Risk Factors for SporadicCampylobacterInfection in the United States: A Case‐Control Study in FoodNet Sites

Abstract

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.

Risk factors for indigenousCampylobacter jejuniandCampylobacter coliinfections in The Netherlands: a case-control study

“…Consumption of undercooked seafood was associated with an increased risk of C. jejuni infection, as was also found in the Foodnet case-control study [14]. Although Campylobacter has been isolated from shellfish and crustaceans [36], the predominant species identified was C. lari [37].…”

“…0) 14 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) Contact with persons with gastroenteritis symptoms outside the household (20) 21 (20) 38 (8) 2 . 8 (1 .…”

“…Numerous case-control studies in the past 20 years have focused on the identification of risk factors for sporadic Campylobacter infections, of which consumption of poultry is most frequently reported [13][14][15][16][17][18][19][20]. Other frequently reported risk factors are consumption of unpasteurized milk [14,15,20], eating in a restaurant [14,17,19,21], contact with pets, especially puppies [13,14,16,19,22,23], contact with farm animals [13,14,17,19,20,23,24] and foreign travel [13-16, 19, 21].…”

“…Other frequently reported risk factors are consumption of unpasteurized milk [14,15,20], eating in a restaurant [14,17,19,21], contact with pets, especially puppies [13,14,16,19,22,23], contact with farm animals [13,14,17,19,20,23,24] and foreign travel [13-16, 19, 21].…”

Direct healthcare costs of selected diseases primarily or partially transmitted by water

“…Campylobacteriosis, salmonellosis, shigellosis, HUS, and toxoplasmosis are transmitted via multiple routes (foodborne, waterborne, person-to-person, and zoonotic transmission have all been documented) with non-water-related routes thought to be the primary mode of transmission. The fraction of cases acquired through water has not been precisely quantified, although some attempts at describing transmission sources have been made [12,[32][33][34][35][36][37][38][39]. Denno et al [33] reported that recreational water exposure was responsible for 44% of E. coli O157 infections (the primary infectious agent of HUS) and 23% of campylobacteriosis cases in children, while 17% of salmonellosis cases were associated with septic tank use and 11% with well water use, but risk factors could differ for adult cases.…”