Reactive arthritis after Salmonella among medical doctors--study of an outbreak

Abstract

Objective: To investigate an outbreak of S. enteritidis enterocolitis which occurred at a radiology symposium in Malmö, Sweden in March, 1990.

Methods: Questionnaires were mailed to the 126 participants after 1 and 6 months inquiring about enterocolitis, joint and eye symptoms and antibiotic treatment. Fifty-one delivered blood samples for serological studies.

Results: One hundred thirteen responded to the questionnaire. Enterocolitis was reported by 108 individuals (96%) and 17 (15%) developed reactive arthritis (ReA). Only 3 persons reported conjunctivitis. Antibody response did not differ between patients with uncomplicated enterocolitis or ReA. IgA antibodies had the highest sensitivity to detect infected individuals. Ten out of 65 patients treated with antibiotics (mean 9.1 days) for enterocolitis and 7 out of 48 nontreated reported joint symptoms. At 6 month followup 8 patients had persistent joint complaints.

Conclusion: Following an outbreak of S. enteritidis dysentery, joint symptoms may be more frequent than previously thought and could not be prevented by early antibiotic treatment. Nor did antibiotics affect the duration of ReA over a 6 month followup period.