Risk factors for sporadic Campylobacter infection in the United States: A case-control study in FoodNet sites.

Campylobacter is a common cause of gastroenteritis in the United States. We conducted a population-based case-control study to determine risk factors for sporadic Campylobacter infection. During a 12-month study, we enrolled 1316 patients with culture-confirmed Campylobacter infections from 7 states, collecting demographic, clinical, and exposure data using a standardized questionnaire. We interviewed 1 matched control subject for each case patient. Thirteen percent of patients had traveled abroad. In multivariate analysis of persons who had not traveled, the largest population attributable fraction (PAF) of 24% was related to consumption of chicken prepared at a restaurant. The PAF for consumption of nonpoultry meat that was prepared at a restaurant was also large (21%); smaller proportions of illness were associated with other food and nonfood exposures. Efforts to reduce contamination of poultry with Campylobacter should benefit public health. Restaurants should improve food-handling practices, ensure adequate cooking of meat and poultry, and consider purchasing poultry that has been treated to reduce Campylobacter contamination.

[1]  Shaohua Zhao,et al.  Prevalence of Campylobacter spp., Escherichia coli, and Salmonella Serovars in Retail Chicken, Turkey, Pork, and Beef from the Greater Washington, D.C., Area , 2001, Applied and Environmental Microbiology.

[2]  L. Slutsker,et al.  Sporadic Campylobacter jejuni infections in Hawaii: associations with prior antibiotic use and commercially prepared chicken. , 2001, The Journal of infectious diseases.

[3]  R. S. Hopkins,et al.  Handling raw chicken as a source for sporadic Campylobacter jejuni infections. , 1983, The Journal of infectious diseases.

[4]  N. Weiss,et al.  The role of poultry and meats in the etiology of Campylobacter jejuni/coli enteritis. , 1986, American journal of public health.

[5]  A. Peters,et al.  Incidence of Campylobacter and Salmonella isolated from retail chicken and associated packaging in South Wales , 2001, Letters in applied microbiology.

[6]  M. B. Skirrow A demographic survey of campylobacter, salmonella and shigella infections in England: A Public Health Laboratory Service Survey , 1987, Epidemiology and Infection.

[7]  M. C. Peterson Rheumatic manifestations of Campylobacter jejuni and C. fetus infections in adults. , 1994, Scandinavian journal of rheumatology.

[8]  H. Rieder,et al.  Risk factors for Campylobacter enteritis in Switzerland. , 1994, Zentralblatt fur Hygiene und Umweltmedizin = International journal of hygiene and environmental medicine.

[9]  D. Toney,et al.  An outbreak of Escherichia coli O157:H7 infections among visitors to a dairy farm. , 2002, The New England journal of medicine.

[10]  M. Blaser,et al.  Experimental Campylobacter jejuni infection in humans. , 1988, The Journal of infectious diseases.

[11]  S. Bloomfield,et al.  The effectiveness of hygiene procedures for prevention of cross‐contamination from chicken carcases in the domestic kitchen , 1999, Letters in applied microbiology.

[12]  N. Marano,et al.  Fluoroquinolone-resistant Campylobacter infections: eating poultry outside of the home and foreign travel are risk factors. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[13]  E. Pugh,et al.  Campylobacter enteritis in young children living in households with puppies. , 1987, British medical journal.

[14]  Robert Fagan Carol M. Knowles Jose Aponte Deborah A. Adam Perry,et al.  Preliminary FoodNet data on the incidence of foodborne illnesses--selected sites, United States, 2001. , 2002, MMWR. Morbidity and mortality weekly report.

[15]  T. Humphrey,et al.  Prevalence and numbers of Salmonella and Campylobacter spp. on raw, whole chickens in relation to sampling methods. , 2002, International journal of food microbiology.

[16]  J. Wells,et al.  Campylobacter enteritis on Hopi and Navajo Indian reservations. Clinical and epidemiologic features. , 1984, The Western journal of medicine.

[17]  M. Blaser,et al.  The influence of immunity on raw milk--associated Campylobacter infection. , 1987, JAMA.

[18]  T. S. Jones,et al.  Campylobacter enteritis at a university: transmission from eating chicken and from cats. , 1987, American journal of epidemiology.

[19]  Jennifer A. Roberts,et al.  The study of infectious intestinal disease in England: risk factors for cases of infectious intestinal disease with Campylobacter jejuni infection , 2001, Epidemiology and Infection.

[20]  R. S. Hopkins ENDEMIC CAMPYLOBACTER JEJUNI INFECTION IN COLORADO IDENTIFIED RISK FACTORS , 1984 .

[21]  J. Cowden,et al.  The Public Health Laboratory Service national case-control study of primary indigenous sporadic cases of campylobacter infection , 1995, Epidemiology and Infection.

[22]  R. Ikram,et al.  A case control study to determine risk factors for campylobacter infection in Christchurch in the summer of 1992-3. , 1994, The New Zealand medical journal.

[23]  S. Ostroff,et al.  Risk factors for sporadic Campylobacter infections: results of a case-control study in southeastern Norway , 1992, Journal of clinical microbiology.

[24]  G. Kapperud,et al.  Descriptive epidemiology of infections due to thermotolerant Campylobacter spp. in Norway, 1979–1988 , 1992, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[25]  E. Nielsen,et al.  Distribution of serotypes of Campylobacter jejuni and C. coli from Danish patients, poultry, cattle and swine. , 1997, FEMS immunology and medical microbiology.

[26]  G. Norkrans,et al.  Epidemiological aspects of Campylobacter jejuni enteritis , 1982, Journal of Hygiene.

[27]  J. Oosterom,et al.  Epidemiological investigations on Campylobacter jejuni in households with a primary infection , 1984, Journal of Hygiene.

[28]  Robert V. Tauxe,et al.  Epidemiology of Campylobacter jejuni infections in the United States and other industrialized nations , 2000 .

[29]  D. Robinson,et al.  Serological studies in two outbreaks of Campylobacter jejuni infection , 1981, Journal of Hygiene.

[30]  M. Blaser,et al.  Serologic Evidence of Previous Campylobacter jejuni Infection in Patients with the Guillain-Barre Syndrome , 1993, Annals of Internal Medicine.

[31]  N. Stern,et al.  Recovery of Campylobacter jejuni from Fresh and Frozen Meat and Poultry Collected at Slaughter. , 1984, Journal of food protection.

[32]  N. Garrett,et al.  Campylobacteriosis in New Zealand: results of a case-control study. , 1997, Journal of epidemiology and community health.

[33]  L. McCaig,et al.  Food-related illness and death in the United States. , 1999, Emerging infectious diseases.

[34]  R. Slack,et al.  Diabetes mellitus, anti-secretory drugs and other risk factors for campylobacter gastro-enteritis in adults: a case-control study , 1997, Epidemiology and Infection.

[35]  H. Dawkins,et al.  A study of the spread of Campylobacter jejuni in four large kitchens , 1984, Journal of Hygiene.

[36]  J. Wells,et al.  Campylobacter enteritis in the United States. A multicenter study. , 1983, Annals of internal medicine.

[37]  A. Kaufmann,et al.  A one-year study of endemic campylobacteriosis in a midwestern city: association with consumption of raw milk. , 1987, The Journal of infectious diseases.

[38]  L. Hutwagner,et al.  An outbreak of salmonellosis among children attending a reptile exhibit at a zoo. , 1998, The Journal of pediatrics.

[39]  M. Green,et al.  The male predominance in the incidence of infectious diseases in children: a postulated explanation for disparities in the literature. , 1992, International journal of epidemiology.

[40]  D P Byar,et al.  Estimating the population attributable risk for multiple risk factors using case-control data. , 1985, American journal of epidemiology.