Identifying the environmental drivers of Campylobacter infection risk in southern Ontario, Canada using a One Health approachs.

Abstract

Campylobacter bacteria infect both humans and animals. Sources of human exposure include contaminated food and water, contact with animals and/or their faeces, and contact with infected individuals. The objectives of this study were to: (a) identify environmental conditions associated with the occurrence of Campylobacter in humans in four regions of Ontario, and (b) identify pooled measures of effect across all four regions and potential sources of heterogeneity. To address objective 1, human Campylobacter cases from four health regions of Ontario, Canada were analysed using negative binomial regression and case cross-over analysis to identify relationships between environmental factors (temperature, precipitation and hydrology of the local watershed) and the risk of human infection. To address objective 2, meta-analytic models were used to explore pooled measures of effect and when appropriate, meta-regression models were used to explore potential sources of heterogeneity. Human incidence exhibited strong seasonality with cases peaking in the late spring and summer. There was a decreasing yearly effect in three of the four health regions. A significant pooled effect was found for mean temperature after a 1-week lag (OR=1.03, 95% CI 1.02, 1.04). No significant pooled effects were found for precipitation or water flow. However, increased precipitation was associated with lower odds of campylobacteriosis in Wellington and York regions at 2- and 3-week lags, respectively, from the case cross-over analysis. These results demonstrate that a climatic factor (specifically, mean temperature in the week prior) was associated with human case occurrence after a biologically plausible time period, but hydrologic factors are not.