Outbreaks of campylobacteriosis in Australia, 2001 to 2006.
ABSTRACT The objective of this study was to examine the frequency of Campylobacter outbreaks in Australia and determine common transmission routes and vehicles. Summary and unit data on Campylobacter outbreaks that occurred between January 2001 and December 2006 were systematically collected and analyzed. Data from Campylobacter mandatory notifications for the same period were used for comparison. During the study period there were 33 Campylobacter outbreaks reported, affecting 457 persons. Of these, 147 (32%) had laboratory-confirmed infections, constituting 0.1% of notified Campylobacter cases. Campylobacter outbreaks most commonly occurred during the Australian Spring (September to November; n = 14, 45%), when notifications generally peaked. Transmission was predominantly foodborne or suspected foodborne (n = 27, 82%), commercial settings (n = 15, 55%) being most commonly involved. There were eight foodborne outbreaks (30%) attributed to food prepared or eaten at institutions; four (15%) at aged care facilities and three (11%) at school camps. A vehicle or suspected vehicle was determined for 16 (59%) foodborne outbreaks; poultry (chicken or duck) was associated with 11 (41%) of these, unpasteurized milk and salad were associated with two outbreaks each. Three potential waterborne outbreaks were detected, and one was due to person-to-person transmission. Campylobacter outbreaks were more commonly detected during this study period compared to a previous 6-year period (n = 9) when prospective recording of information was not undertaken. However, outbreak cases continue to constitute a very small proportion of notifications. Improved recognition through subtyping is required to enhance outbreak detection and investigation so as to aid policy formulation for prevention of infection. In addition to detection of chicken as a common source of outbreaks, these data highlight the importance of directing policy at commercial premises, aged care facilities, and school camps to reduce Campylobacter disease burden.
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ABSTRACT: SUMMARY A retrospective cohort study was performed following several reported cases of gastrointestinal illness after a catered event. The attack rate was 45/77 (58·4%) by clinical case definition, with four individuals confirmed to have Campylobacter. There was near universal exposure to most foodstuffs served; consumption of duck liver pâté [relative risk (RR) 2·53, 95% confidence interval (CI) 1·05-6·10], mixed leaf salad (RR 2·91, 95% CI 1·22-6·92) and table water (RR undefined, P < 0·01) were associated with illness in univariate analysis, with only the latter associated in the final multivariable model (P < 0·001). Samples of cooked duck liver pâté subsequently prepared using identical methods at the venue were contaminated with Campylobacter jejuni and C. coli; water sampling was negative. Making inferences about causation in the presence of near universal exposures in this study required consideration of the limitations of statistical analysis, with the most compelling evidence of the causal role of inadequately prepared duck liver pâté provided by environmental investigation.Epidemiology and Infection 08/2013; · 2.49 Impact Factor
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ABSTRACT: In July 2012, an outbreak of Campylobacter infection was investigated by the South Australian Communicable Disease Control Branch and Food Policy and Programs Branch. The initial notification identified illness at a surprise birthday party held at a restaurant on 14 July 2012. The objective of the investigation was to identify the potential source of infection and institute appropriate intervention strategies to prevent further illness. A guest list was obtained and a retrospective cohort study undertaken. A combination of paper-based and telephone questionnaires were used to collect exposure and outcome information. An environmental investigation was conducted by Food Policy and Programs Branch at the implicated premises. All 57 guests completed the questionnaire (100% response rate), and 15 met the case definition. Analysis showed a significant association between illness and consumption of chicken liver pâté (relative risk: 16.7, 95% confidence interval: 2.4-118.6). No other food or beverage served at the party was associated with illness. Three guests submitted stool samples; all were positive for Campylobacter. The environmental investigation identified that the cooking process used in the preparation of chicken liver pâté may have been inconsistent, resulting in some portions not cooked adequately to inactivate potential Campylobacter contamination. Chicken liver products are a known source of Campylobacter infection; therefore, education of food handlers remains a high priority. To better identify outbreaks among the large number of Campylobacter notifications, routine typing of Campylobacter isolates is recommended.Western Pacific surveillance and response journal : WPSAR. 10/2012; 3(4):16-9.
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ABSTRACT: Campylobacter is a food-borne zoonotic pathogen that causes human gastroenteritis worldwide. These bacteria are commensal in the intestine of many food production animals including duck and chickens. The objective of the study was to determine the prevalence of Campylobacter species in domestic ducks and the agar dilution method was used to determine resistance of the isolates to eight antibiotics. In addition, multilocus sequence typing (MLST) was performed to determine the sequence types (STs) of selected Campylobacter isolates. Between May and September 2012, 58 duck farms were analyzed and 56 (96.6%) were positive for Campylobacter. Among the isolates, 82.1% were C. jejuni, 16.1% were C. coli, and one was unidentified by PCR. Of the 46 C. jejuni isolates, 87.0%, 10.9%, and 21.7% were resistant to ciprofloxacin, erythromycin, and azithromycin, respectively. Among the C. coli isolates, all 9 strains were resistant to ampicillin, 77.8% and 33.3% were resistant to ciprofloxacin and azithromycin. The majority of the Campylobacter isolates were classified as multi-drug resistant. Twenty-eight STs were identified, 20 STs for C. jejuni and 8 STs for C. coli, respectively. The most common clonal complexes in C. jejuni were the ST-21 complex and ST-45 complex, while ST-828 complex, predominated in C. coli. The majority of isolates were of STs noted in ducks and humans from earlier studies, along with seven STs previously only associated with human disease. These STs overlapped between duck and human isolates, indicating that Campylobacter isolates from ducks should be considered potential sources of human infection.Applied and Environmental Microbiology 09/2014; · 3.95 Impact Factor