Campylobacteriosis outbreaks in the state of Hesse, Germany, 2005-2011: Raw milk yet again
Campylobacter is the most frequently reported cause of acute infectious diarrhea in Germany. Campylobacter outbreaks are rare events. However, their investigation provides useful information on risks of infection and unused prevention potentials.
We analyzed the Hessian database for notifiable diseases for cases of campylobacteriosis reported from 2005 through 2011. For campylobacter outbreaks including five or more cases we prospectively obtained additional information from local public health authorities.
From 2005 through 2011, 29,473 cases of campylobacteriosis were reported in Hesse, Germany (approx. 6 million inhabitants), yielding an annual incidence ranging from 53.4 to 81.4 cases per 100,000 inhabitants. Only 236 cases were part of 16 outbreaks with five or more cases. Among these, six outbreaks occurred among groups traveling outside Germany, four were associated with the consumption of raw milk. For eight outbreaks consumption of poultry was considered a probable or - based on the frequent consumption of poultry during group travel - possible vehicle of infection. Two of the raw-milk associated outbreaks were reported among two groups who visited the same farm within 18 days. Five of 14 members of several families and 77 of 117 students fell sick. The local public health authority was only informed when both groups had visited the farm.
The reported outbreaks can be attributed to known risk factors for campylobacteriosis - consumption of raw milk and poultry and international travel. This underlines that prevention possibilities are insufficiently used. These include avoiding the consumption of unpasteurized milk and milk products, the hygienically correct handling of raw poultry and timely identification and notification of outbreaks to public health authorities.
Available from: Shanker Kumar Singh
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ABSTRACT: Abstract: Globally, Campylobacters have been reported as leading cause of gastroenteritis in man as well as animals and considered as emerging zoonotic problem particularly in developing countries including India. A cross-sectional study was conducted to know the prevalence and epidemiological determinants for Campylobacter spp. in dogs in and around Mathura city, Uttar Pradesh, India. Based on isolation, cultural and biochemical characterization of bacteria, the prevalence of Campylobacter spp. was 34.24%. Younger dogs (less than 1 year of age) were more likely to carry Campylobacter spp. High prevalence of Campylobacter spp. supports the hypothesis that dogs, particularly younger animals, may be an important source of Campylobacter infection for humans. Breed-wise prevalence showed that non-descript dogs (45.97%) were more likely to carry Campylobacter infections. Dogs showing clinical signs of gastroenteritis were showing higher prevalence (47.21%) in comparison to that of animals without gastro-intestinal disorders (15.04%). Out of 113 Campylobacter isolates of canine origin, two isolates were resistant to all the nineteen antibiotics used in the study, while all the isolates were resistant to Streptomycin, Ampicillin, Amoxycillin, Aztreonam, Lincomycin, Tetracyclin, Oxytetracyclin and Penicillin. A high rate of resistance was observed to Cefotaxim (97.35%), Peefloxacin (91.15%), Chloramphenicol (90.27%), Ofloxacin (84.07%), Ciprofloxacin (83.18%), Cefaclor (80.53%), Nitrofurazone (76.11%), Norfloxacin (74.33%), Gentamicin (42.48%), Amikacin (40.71%) and Enrofloxacin (36.28%). Our results indicate Amikacin and Gentamicin as drugs suitable for the treatment of campylobacteriosis in dogs.
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ABSTRACT: A quantitative risk assessment (RA) model was developed to describe the risk of campylobacteriosis linked to consumption of raw milk sold in vending machines in Italy. Exposure assessment was based on the official microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2011, microbial growth during storage, destruction experiments, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4 °C throughout all phases) and the worst time-temperature field handling conditions detected. Two separate RA models were developed, one for the consumption of boiled milk and the other for the consumption of raw milk, and two different dose-response (D–R) relationships were considered. The RA model predicted no human campylobacteriosis cases per year either in the best (4 °C) storage conditions or in the case of thermal abuse in case of boiling raw milk, whereas in case of raw milk consumption the annual estimated campylobacteriosis cases depend on the dose-response relationships used in the model (D–R I or D–R II), the milk time-temperature storage conditions, consumer behaviour and age of consumers, namely young (with two cut-off values of ≤5 or ≤6 years old for the sensitive population) versus adult consumers. The annual estimated cases for young consumers using D–R II for the sensitive population (≤5 years old) ranged between 1013.7/100,000 population and 8110.3/100,000 population and for adult consumers using D–R I between 79.4/100,000 population and 333.1/100,000 population. Quantification of the risks associated with raw milk consumption is necessary from a public health perspective and the proposed RA model represents a useful and flexible tool to perform future RAs based on local consumer habits to support decision-making on safety policies.
Available from: Si Ming Man
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ABSTRACT: Campylobacter jejuni infection is one of the most widespread infectious diseases of the last century. The incidence and prevalence of campylobacteriosis have increased in both developed and developing countries over the last 10 years. The dramatic increase in North America, Europe, and Australia is alarming, and data from parts of Africa, Asia, and the Middle East indicate that campylobacteriosis is endemic in these areas, especially in children. In addition to C. jejuni, there is increasing recognition of the clinical importance of emerging Campylobacter species, including Campylobacter concisus and Campylobacter ureolyticus. Poultry is a major reservoir and source of transmission of campylobacteriosis to humans. Other risk factors include consumption of animal products and water, contact with animals, and international travel. Strategic implementation of multifaceted biocontrol measures to reduce the transmission of this group of pathogens is paramount for public health. Overall, campylobacteriosis is still one of the most important infectious diseases that is likely to challenge global health in the years to come. This review provides a comprehensive overview of the global epidemiology, transmission, and clinical relevance of Campylobacter infection.
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