Immunoepidemiology of post-Salmonella reactive arthritis in a cohort of women.

Following a foodborne outbreak of Salmonella dysentery in a group of 79 women and 4 men, 6 individuals were found to have reactive arthritis (ReA). None of the affected individuals had the classical genetic marker HLA B27 although 2 of the 6 had CREG antigens. IgA antibodies to the lipopolysaccharide of the causative organism, Salmonella heidelberg, were found to be elevated in those patients with active ReA compared to those with inactive ReA or those who had dysentery but did not develop ReA. The lymphocyte proliferative response to both PHA and the whole S. heidelberg organism was impaired in the patients with ReA (active or inactive) compared with the non-ReA patient controls. In this predominantly female outbreak of Salmonellosis, the development of ReA lacked an association with HLA class I antigens commonly recognized.