Abstract
An annual increase in Campylobacter infection in England and Wales begins in May and reaches a maximum in early June. This increase occurs in all age groups and is seen in all geographic areas. Examination of risk factors that might explain this seasonal increase identifies flies as a potential source of infection. The observed pattern of infection is hypothesized to reflect an annual epidemic caused by direct or indirect contamination of people by small quantities of infected material carried by flies that have been in contact with feces. The local pattern of human illness appears random, while having a defined geographic and temporal distribution that is a function of the growth kinetics of one or more fly species. The hypothesis provides an explanation for the seasonal distribution of Campylobacter infections seen around the world.
Highlights
Bird-pecked milk is unlikely to be the cause of the worldwide seasonal seasonal changes in the inputs to the environment from bird feces and distribution of Campylobacter infections
The rarity of outbreaks associated with public water supplies suggests that drinking water is not a substantial source of Campylobacter infection
Illness associated with recreational water activity has not been established, and this is unlikely to be the source of the spring increase in campylobacteriosis
Summary
Chicken is the food most commonly contaminated with Campylobacter. Chicken is not the vehicle for most sporadic Campylobacter infections. Cross-contamination from raw meats to ready to eat foods within kitchens and retail premises probably contributes significantly to Campylobacter infection. No evidence shows that the seasonality of human disease is largely due to unpasteurized milk because this product is not commonly consumed. Bird-pecked milk is unlikely to be the cause of the worldwide seasonal seasonal changes in the inputs to the environment from bird feces and distribution of Campylobacter infections. Evidence from birds could be a seasonally changing driver to human disease (40). Barbecue use might be a contributing factor to the total Campylobacter Barbecue use on its own is unlikely a big enough, or seasonal enough, infection because standards of food safety associated with barbecue driver of disease to account for seasonal changes in incidence. Case-control studies have found associations between barbecue use and sporadic Campylobacter infection (44,45)
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