An outbreak ofCampylobacter infection associated with the consumption of unpasteurised milk at a large festival in England

Morgan, Deborah; Gunneberg, Christian; Gunnell, DJ; Healing, T. D.; Lamerton, S.; Soltanpoor, N; Lewis, Deirdre; White, D. G.

doi:10.1007/bf01719576

Cited by 36 publications

(23 citation statements)

References 6 publications

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“…A lack of respect for food hygiene rules has also been observed during such festivals [17,18,20]. Factors that contribute to gastrointestinal outbreaks at these festivals include (i) excessive production of food beyond the safe food production capacity [17], (ii) preparation of meals by a large number of volunteer food handlers [14,18], and (iii) the sale of food prepared under unsanitary conditions, sometimes by vendors without a license [19][20][21].…”

Section: Faecal-oral Transmission and Gastrointestinal Diseasesmentioning

confidence: 99%

Outbreaks associated to large open air festivals, including music festivals, 1980 to 2012

Botelho-Nevers

2013

Eurosurveillance

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In the minds of many, large scale open air festivals have become associated with spring and summer, attracting many people, and in the case of music festivals, thousands of music fans. These festivals share the usual health risks associated with large mass gatherings, including transmission of communicable diseases and risk of outbreaks. Large scale open air festivals have however specific characteristics, including outdoor settings, on-site housing and food supply and the generally young age of the participants. Outbreaks at large scale open air festivals have been caused by Cryptosporium parvum, Campylobacter spp., Escherichia coli, Salmonella enterica, Shigella sonnei, Staphylococcus aureus, hepatitis A virus, influenza virus, measles virus, mumps virus and norovirus. Faecal-oral and respiratory transmissions of pathogens result from non-compliance with hygiene rules, inadequate sanitation and insufficient vaccination coverage. Sexual transmission of infectious diseases may also occur and is likely to be underestimated and underreported. Enhanced surveillance during and after festivals is essential. Preventive measures such as immunisations of participants and advice on-site and via social networks should be considered to reduce outbreaks at these large scale open air festivals.

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Section: Faecal-oral Transmission and Gastrointestinal Diseasesmentioning

confidence: 99%

Outbreaks associated to large open air festivals, including music festivals, 1980 to 2012

Botelho-Nevers

2013

Eurosurveillance

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“…Although most of the human cases are sporadic in nature, outbreaks caused by Campylobacter spp. have been reported in the past, caused by the consumption of raw milk and contaminated water (30,39).…”

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confidence: 99%

Campylobacter coliin Swine Production: Antimicrobial Resistance Mechanisms and Molecular Epidemiology

Thakur

Gebreyes

2005

J Clin Microbiol

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The aim of this study was to determine antimicrobial resistance, to evaluate and compare the use of two genotyping methods for molecular epidemiology purposes, and to determine the genotypic diversity of Campylobacter coli of porcine origin. A total of 100 C. coli isolates from swine were tested for susceptibility to six antimicrobials using the agar dilution method and genotyped using two high-resolution fingerprinting approaches: multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Evaluation of the methods was based on their resistance patterns, discriminatory indexes (DI), high test throughputs, costs, and turnaround times. Resistance to erythromycin and tetracycline was the most common. Both genotypic methods were found to have high discriminatory power, although MLST had a higher DI (0.936) than PFGE (DI ‫؍‬ 0.889). It also had a higher throughput than PFGE. Isolates were clustered into 27 groups by MLST compared to 11 by PFGE. MLST was able to further discriminate the isolates grouped under the same cluster by PFGE. Out of the 65 MLST sequence types (STs) identified among the total isolates, 50 were reported for the first time. Most STs were found to be specific to the farm (n ‫؍‬ 38) and to slaughter (n ‫؍‬ 22). Resistance against tetracycline and erythromycin was encoded by the tet(O) gene and a A2075G point mutation in the 23S rRNA gene, respectively. A high ciprofloxacin MIC (>64 g/liter) was conferred by a point mutation in the gyrA gene. The weak clonal structure of the C. coli population among swine was further highlighted by the index of association value of 0.293. The findings of this study indicate that multidrug-resistant diverse C. coli strains exhibiting resistance to ciprofloxacin and erythromycin are concerning, since these are the drugs of choice for treating invasive campylobacteriosis cases in humans.

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“…Contaminated milk has been responsible for large outbreaks of C. jejuni enteritis (24). Contamination of milk can be caused by direct excretion from an asymptomatic cow with mastitis (17) or, more commonly, by fecal contamination during milking (43).…”

mentioning

confidence: 99%

Utility of Multilocus Sequence Typing as an Epidemiological Tool for Investigation of Outbreaks of Gastroenteritis Caused by Campylobacter jejuni

2003

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Multilocus sequence typing (MLST) has been proven useful for the study of the global population structure of Campylobacter jejuni; however, its usefulness for the investigation of outbreaks of disease caused by C. jejuni has not been proven. In this study, MLST plus sequencing of the flaA short variable region (SVR) were applied to 47 isolates from 12 outbreaks of C. jejuni infection whose relatedness has been determined previously, and the results were compared to those of serotyping and pulsed-field gel electrophoresis (PFGE). Isolates implicated in an outbreak were indistinguishable by all four subtyping methods, with sporadic isolates being distinguished from outbreak isolates. Two sporadic isolates from one outbreak were resistant to SmaI digestion and therefore nontypeable by PFGE but were differentiated from the outbreak strain by the other methods. PFGE and flaA SVR typing were the most discriminatory methods, with discriminatory indices (DI) of 0.930 and 0.923, respectively. However, an epidemic strain from one outbreak was distinguished from the other outbreak isolates by flaA SVR typing; its flaA allele was different at five nucleotides, suggesting that this change was possibly mediated by recombination. MLST was less discriminatory than PFGE and flaA SVR typing (DI ‫؍‬ 0.859), and many of the epidemic strains possessed common sequence types (STs) including ST-8, -21, -22, and -42. However, further discrimination within STs was achieved by flaA SVR typing or PFGE. The results from this study demonstrate that a combined approach of MLST plus flaA SVR typing provides a level of discrimination equivalent to PFGE for outbreak investigations.

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An outbreak ofCampylobacter infection associated with the consumption of unpasteurised milk at a large festival in England

Cited by 36 publications

References 6 publications

Outbreaks associated to large open air festivals, including music festivals, 1980 to 2012

Outbreaks associated to large open air festivals, including music festivals, 1980 to 2012

Campylobacter coliin Swine Production: Antimicrobial Resistance Mechanisms and Molecular Epidemiology

Utility of Multilocus Sequence Typing as an Epidemiological Tool for Investigation of Outbreaks of Gastroenteritis Caused by Campylobacter jejuni

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