Stool samples from approximately 2,550 patients with gastrointestinal infections were cultured for bacterial pathogens between January 1978 and September 1979, and 277 campylobacter (10.9%), 183 salmonella, 89 shigella, and 17 yersinia infections were identified. Campylobacter was found in all age groups, with the majority in the age group of 20-34 years. Most cases of campylobacter diarrhea were isolated during summer or late fall. After five weeks, 90% of the patients had no Campylobacter in their stools. The incubation time was estimated to be one to six days. Campylobacter gastroenteritis, even more common than salmonella gastroenteritis, was in general not regarded as a serious disease, despite the fact that most patients had marked symptoms. Almost all patients recovered without antibiotic treatment, although in some cases the disease was long-lasting, and 50 of the 277 patients required hospitalization. Thus, Campylobacter must be considered in the diagnosis of patients with diarrhea.

An epidemiological study on Campylobacter jejuni enterocolitis was performed in an urban Swedish community. The study included 55 patients gathered during a six-month period. Forty-one of the 55 patients (75%) were infected outside Sweden. Campylobacter enterocolitis was rare among children within the country. Patients infected in Sweden had eaten chicken significantly more often than a corresponding control group. Seven out of nine chicken consuming campylobacter patients also had prepared the fresh chicken alone, and none of their family members became ill. Thus the preparation of food contaminated with Campylobacter seems to elevate the risk for contracting the disease. Sick household pets transmitted the campylobacter infection to two patients. Forty-six of the patients had a total of 85 close household members. Three definite secondary cases were found. There was no evidence of transmission of Campylobacter by food prepared by two cooks who were working while still being asymptomatic excreters. Clinical reinfection with Campylobacter was observed in one patient. No patients became long-term carriers of Campylobacter.

Eighty six of 106 (81%) guests attending a party were followed up after an outbreak ofCampylobacter jejuni enterocolitis. Acute diarrhoeal illness was reported in 35 subjects (33%), of whom seven showed acute rheumatic symptoms either alone or with other symptoms of infection with Cjejuni. The We report here a five year follow up study of an outbreak of C jejuni in 106 guests attending a party at which coq au vin, boiled rice, and fresh salad were served. This outbreak gave an opportunity to study the symptoms, signs, and natural course of musculoskeletal involvement following C jejuni enterocolitis, including patients without overt gastrointestinal illness. Materials and methods SUBJECTSA private party on 6 October 1981 was attended by 106 guests, all hospital staff members and their partners. Coq au vin (a chicken dish), boiled rice, and fresh salad were consumed by all the guests. After one to seven days 35 guests (33%) experienced fever, diarrhoea, malaise, and/or headache. Within five to ten days 86 (8 1%) of the guests were identified, interviewed, and their stools examined by routine bacteriological procedures. The remaining 20 participants did not reply to a questionnaire and were not included in the study ( figure).Early serum samples (SI) were obtained from 81 subjects 9-21 days (mean (SEM) 10-3 (0-2) days) after the party. A second serum sample (S2) was obtained from 49 of the subjects days after the party. The mean interval between Sl and S2 was 20-9 (0 7) days (range 5-33 days). Three subjects were admitted to hospital owing to severe enterocolitis. Two years after the infection all the 86 subjects interviewed were asked to complete a questionnaire about present or past rheumatic complaints. Answers were obtained from all 86 subjects. Five years after the party the 15 subjects who had reported locomotor symptoms were interviewed by telephone. Medical records were collected when available. Five subjects reporting long term locomotor symptoms starting after the party were examined clinically. The subjects knew about their bacteriological, but not their serological, test performed immediately after the party. The researchers were blind to the results of the bacteriological and serological tests when assessing the questionnaires.

SUMMARYCampylobacter jejuni was an almost regular finding in chickens and in minced meat from pigs and cattle sold in ordinary food stores. The bacteria survived on the food at 4°C for one week and frozen at -20°C for three months. None of the stains tested survived heat treatment at 60°C for longer than 15 min. C. jejuni is apparently a frequent guest in most kitchens. Correct food handling and heat treatment to at least 60 'C for 15 min should be enough to prevent infection.

No abstract