Abstract
BackgroundCampylobacter is a leading cause of foodborne illness in the United States. Campylobacter infections have been associated with individual risk factors, such as the consumption of poultry and raw milk. Recently, a Maryland-based study identified community socioeconomic and environmental factors that are also associated with campylobacteriosis rates. However, no previous studies have evaluated the association between community risk factors and campylobacteriosis rates across multiple U.S. states.MethodsWe obtained Campylobacter case data (2004–2010; n = 40,768) from the Foodborne Diseases Active Surveillance Network (FoodNet) and socioeconomic and environmental data from the 2010 Census of Population and Housing, the 2011 American Community Survey, and the 2007 U.S. Census of Agriculture. We linked data by zip code and derived incidence rate ratios using negative binomial regression models.ResultsCommunity socioeconomic and environmental factors were associated with both lower and higher campylobacteriosis rates. Zip codes with higher percentages of African Americans had lower rates of campylobacteriosis (incidence rate ratio [IRR]) = 0.972; 95 % confidence interval (CI) = 0.970,0.974). In Georgia, Maryland, and Tennessee, three leading broiler chicken producing states, zip codes with broiler operations had incidence rates that were 22 % (IRR = 1.22; 95 % CI = 1.03,1.43), 16 % (IRR = 1.16; 95 % CI = 0.99,1.37), and 35 % (IRR = 1.35; 95 % CI = 1.18,1.53) higher, respectively, than those of zip codes without broiler operations. In Minnesota and New York FoodNet counties, two top dairy producing areas, zip codes with dairy operations had significantly higher campylobacteriosis incidence rates (IRR = 1.37; 95 % CI = 1.22, 1.55; IRR = 1.19; 95 % CI = 1.04,1.36).ConclusionsCommunity socioeconomic and environmental factors are important to consider when evaluating the relationship between possible risk factors and Campylobacter infection.
Highlights
Campylobacter is a leading cause of foodborne illness in the United States
From 2004 to 2010, 40,768 cases of culture-confirmed Campylobacter infection were reported to Foodborne Diseases Active Surveillance Network (FoodNet)
Community socioeconomic factors In six of the 10 FoodNet sites, campylobacteriosis incidence rates were lower in zip codes with higher percentages of African Americans
Summary
Campylobacter is a leading cause of foodborne illness in the United States. Campylobacter infections have been associated with individual risk factors, such as the consumption of poultry and raw milk. No previous studies have evaluated the association between community risk factors and campylobacteriosis rates across multiple U.S states. An estimated 9.4 million domestically acquired foodborne illnesses, associated with 31 known pathogens, occur each year in the United States [1]. Campylobacter, a leading bacterial cause of these foodborne illnesses, is responsible for an estimated 1 million cases each year [1]. Current interventions to reduce the incidence of Campylobacter infection in the United States have focused on improving food safety by the development of poultry industry performance standards; yet, incidence rates in 2013 were higher than in 2006–2008 [8, 9]
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