinia enterocolitica was first described in New York State, in 1933.1 Despite this initial observation, yersiniosis has been recognized in this country much less frequently than in other areas of the world, such as Scandinavia,23 Northern Europe,45 Japan6 and Canada.7 Outbreaks of yersiniosis have occurred in schools89 in a hospital10 and in families.1112 However, the previously reported outbreak in the United States affected four related families in North Carolina and may have been initiated by contact with sick dogs.12 A recent outbreak of yersiniosis in the United States is reported here. Epidemiologic Investigation From records at.
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