A prospective study of acute diarrhoea was performed during 15 months 1981/1982 and included 731 patients and 240 controls. 43% had been infected abroad. A cluster of travellers with bacterial pathogens was diagnosed in July-August. The following pathogens were found: Campylobacter (18%), enterotoxigenic E. coli (6%), Salmonella spp. (5%), rotavirus (4%), Yersinia enterocolitica (3%), Giardia lamblia (3%), Shigella spp. (2%), Clostridium difficile (2%), enteroviruses (2%) and Entamoeba histolytica (less than 1%). More than 90% of the bacterial or parasitic enteropathogens were detected in the first stool sample. Only 10% of the patients needed hospital treatment and for 97% oral fluids were sufficient. The median duration of diarrhoea was 9 days. No fatal cases occurred and only 2 cases of chronic bowel disease were detected.
Campylobacteriosis is the most frequently reported zoonosis in the EU and the epidemiology of sporadic campylobacteriosis, especially the routes of transmission, is to a great extent unclear. Poultry easily become colonised with Campylobacter spp., being symptom-less intestinal carriers. Earlier it was estimated that internationally between 50% and 80% of the cases could be attributed to chicken as a reservoir. In a Norwegian surveillance programme all broiler flocks under 50 days of age were tested for Campylobacter spp. The aim of the current study was to identify simultaneous local space-time clusters each year from 2002 to 2007 for human cases of campylobacteriosis and for broiler flocks testing positive for Campylobacter spp. using a multivariate spatial scan statistic method. A cluster occurring simultaneously in humans and broilers could indicate the presence of common factors associated with the dissemination of Campylobacter spp. for both humans and broilers.
Local space-time clusters of humans and broilers positive for Campylobacter spp. occurring simultaneously were identified in all investigated years. All clusters but one were identified from May to August. Some municipalities were included in clusters all years.
The simultaneous occurrence of clusters of humans and broilers positive for Campylobacter spp. combined with the knowledge that poultry meat has a nation-wide distribution indicates that campylobacteriosis cases might also be caused by other risk factors than consumption and handling of poultry meat.Broiler farms that are positive could contaminate the environment with further spread to new broiler farms or to humans living in the area and local environmental factors, such as climate, might influence the spread of Campylobacter spp. in an area. Further studies to clarify the role of such factors are needed.
Cites: Appl Environ Microbiol. 2004 Dec;70(12):7474-8015574950
In this study comprising isolates from 2001 to 2003, resistance was considerably more widespread among Campylobacter jejuni from humans infected abroad than infected within Norway. The discrepancy was particularly notable for fluoroquinolone resistance (67.4% vs. 6.5%). This is probably a reflection of a low resistance prevalence in Norwegian broiler isolates (1.2% fluoroquinolone resistant).
This paper describes initial results from a research program that aims to gain greater understanding of sources of pathogens and the environmental factors that influence their survival and transport in watersheds. An additional goal is to enhance the ability to predict potential levels of pathogenic microorganisms arriving at drinking-water treatment plant intakes. The objectives will be supported by an intensive monitoring program examining the temporal and spatial variability of pathogens in a test watershed (the Grand River Watershed, Ontario). As many as 500,000 people potentially receive at least part of their drinking water from the Grand River. The watershed has significant urban and agricultural use. Sampling for total coliforms, fecal coliforms, Escherichia coli, Escherichia coli O157:H7, and Campylobacter spp. began in July 2002. Although presumptive tests were occasionally positive, no Escherichia coli O157:H7 or Campylobacter spp. were confirmed to be present in water samples taken. Escherichia coli O157:H7 was, however, detected in a tributary of the Grand River during an initial investigation. Preliminary results did not show any statistically significant differences between coliform concentrations upstream and downstream of wastewater treatment plants. Data suggest that nonpoint sources may have a greater effect on routine stream coliform concentrations.
Invasive disease as a result of Campylobacter is rarely reported. We reviewed 46 cases of blood stream infection with Campylobacter in a Danish population with complete follow-up. The incidence was 2.9 per 1 million person-years with a peak incidence in the age group above 80 years. In the population, the ratio of notified bacteraemia/enteritis patients with Campylobacter infection was 0.004. Patients with bacteraemia were older and had higher comorbidity, e.g. alcoholism, immunosuppression, previous gastrointestinal surgery or HIV infection. We found 26% of blood isolates resistant to ciprofloxacin. The length of hospitalization was significantly longer in bacteraemia patients, whereas the outcome was favourable with 28-day mortality of 4% in bacteraemia patients and 1% in enteritis patients. None of the bacteraemia patients relapsed within 365-day follow-up.
BACKGROUND: Denmark has in recent years experienced an increase in the number of bacterial gastrointestinal infections. METHODS: We have reviewed patients hospitalized with culture-confirmed bacterial gastroenteritis in Roskilde County during 1991-93. RESULTS: Two hundred and seven patients were included; 68 were children ( 38 degrees C), and 66% abdominal pain. Blood in stools was most frequent in patients infected with Campylobacter. Leukocytosis was rare. Twenty-four patients had bacteremia. Reactive arthritis occurred in 4.8%. Three patients died, all infected with zoonotic Salmonella types. Three stool cultures were made for 115 patients, and in 73% all 3 cultures were positive. CONCLUSIONS: Bacterial gastroenteritis requiring hospitalization affects mainly children and young adults. Infections due to zoonotic Salmonella types were more severe than Campylobacter and Y. enterocolitica gastroenteritis. It seems necessary to make at least three stool cultures to secure a bacteriologic diagnosis.
This study surveyed the presence of bacterial pathogens in eight Swedish sewage treatment plants (STPs), with four different treatment methods, focusing on detection of zoonotic bacteria in raw and treated sludge. Salmonella spp., Listeria monocytogenes, Campylobacter coli and jejuni, Escherichia coli O157 and indicator bacteria were investigated. Samplings were performed from July 2000 to June 2002, resulting in 64 raw sludge samples and 69 treated sludge samples. The samples from raw sludge (67%) and treated sludge (55%) were positive for Salmonella; 49 different serotypes were detected. Restriction enzyme analysis and pulsed field gel electrophoresis of Salmonella serotypes indicated that Salmonella persists in STPs and that there is a continuous supply of new strains. There are differences in treatment methods concerning the reduction of pathogens and indicator bacteria. If spread on arable land, sludge increases the environmental load of pathogens; this increases the risk for spreading diseases to people and animals.
Unlike most jurisdictions in the United States, Alaska performs pulsed-field gel electrophoresis (PFGE) characterization of all Campylobacter sp. isolates at the state public health laboratory--a practice that started in 2002. Moreover, in order to ensure early detection and response to campylobacteriosis outbreaks, the Alaska Section of Epidemiology has investigated all incident Campylobacter sp. case reports since 2004. This report summarizes the public health impact of routine incident case investigations and molecular characterization of all Campylobacter sp. isolates. In sum, we found that these efforts have contributed to better characterization of the epidemiology of campylobacteriosis in Alaska, and facilitated more rapid outbreak detection, more public health investigations, and earlier public health interventions.