Risk factors for campylobacteriosis of chicken, ruminant, and environmental origin: a combined case-control and source attribution analysis

Campylobacteriosis contributes strongly to the disease burden of food-borne pathogens. Case-control studies are limited in attributing human infections to the different reservoirs because they can only trace back to the points of exposure, which may not point to the original reservoirs because of cr...

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Bibliographic Details
Published in:PloS one 2012-08, Vol.7 (8), p.e42599
Main Authors: Mughini Gras, Lapo, Smid, Joost H, Wagenaar, Jaap A, de Boer, Albert G, Havelaar, Arie H, Friesema, Ingrid H M, French, Nigel P, Busani, Luca, van Pelt, Wilfrid
Format: Article
Language:English
Subjects:
Animals
association
Bacteriology
Beef cattle
Biological evolution
Biology
Birds
Campylobacter
Campylobacter - classification
Campylobacter Infections - epidemiology
Campylobacter Infections - microbiology
Campylobacter jejuni
Campylobacteriosis
Case-Control Studies
Cattle
Chickens - microbiology
Cloning
coli
Confidence Intervals
disease burden
Disease control
Disease Reservoirs - microbiology
Ecological risk assessment
Environmental Microbiology
Epidemiology
Food contamination
Food contamination & poisoning
Food safety
fragment length polymorphism
Genetics
Genotypes
Guillain-Barre syndrome
Health aspects
Humans
identification
Infection
Infections
Infectious diseases
jejuni clones
Laboratories
Medical research
Medicine
Multilocus Sequence Typing
Multivariate Analysis
netherlands
Netherlands - epidemiology
new-zealand
Odds Ratio
Population
Population genetics
Pork
Poultry
Public health
Reservoirs
Reservoirs (Water)
Risk analysis
Risk Factors
Risk management
Ruminants - microbiology
Sheep
Strains (organisms)
Studies
Swimming pools
Urban areas
Veterinary Science
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Description
Summary:Campylobacteriosis contributes strongly to the disease burden of food-borne pathogens. Case-control studies are limited in attributing human infections to the different reservoirs because they can only trace back to the points of exposure, which may not point to the original reservoirs because of cross-contamination. Human Campylobacter infections can be attributed to specific reservoirs by estimating the extent of subtype sharing between strains from humans and reservoirs using multilocus sequence typing (MLST). We investigated risk factors for human campylobacteriosis caused by Campylobacter strains attributed to different reservoirs. Sequence types (STs) were determined for 696 C. jejuni and 41 C. coli strains from endemic human cases included in a case-control study. The asymmetric island model, a population genetics approach for modeling Campylobacter evolution and transmission, attributed these cases to four putative animal reservoirs (chicken, cattle, sheep, pig) and to the environment (water, sand, wild birds) considered as a proxy for other unidentified reservoirs. Most cases were attributed to chicken (66%) and cattle (21%), identified as the main reservoirs in The Netherlands. Consuming chicken was a risk factor for campylobacteriosis caused by chicken-associated STs, whereas consuming beef and pork were protective. Risk factors for campylobacteriosis caused by ruminant-associated STs were contact with animals, barbecuing in non-urban areas, consumption of tripe, and never/seldom chicken consumption. Consuming game and swimming in a domestic swimming pool during springtime were risk factors for campylobacteriosis caused by environment-associated STs. Infections with chicken- and ruminant-associated STs were only partially explained by food-borne transmission; direct contact and environmental pathways were also important. This is the first case-control study in which risk factors for campylobacteriosis are investigated in relation to the attributed reservoirs based on MLST profiles. Combining epidemiological and source attribution data improved campylobacteriosis risk factor identification and characterization, generated hypotheses, and showed that genotype-based source attribution is epidemiologically sensible.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0042599