Epidemiology and Infection

Association between environmental risk factors and campylobacter infections in Sweden

a1 Swedish Institute for Infectious Disease Control, Stockholm, Sweden
a2 European Programme for Intervention Epidemiology Training, Sweden
a3 Norwegian Institute of Public Health and University of Oslo, Norway
a4 Institute for Hygiene and Public Health, University of Bonn, Germany

Article author query
nygard k   [PubMed][Google Scholar] 
andersson y   [PubMed][Google Scholar] 
rottingen j   [PubMed][Google Scholar] 
svensson a   [PubMed][Google Scholar] 
lindback j   [PubMed][Google Scholar] 
kistemann t   [PubMed][Google Scholar] 
giesecke j   [PubMed][Google Scholar] 


Campylobacter sp. is the most common cause of acute bacterial gastroenteritis in Sweden and the incidence has been increasing. Case-control studies to identify risk factors have been conducted in several countries, but much remains unexplained. The geographical distribution of campylobacter infections varies substantially, and many environmental factors may influence the observed pattern. Geographical Information Systems (GIS) offer an opportunity to use routinely available surveillance data to explore associations between potential environmental risk factors showing a geographical pattern and disease incidence, complementing traditional approaches for investigating risk factors for disease. We investigated associations between campylobacter incidence and environmental factors related to water and livestock in Sweden. Poisson regression was used to estimate the strength of the associations. Positive associations were found between campylobacter incidence and average water-pipe length per person, ruminant density, and a negative association with the percentage of the population receiving water from a public water supply. This indicates that drinking water and contamination from livestock may be important factors in explaining sporadic human campylobacteriosis in Sweden, and that contamination occurring in the water distribution system might be more important than previously considered.

(Accepted November 20 2003)

c1 Karin Nygård, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403 Oslo, Norway.