The epidemiology of human campylobacteriosis is complex but in recent years understanding of this disease has advanced considerably. Despite being a major public health concern in many countries, the presence of multiple hosts, genotypes and transmission pathways has made it difficult to identify and quantify the determinants of human infection and disease. This has delayed the development of successful intervention programmes for this disease in many countries including New Zealand, a country with a comparatively high, yet until recently poorly understood, rate of notified disease. This study investigated the epidemiology of Campylobacter jejuni at the genotype-level over a 3-year period between 2005 and 2008 using multilocus sequence typing. By combining epidemiological surveillance and population genetics, a dominant, internationally rare strain of C. jejuni (ST474) was identified, and most human cases (65.7%) were found to be caused by only seven different genotypes. Source association of genotypes was used to identify risk factors at the genotype-level through multivariable logistic regression and a spatial model. Poultry-associated cases were more likely to be found in urban areas compared to rural areas. In particular young children in rural areas had a higher risk of infection with ruminant strains than their urban counterparts. These findings provide important information for the implementation of pathway-specific control strategies.

Background:The COVID-19 pandemic has disrupted cancer services globally. New Zealand has pursued an elimination strategy to COVID-19, reducing (but not eliminating) this disruption. Early in the pandemic, our national Cancer Control Agency ( Te Aho o Te Kahu ) began monitoring and reporting on service access to inform national and regional decision-making. In this manuscript we use high-quality, nationallevel data to describe changes in cancer registrations, diagnosis and treatment over the course of New Zealand's response to COVID-19. Methods: Data were sourced (2018-2020) from national collections, including cancer registrations, inpatient hospitalisations and outpatient events. Cancer registrations, diagnostic testing (gastrointestinal endoscopy), surgery (colorectal, lung and prostate surgeries), medical oncology access (first specialist appointments [FSAs] and intravenous chemotherapy attendances) and radiation oncology access (FSAs and megavoltage attendances) were extracted. Descriptive analyses of count data were performed, stratified by ethnicity (Indigenous M āori, Pacific Island, non-M āori/non-Pacific). Findings: Compared to 2018-2019, there was a 40% decline in cancer registrations during New Zealand's national shutdown in March-April 2020, increasing back to pre-shutdown levels over subsequent months. While there was a sharp decline in endoscopies, pre-shutdown volumes were achieved again by August. The impact on cancer surgery and medical oncology has been minimal, but there has been an 8% year-todate decrease in radiation therapy attendances. With the exception of lung cancer, there is no evidence that existing inequities in service access between ethnic groups have been exacerbated by COVID-19. Interpretation: The impact of COVID-19 on cancer care in New Zealand has been largely mitigated. The New Zealand experience may provide other agencies or organisations with a sense of the impact of the COVID-19 pandemic on cancer services within a country that has actively pursued elimination of COVID-19. Funding: Data were provided by New Zealand's Ministry of Health, and analyses completed by Te Aho o Te Kahu staff.

Despite recent improvements, New Zealand still has one of the highest per-capita incidence rates of campylobacteriosis in the world. To reduce the incidence, a thorough understanding of the epidemiology of infection is needed. This retrospective analysis of 36 000 notified human cases during a high-risk period between 2001 and 2007 explored the spatial and temporal determinants of Campylobacter notifications at a fine spatial scale in order to improve understanding of the complex epidemiology. Social deprivation was associated with a decreased risk of notification, whereas urban residence was associated with an increased risk. However, for young children rural residence was a risk factor. High dairy cattle density was associated with an increased risk of notification in two of the three regions investigated. Campylobacter notification patterns exhibit large temporal variations; however, few factors were associated with periods of increased risk, in particular temperature did not appear to drive the seasonality in campylobacteriosis.

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Intensification of dairying on irrigated pastures has led to concern over the microbial quality of shallow groundwater used for drinking purposes. The effects of intensive dairying and border-strip irrigation on the leaching of E. coli and Campylobacter to shallow groundwater were assessed over a three-year period in the Waikakahi catchment, Canterbury, New Zealand. Well selection excluded other sources of contamination so that the effect of dairying with border-strip irrigation could be assessed. Groundwater samples (135) were collected, mostly during the irrigation season, with E. coli being detected in 75% of samples. Campylobacter was identified in 16 samples (12%). A risk assessment of drinking water with these levels of Campylobacter was undertaken. A probability distribution was fitted to the observed Campylobacter data and the @RISK modeling software was used, assuming a dose response relationship for Campylobacter and consumption of 1 L/day of water. The probability of infection on any given day in the study area was estimated at 0.50% to 0.76%, giving an estimated probability of infection during the irrigation season of 60% to 75%. An epidemiological assessment of the Canterbury region comparing areas encompassing dairy within major irrigation schemes (,55% border-strip irrigation) to two control groups was undertaken. Control group 1 (CG1) encompasses areas of dairying without major irrigation schemes, and a second larger control group (CG2) comprises the rest of the Canterbury region. Comparisons of the subject group to control groups indicated that there was a statistically significant increase in age-standardised rates of campylobacteriosis (CG1 Relative Risk (RR) ¼ 1.51 (95% CI ¼ 1.31-1.75); CG2 RR ¼ 1.51 (1.33-1.72)); cryptosporidiosis (CG1 RR ¼ 2.08 (1.55-2.79); CG2 RR ¼ 5.33 (4.12-6.90)); and salmonellosis (CG2 RR ¼ 2.05 (1.55-2.71)).