title: Reactive arthritis following an outbreak of Salmonella Bovismorbificans infection.
abstract: A large, single-source Salmonella outbreak caused by a rare serovar Bovismorbificans (6,8:r:1,5) occurred in southern Finland in 1994. The origin of the outbreak was sprouted alfalfa seeds. A questionnaire was mailed to all 210 subjects with positive stool culture. Ninety-one percent (191/210) returned the questionnaire. One hundred and fifty-three (80%) were adults. One hundred and fifty-nine out of one hundred and ninety-one (83%) reported diarrhoea, 109 (57%) fever, 104 (54%) abdominal pains, 83 (43%) fatigue, 66 (35%) articular symptoms and 20 (10%) had no symptoms. The median duration of diarrhoea was 5 days (range 1-35), that of other symptoms 4 days (range 1-30). Those reporting articular symptoms were examined (51 patients) or contacted by telephone (13 patients). Twelve percent (22/191) fulfilled the criteria for reactive arthritis (ReA). The difference in the incidence of ReA between children and adults was not significant (8%, vs. 12%). The median onset of joint symptoms was 8.5 days; symptoms were oligoarticular in 14 (67%) and polyarticular in four (19%) patients. Mostly ReA was mild, but in four patients (18%) the joint symptoms lasted for more than 4 months. Ten (45%) ReA patients had HLA-B27 tissue type. The duration and severity of ReA did not differ between HLA-B27 positive and negative patients. Fourteen (64%) ReA patients had received fluoroquinolone treatment before reactive joint or tendon symptoms manifested, but this treatment did not prevent ReA symptoms.
authors.affiliation: Laboratory of Enteric Pathogens, National Public Health Institute, Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Mattila
authors.forename: M
authors.initials: M
authors.lastname: Leirisalo-Repo
authors.forename: P
authors.initials: P
authors.lastname: Pelkonen
authors.forename: S
authors.initials: S
authors.lastname: Koskimies
authors.forename: K
authors.initials: K
authors.lastname: Granfors
authors.forename: A
authors.initials: A
authors.lastname: Siitonen
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000276:immunology; D016918:Arthritis, Reactive / Q000209:etiology* / Q000276:immunology; D004196:Disease Outbreaks; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D000091402:Prohibitins; D012480:Salmonella Infections / Q000150:complications* / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; C000717331:PHB2 protein, human; D000091402:Prohibitins