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Chapter 9 : Epidemiology of Campylobacter jejuni Infections in Industrialized Nations
Category: Bacterial Pathogenesis
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Knowledge of the epidemiology of the infections of the Campylobacter organism causes has been steadily accumulating. The majority of these infections are sporadic; Campylobacter jejuni is far less often recognized as a cause of outbreaks than is Salmonella. In the first comprehensive epidemiological report of the European Centre of Disease Prevention and Control (ECDC) covering 2005, campylobacteriosis was the most frequently occurring enteric bacterial infection, second only to Chlamydia infection among all diseases reported. Much of the difference in incidence rates between the otherwise comparable countries Denmark and The Netherlands is explained by the fact that all Danish laboratories report Campylobacter diagnoses to the national level, compared with 51% of the Dutch laboratories. As the efficacy of serological methods for diagnosis of Campylobacter infection are further validated, including appropriate control sera, and as mathematical models advance, the usefulness of seroepidemiology to study the incidence of Campylobacter infections will become clearer. The vast majority of Campylobacter infections are sporadic individual infections and often affect young adults and young children. Consumption of untreated water, raw milk, or milk products and contact with pets are important sources of infection. Routine treatment of drinking water and pasteurization of milk are core prevention strategies. Veterinary use of fluoroquinolones in poultry explains the recent rise in ciprofloxacin-resistant Campylobacter infections in humans in the United States and may explain much of the geographic variation in resistance around the world.
Reported incidence of Campylobacter infections in FoodNet, by month and year, 1996 to 2005.
Relative incidence rate of Campylobacter infections in FoodNet through 2005, compared with baseline period 1996 to 1998, using a negative binomial Poisson regression model to account for effect of new sites added over time ( CDC, 2006 ).
Annual incidence of Campylobacter infections, by site, FoodNet, 2005. CA, California; CO, Colorado; CT, Connecticut; GA, Georgia; MD, Maryland; MN, Minnesota; NM, New Mexico; NY, New York; OR, Oregon; TN, Tennessee.
Incidence of Campylobacter infections by age group and sex, FoodNet, 2005.
Surveillance pyramid used to estimate the burden of food-borne diseases in FoodNet.
Trends in reported incidence of Campylobacter infections for six countries and the European Union, 1979 to 2006. Data sources: Denmark, Statens Serum Institut (http://www.mave-tarm.dk) and Statistics Denmark; Norway, Folkehelseinstituttet (http://www.msis.no) and Statistics Norway; Sweden, Smittskyddinstitutet (http://www.smittskyddsinstitutet.se/statistik/), M. Löfdahl (personal communication), and Statistics Sweden; England and Wales, Health Protection Agency (http://www.hpa.org.uk/infections/topics_az/campy/data_ew.htm); Australia, National Notifiable Diseases Surveillance System (http://http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health-pubhlth-strateg-communic-index.htm) and J. Musto, NSW Department of Health (personal communication); NZ, M. Baker, University of Otago, Wellington (personal communication) and Statistics New Zealand; ECDC, European Centre of Disease Prevention and Control and A. Amato (personal communication).
Number of human infections with Campylobacter, proportion of isolates from humans resistant to ciprofloxacin, and prevalence of cecal carriage of Campylobacter in broiler flocks, by 4-week interval, The Netherlands, aggregated over the time period, 2002 to 2006 ( van Pelt et al., 2007 ). Human surveillance coverage is approximately 50%.
Schema of transmission pathways for Campylobacter jejuni, 2007.
Antimicrobial resistance in C. jejuni isolates, United States, 1997 to 2004 ( CDC, 2007 ).
Food- and waterborne outbreaks of Campylobacter infections reported in the United States, by vehicle, 1998–2004
Case-control studies of laboratory-confirmed sporadic campylobacteriosis within the United States
Case-control studies of sporadic campylobacteriosis in industrialized countries outside the United States