Epidemiology and Infection



The study of infectious intestinal disease in England: risk factors for cases of infectious intestinal disease with Campylobacter jejuni infection


L. C.  RODRIGUES  a1 c1, J. M.  COWDEN  a2, J. G.  WHEELER  a1, D.  SETHI  a1, P. G.  WALL  a3, P.  CUMBERLAND  a1, D. S.  TOMPKINS  a4, M. J.  HUDSON  a5, J. A.  ROBERTS  a1 and P. J.  RODERICK  a6 1
a1 London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT
a2 Scottish Centre for Infection and Environmental Health
a3 Food Safety Authority of Ireland
a4 Leeds Public Health Laboratory
a5 Centre for Applied Microbiology and Research (CAMR), Salisbury
a6 Southampton University

Abstract

This is a case-control study aimed at identifying risk factors for intestinal infection with Campylobacter jejuni. Cases were defined as subjects with diarrhoea occurring in community cohorts or presenting to General Practitioners (GPs) with Campylobacter jejuni in stools. Controls were selected from GP lists or cohorts, matched by age, sex, and GP practice. Travel abroad and consumption of chicken in a restaurant were statistically significantly associated with being a case. There was no statistically significant risk associated with consumption of chicken other than in restaurants nor with reported domestic kitchen hygiene practices. Consumption of some foods was associated with a lower risk of being a case. Most cases remained unexplained. We suggest that infection with low numbers of micro-organisms, and individual susceptibility may play a greater role in the causation of campylobacter infection than previously thought. It is possible that in mild, sporadic cases infection may result from cross contamination from kitchen hygiene practices usually regarded as acceptable. Chicken may be a less important vehicle of infection for sporadic cases than for outbreaks, although its role as a source of infection in both settings requires further clarification in particular in relation to the effect of domestic hygiene practices. The potential effect of diet in reducing the risk of campylobacteriosis requires exploration.

(Accepted June 20 2001)


Correspondence:
c1 Author for correspondence.


Footnotes

1 On behalf of the IID Study Executive, whose membership included: J. S. Brazier, M. M. Brett, D. Brennan, W. Browne, P. E. Cook, J. M. Cowden, P. Cumberland, R. P. Eglin, N. Fasey, S. Gordon-Brown, P. Hayes, M. J. Hudson, V. King, J. M. Kramer, J. Martin, C. Olohan-Bramley, R. J. Owen, J. A. Roberts, P. J. Roderick, L. C. Rodrigues, B. Rowe, D. Sethi, H. R. Smith, M. T. Skinner, R. Skinner, P. N. Sockett, D. S. Tompkins, P. G. Wall, J. G. Wheeler, A. L. Wight.



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