Abstract
BackgroundCampylobacteriosis is the most frequently reported food- and waterborne infection in Norway. We investigated the risk factors for sporadic Campylobacter infections in Norway in order to identify areas where control and prevention measures could be improved.MethodsA national prospective case-control study of factors associated with Campylobacter infection was conducted from July 2010 to September 2011. Cases were recruited from the Norwegian Surveillance System of Communicable Diseases (MSIS). Controls were randomly selected from the Norwegian Population Registry. Cases and controls were mailed a paper questionnaire with a prepaid return envelope. Univariable analyses using logistic regression were conducted for all exposures. A final parsimonious multivariable model was developed using regularized/penalized logistic regression, and adjusted odds ratios were calculated.ResultsA total of 995 cases and 1501 controls were included in the study (response proportion 55% and 30%, respectively). Exposures that had significant increases in odds of Campylobacter infection in multivariable analysis were drinking water directly from river, stream, or lake (OR: 2.96), drinking purchased bottled water (OR: 1.78), eating chicken (1.69), eating meat that was undercooked (OR: 1.77), eating food made on a barbecue (OR: 1.55), living on a farm with livestock (OR: 1.74), having a dog in the household (OR: 1.39), and having household water supply serving fewer than 20 houses (OR: 1.92).ConclusionsConsumption of poultry and untreated water remain important sources of Campylobacter infection in Norway, despite ongoing control efforts. The results justify the need for strengthening education for consumers and food handlers about the risks of cross-contamination when preparing poultry and with consuming raw or undercooked chicken. The public should also be reminded to take precautions when drinking untreated water in nature and ensure continued vigilance in order to protect and maintain the quality of water from small-scale water supply systems.
Highlights
Campylobacteriosis is the most frequently reported food- and waterborne infection in Norway, as well as many other European countries [1]
Exposures that had significant increases in odds of Campylobacter infection in multivariable analysis were drinking water directly from river, stream, or lake (OR: 2.96), drinking purchased bottled water (OR: 1.78), eating chicken (1.69), eating meat that was undercooked (OR: 1.77), eating food made on a barbecue (OR: 1.55), living on a farm with livestock (OR: 1.74), having a dog in the household (OR: 1.39), and having household water supply serving fewer than 20 houses (OR: 1.92)
Symptoms of campylobacteriosis are generally limited to abdominal pain and diarrhea for several days, sequelae including Guillain-Barré syndrome (GBS), reactive arthritis, and irritable bowel syndrome (IBS) can occur, causing considerable morbidity and economic impact [2]
Summary
Campylobacteriosis is the most frequently reported food- and waterborne infection in Norway, as well as many other European countries [1]. Between 1990 and 2001, the annual notification rates of Campylobacter infection in Norway via the Norwegian Surveillance System for Communicable Diseases (MSIS) increased substantially, peaking in 2001 at 65 cases per 100,000 population (Fig 1). Since 2001, the annual notification rates have continued to increase moderately, with between 2300 and 3000 cases reported annually, of which between 50 and 55% were associated with travel abroad. Up to one-third of cases of GBS, which has a case-fatality rate between 3% and 10% in high-income countries, have been attributed to Campylobacter infection. More than 35% of patients with campylobacteriosis have reported IBS within 1–2 years after infection. Campylobacteriosis is the most frequently reported food- and waterborne infection in Norway. We investigated the risk factors for sporadic Campylobacter infections in Norway in order to identify areas where control and prevention measures could be improved
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