Fresh chicken as main risk factor for campylobacteriosis, Denmark.We report the findings of a case-control study case-control study, n an investigation employing an epidemiologic approach in which previously existing incidents of a medical condition are used in lieu of gathering new information from a randomized population. of risk factors for sporadic sporadic /spo·rad·ic/ (spo-rad´ic) occurring singly; widely scattered; not epidemic or endemic. spo·rad·ic or spo·rad·i·cal adj. 1. Occurring at irregular intervals. 2. cases of human campylobacteriosis in Denmark. In 3 different analytical analytical, analytic pertaining to or emanating from analysis. analytical control control of confounding by analysis of the results of a trial or test. models, the main domestic risk factor identified was eating fresh, unfrozen chicken. Specifically, 28 of 74 domestically acquired case-patients were exposed to fresh chicken compared with 21 of 114 controls (multivariate The use of multiple variables in a forecasting model. matched odds ratio 5.8; 95% confidence interval confidence interval, n a statistical device used to determine the range within which an acceptable datum would fall. Confidence intervals are usually expressed in percentages, typically 95% or 99%. 2.1-15.9). In contrast, a risk from eating other poultry poultry, domesticated fowl kept primarily for meat and eggs; including birds of the order Galliformes, e.g., the chicken, turkey, guinea fowl, pheasant, quail, and peacock; and natatorial (swimming) birds, e.g., the duck and goose. , including previously frozen chicken, was only indicated from borderline borderline /bor·der·line/ (-lin) of a phenomenon, straddling the dividing line between two categories. borderline significant 2-factor interactions. The marked increase in consumption of fresh, unfrozen poultry in Denmark during the 1990s likely contributed substantially to the increasing incidence of human campylobacteriosis in this period. ********** Campylobacter Campylobacter Genus of gram-negative spiral-shaped bacteria infecting mammals. Many species, especially C. fetus, cause miscarriage in sheep and cattle. C. jejuni is a common cause of food poisoning. Sources include meats (particularly chicken) and unpasteurized milk. spp. are the most common cause of acute bacterial gastroenteritis
Bacterial gastroenteritis is an inflammation of the stomach and intestines caused by bacteria or bacterial toxins. in industrialized in·dus·tri·al·ize v. in·dus·tri·al·ized, in·dus·tri·al·iz·ing, in·dus·tri·al·iz·es v.tr. 1. To develop industry in (a country or society, for example). 2. countries. Although rarely fatal, Campylobacter infections cause considerable illness and loss of productivity and may be associated with severe disabling dis·a·ble tr.v. dis·a·bled, dis·a·bling, dis·a·bles 1. To deprive of capability or effectiveness, especially to impair the physical abilities of. 2. Law To render legally disqualified. consequences, including arthritis and demyelinating disease de·my·e·lin·at·ing disease n. Any of a group of diseases of unknown cause in which there is extensive loss of the myelin sheaths of nerve fibers, as in multiple sclerosis. (Guillain-Barre syndrome Guil·lain-Bar·ré syndrome n. See acute idiopathic polyneuritis. ) (1). Denmark is among a limited number of countries worldwide with comprehensive national laboratory-based surveillance of human campylobacteriosis. Denmark, like several other industrialized countries, has recorded a marked increase in the incidence of human campylobacteriosis. From 1980 to 2001 the incidence quadrupled, reaching 86 cases per 100,000 inhabitants
The game is based loosely on the concepts from SameGame. in 2001 (Figure). Most persons who contract Campylobacter infections are not part of recognized outbreaks. Risk factors for sporadic Campylobacter infections have been investigated in United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , Canada, Australia, New Zealand New Zealand (zē`lənd), island country (2005 est. pop. 4,035,000), 104,454 sq mi (270,534 sq km), in the S Pacific Ocean, over 1,000 mi (1,600 km) SE of Australia. The capital is Wellington; the largest city and leading port is Auckland. , and Europe (including Denmark) within the last 20 years (2-7). Most studies have identified consumption of poultry and poultry products as risk factors. Other domestic risk factors include drinking untreated water; consuming raw or unpasteurized Adj. 1. unpasteurized - not having undergone pasteurization unpasteurised milk; handling and cooking food, particularly raw meat, in relation to barbecuing bar·be·cue n. 1. A grill, pit, or outdoor fireplace for roasting meat. 2. a. A whole animal carcass or section thereof roasted or broiled over an open fire or on a spit. b. ; and having contact with food-producing animals food-producing animals see food animals. and pets. Although the findings from these studies have provided insight to the epidemiology epidemiology, field of medicine concerned with the study of epidemics, outbreaks of disease that affect large numbers of people. Epidemiologists, using sophisticated statistical analyses, field investigations, and complex laboratory techniques, investigate the cause of Campylobacter infections, our understanding is still incomplete. The relative importance of the different sources is not well known, and in many countries, no clear explanation for the increasing incidence of Campylobacter infections has been determined. Recent experience from Iceland has pointed to an increased consumption of fresh versus frozen poultry as a potential explanation for the increasing disease incidence (8). The first case-control study of risk factors for human campylobacteriosis in Denmark (6) did not distinguish clearly between fresh and previously frozen poultry meat. Several factors, for example, consuming undercooked poultry, but not handling and consuming poultry in general, were risks for human campylobacteriosis. Thawing poultry was found to be protective in this study, which might indirectly indicate that fresh, not frozen, poultry was the main poultry-associated risk factor (6). We report the findings of a second case-control study of risk factors for sporadic human campylobacteriosis in Denmark. In this study, unlike the earlier study, we made a clear distinction in the questionnaire between exposure to fresh, unfrozen meat and exposure to previously frozen meat so we could independently assess the risk of the 2 different categories. Materials and Methods From October 2000 to September 2001, the second case-control study on acute sporadic human campylobacteriosis was conducted in Denmark. Participation in the study was voluntary and required written consent. Three groups were interviewed (computer-aided telephone interviews). The first included campylobacteriosis (CB) patients: persons with laboratory-confirmed campylobacteriosis. The second included healthy controls matched to CB patients by age, sex, and geography (6 controls per CB patient were randomly selected through the Danish Civil Registry The examples and perspective in this article or section may not represent a worldwide view of the subject. Please [ improve this article] or discuss the issue on the talk page. In many countries, vital events (eg. system after receipt of a signed consent form from a CB patient). Eligible controls received a questionnaire and a consent form by mail. The time between disease onset for the CB patient and the time of interview of controls was sought diminished di·min·ish v. di·min·ished, di·min·ish·ing, di·min·ish·es v.tr. 1. a. To make smaller or less or to cause to appear so. b. (mean 27 days). The third group included non-CB bacterial gastroenteritis patients (non-CB controls): patients whose specimens were culture-positive for other zoonotic Zoonotic A disease which can be spread from animals to humans. Mentioned in: Zoonosis bacterial infections (mainly Salmonella salmonella Any of the rod-shaped, gram-negative, non-oxygen-requiring bacteria that make up the genus Salmonella. Their main habitat is the intestinal tract of humans and other animals. spp.). Twice a week, 2-4 CB patients and 3 non-CB patients per CB patient were selected in 6 of 16 Danish counties among patients identified the previous week. An approximate match of non-CB controls to CB patients by onset date was obtained (mean 5 days apart). Children < 1 year of age were omitted. Recruitment of patients increased during summer when the incidence was higher. A total of 272 persons with Campylobacter infection, 786 non-CB controls, and 2,403 healthy controls were invited for the study. The response rates were 50% for CB cases and non-CB controls and 22% for the healthy controls, respectively. The questionnaire sought data on the following subjects: symptoms; other diseases; use of medications; use of vitamins; consumption of meat (including type, storing [frozen vs. not frozen], and handling); use of barbecue barbecue [West Indian or South American], in the United States, traditionally an open-air gathering, political or social, in which meats are roasted whole over a pit of embers and food and drink are liberally enjoyed. grill; consumption of rice and pasta While the only basic difference between these names is the shape of the pasta, each pasta is typically matched with a particular sauce based on cooking time, consistency, ability to hold sauce, ease of eating, etc. , fruit, vegetables, cereals, bread, milk, milk products, spices and herbs, and organic products; cooking; kitchen hygiene; vacation or travel experiences; contact with ill persons; information on drinking water drinking water supply of water available to animals for drinking supplied via nipples, in troughs, dams, ponds and larger natural water sources; an insufficient supply leads to dehydration; it can be the source of infection, e.g. leptospirosis, salmonellosis, or of poisoning, e.g. , swimming, household, place of residence, and whether a summer house was used; and respondent's occupation, hobbies It may never be fully completed or, depending on its its nature, it may be that it can never be completed. However, new and revised entries in the list are always welcome. This is a list of hobbies. , and socioeconomic so·ci·o·ec·o·nom·ic adj. Of or involving both social and economic factors. socioeconomic Adjective of or involving economic and social factors Adj. 1. data. More than 350 original or recoded variables were tested in the analysis. Three analyses were conducted: A) 107 CB patients versus 178 matched healthy controls (including travel-related cases); B) 74 CB patients (domestically acquired only) versus 114 matched healthy controls; and C) 141 CB patients versus 386 non-CB controls matched to patients only on time of disease onset. Initially, variables in analyses A and B were tested by univariate conditional logistic regression In statistics, logistic regression is a regression model for binomially distributed response/dependent variables. It is useful for modeling the probability of an event occurring as a function of other factors. (PROC (language) PROC - The job control language used in the Pick operating system. ["Exploring the Pick Operating System", J.E. Sisk et al, Hayden 1986]. PHREG, SAS Institute SAS Institute Inc., headquartered in Cary, North Carolina, USA, has been a major producer of software since it was founded in 1976 by Anthony Barr, James Goodnight, John Sall and Jane Helwig. , Cary, NC, USA [9]). Variables with [P.sub.(univariate)] [less than or equal to] 0.30 and other relevant variables were selected for multivariate conditional logistic regression analysis. Variables with p<0.01 were kept in the final models. In analysis B, 2-factor interactions between variables in final model, match variables, and other interactions relevant to the hypotheses were tested; the population attributable risk attributable risk Epidemiology Any factor which ↑ the risk of suffering a particular condition. See Relative risk, Risk factor. Cf Nonattributable risk Statistics The rate of a disorder in exposed subjects that is attributable to the exposure derived from (PAR) was then estimated (10). In analysis C, univariate logistic regression (PROC GENMOD, SAS Institute [9]) was used for screening of effect of variables. Effect modification effect modification Epidemiology An interaction among multiple possible cause-and-effect relationships, where the estimate of the effect of one factor on a disease process depends on other factors in the study of covariates (age, sex, geography, and season) was tested in analysis C. As the modifying effect was negligible  This article or section is written like a personal reflection or and may require .Please [ improve this article] by rewriting this article or section in an . , the results from analyses without covariates is presented (Table 1). Results Analysis A (full dataset) identified that travel to southern Europe Southern Europe or sometimes Mediterranean Europe is a region of the European continent. There is no clear definition of the term which can vary depending on whether geographic, cultural, linguistic or historical factors are taken into account. (odds ratio [OR] 15.81) and outside Europe (16/107 patients exposed vs. 1/178 controls) was associated with Campylobacter infection, whereas travel to other parts of Europe was more common in controls than in patients (OR 0.068). Other risk factors identified in analysis A are listed in Tables 1 and 2. Analysis B (domestic cases only) identified eating chicken, bought fresh and not frozen in the home, to be the only significant risk factor for campylobacteriosis (OR 5.80). Some exposures, including pork prepared in large pieces (OR 0.15), eating apples or pears (OR 0.21), eating raw vegetables daily (OR 0.24), and days off (besides weekends) in the week before onset (OR 0.23) were more common in controls than patients (p<0.01). Analysis C (CB vs. non-CB patients) found that, among the variables with p<0.05 in analysis A or B, only eating chicken, bought fresh and not frozen in the home, was significantly more associated with Campylobacter infections than with other bacterial gastrointestinal infections. Contrary to this finding, travel to central and northern Europe and eating pork prepared in large pieces were less associated with Campylobacter infection than with other infections. The domestic PAR from chicken bought unfrozen was 23.8% (95% confidence interval 7.98-52.9). Only in model B (domestic patients) were 2-factor interactions examined. The risk from fresh chicken was significantly increased (p<0.05) in summer (vs. winter) and when preparing whole chicken (vs. cuts). The risk was reduced (p<0.05) by frequently eating fruits, raw vegetables, high-fiber cereals, vitamins (p = 0.050), and acidified acidified /acid·i·fied/ (ah-sid´i-fid) having been made acid. milk products (p = 0.070). Eating turkey bought fresh and chicken in general interacted borderline significantly with season (chicken: higher risk in summer [p = 0.078], turkey: higher risk in winter [p = 0.056]). A borderline significant interaction between risk from chicken cuts and barbecuing was found (p = 0.0502). Finally, the apparent protection from eating apples or pears was stronger in the cold season (p = 0.043). Discussion and Conclusion We found that the main domestic risk factor for campylobacteriosis is eating chicken meat that is bought fresh and subsequently not frozen in the home. Eating other poultry meat products and eating previously frozen chicken meat were borderline significant risk factors. Adding the case-case approach to the risk factor study (CB patients vs. non-CB patients) was expected to highlight risk factors or potentially protective factors, which are specific for campylobacteriosis. Only exposure to unfrozen chicken remained a significant risk factor for campylobacteriosis in the case-case study. The study findings strongly support the contribution of fresh poultry specifically as a source of human campylobacteriosis. In contrast, true common factors for both case groups were expected to be reduced or disappear. Also the apparent effect of factors associated with willingness to participate as a control in the case-control studies was expected to be eliminated. Several significant risk factors from the case-control studies were insignificant or markedly reduced in the case-case study (e.g., apparently protective factors [certain fruits and vegetables] and risk factors [travel, certain types of bread, and fresh turkey]). The results of the present study are consistent with the hypothesis that a marked increase in the consumption of fresh chicken has been a major driving force behind the increasing incidence of human campylobacteriosis in Denmark during the 1990s. Bacteriologic bac·te·ri·ol·o·gy n. The study of bacteria, especially in relation to medicine and agriculture. bac·te investigation of fresh and frozen chicken collected at retail outlets retail outlet n → punto de venta retail outlet n → point m de vente retail outlet retail n → in Denmark has shown that the number of viable Campylobacter bacteria in fresh samples exceeds that of previously frozen chicken. In a survey of chicken meat in retail stores, 194 (79.8%) of 243 samples of frozen chicken harbored <0.4 thermophilic ther·mo·phil·ic adj. Requiring high temperatures for normal development, as certain bacteria. Campylobacter bacteria per gram, whereas 134 (46.4%) of 289 samples of fresh chicken were below this level (11). This result is because the freezing process reduces the number of viable Campylobacter organisms Organisms See also animals; bacteria; biology; plants; zoology. anabolism Biology, Physiology. the synthesis in living organisms of more complex substances from simpler ones. Cf. catabolism. — anabolic, adj. . In the 1990s, the national consumption of poultry meat increased by [approximately equal to] 40% (1991: 63,900 tons, 1998: 93,200 tons) (12). The increase was observed for almost all types of chicken and turkey products but most markedly in fresh cuts. In the same period, the incidence of campylobacteriosis increased by >400%, from 20 to 86 cases per 100,000 inhabitants. The bacteriologic data, which show higher loads of Campylobacter in fresh poultry, suggest that the exposures to Campylobacter spp. have increased much more than the general increase in poultry consumption and thus explains why the increase in human disease incidence has exceeded the increase in poultry consumption. The Danish broiler broiler a young (about 8 weeks old) male or female chicken weighing 3 to 3.5 lb. industry, in collaboration with governmental institutions, introduced a voluntary control program in 2002-2003, whereby among other initiatives, flocks of chicken are tested for Campylobacter spp. immediately before slaughter slaughter 1. the killing of animals for the preparation of meat for human consumption. Many methods are used. See also emergency slaughter, captive bolt pistol, carbon dioxide anesthesia, jewish slaughter, muslim slaughter, pithing, puntilla, shechita, sikh slaughter. 2. (13). Positive flocks are, to the extent that doing so is logistically feasible, used to produce frozen products, whereas Campylobacter-free flocks are primarily used to produce fresh chicken. In the winter, the prevalence of Campylobacter-free flocks is sufficiently elevated to enable a near complete separation, but in the summer, when the flock flock 1. a group of one species of animal or bird which eats or travels or is kept together, e.g. flock of sheep, of wild geese. 2. wool or cotton particles or debris used as stuffing or packing. prevalence is high, Campylobacter-positive flocks are also included in the fresh product line to some extent. In 2002, the incidence of human campylobacteriosis dropped 5% from the year before and in 2003 another 19%, possibly as a result of the control program (Figure). Thus, the program appears to have a positive effect, which lends further support to the hypothesis. In conclusion, the results of this study support the hypothesis that fresh chicken is the main risk factor for domestically acquired campylobacteriosis in Denmark. This risk is significantly increased in the summer, when the incidence of infected in·fect tr.v. in·fect·ed, in·fect·ing, in·fects 1. To contaminate with a pathogenic microorganism or agent. 2. To communicate a pathogen or disease to. 3. To invade and produce infection in. broiler flocks peak, and when whole chickens are prepared. Travel to southern Europe and travel outside Europe, respectively, were also significant risk factors. The marked increase in consumption of fresh poultry during the 1990s may explain, at least in part, the increased incidence of human campylobacteriosis in Denmark in this period. Reference (1.) Friedman CR, Neimann J, Wegener HC, Tauxe RV. Epidemiology of Campylobacter jejuni Campylobacter jejuni Vibrio jejuni, Campylobacter fetus ssp jejuni A curved or spiral gram-negative bacillus with a single polar flagellum Epidemiology Linked to contact with domestic and farm animals, unpasteurized milk, primates, day care infections in the United States and other industrialized nations. In: Nachamkin I, Blaser MJ, editors. Campylobacter. Washington: American Society for Microbiology The American Society for Microbiology (ASM) is a scientific organization, based in the United States although with over 43,000 members throughout the world. It is the largest single life science professional organization and its members include those whose interests encompass basic ; 2000. p. 121-38. (2.) Eberhart-Phillips J, Walker N, Garrett N, Bell D, Sinclair D, Rainger W, et al. Campylobacteriosis in New Zealand: results of a case-control study. J Epidemiol Community Health. 1997;51:686-91. (3.) Friedman CR, Hoekstra RM, Samuel M, Marcus R, Bender J, Shiferaw C, et al. Risk factors for sporadic Campylobacter infection in the United States: a case-control study in FoodNet Sites. Clin Infect infect /in·fect/ (in-fekt´) 1. to invade and produce infection in. 2. to transmit a pathogen or disease to. in·fect v. 1. Dis. 2004;38(Suppl 3):S285-96. (4.) Kapperud G, Espeland G, Wahl E, Walde A, Herikstad H, Gustavsen S, et al. Factors associated with increased and decreased risk of Campylobacter infection: a prospective case-control study in Norway. Am J Epidemiol. 2003;158:234-42. (5.) Michaud S Michaud is a surname, and may refer to:
This page or section lists people with the surname Michaud. , Menard S Menard is the name of several places in the United States:
(6.) Neimann J, Engberg J, Molbak K, Wegener HC. A case-control study of risk factors for sporadic Campylobacter infections in Denmark. Epidemiol Infect. 2003;130:353-66. (7.) Tenkate TD, Stafford RJ. Risk factors for Campylobacter infection in infants and young children: a matched case-control study. Epidemiol Infect. 2001;127:399-404. (8.) Stem NJ, Hiett KL, Alfredsson GA, Kristinsson KG, Reiersen J, Hardardottir H, et al. Campylobacter spp. in Icelandic poultry operations and human disease. Epidemiol infect. 2003;130:23-32. (9.) SAS (1) (SAS Institute Inc., Cary, NC, www.sas.com) A software company that specializes in data warehousing and decision support software based on the SAS System. Founded in 1976, SAS is one of the world's largest privately held software companies. See SAS System. version 8. Cary (NC): SAS Institute Inc; 1999. (10.) Coughlin SS, Benichou J, Weed DL. Attributable risk estimation estimation In mathematics, use of a function or formula to derive a solution or make a prediction. Unlike approximation, it has precise connotations. In statistics, for example, it connotes the careful selection and testing of a function called an estimator. in case-control studies. Epidemiol Rev. 1994;16:51-64. (11.) Annual report on zoonoses Zoonoses Infections of humans caused by the transmission of disease agents that naturally live in animals. People become infected when they unwittingly intrude into the life cycle of the disease agent and become unnatural hosts. in Denmark 2002. Danish Ministry of Food, Agriculture and Fisheries fisheries. From earliest times and in practically all countries, fisheries have been of industrial and commercial importance. In the large N Atlantic fishing grounds off Newfoundland and Labrador, for example, European and North American fishing fleets have long [cited 2 Jan 2006]. Available from http://www.dfvf.dk/Files/Filer/Zoonosecentret/Publikationer/ Annual%20Report/Annual Report_2002_fra_Datagraf.pdf 12. Agricultural Statistics, 1991-1998. Statistics Denmark Statistics Denmark (Danish: Danmarks Statistik) is a Danish governmental organization under the Ministry of Economic and Business Affairs. The organization is responsible for creating statistics on the Danish society, for example employment statistics, trade balance, and : Copenhagen, 1999. (13.) Annual report on zoonoses in Denmark 2003. Danish Ministry of Food, Agriculture and Fisheries [cited 2 Jan 2006]. Available from http://www.dfvf.dk/ files/filer/zoonosecentret/publikationer/annual%20report/ annual_report_2003-endelig.pdf Anne Wingstrand, * Jakob Neimann, * (1) Jorgen Engberg, ([dagger]) Eva Moller Nielsen, * ([dagger]) Peter Gerner-Smidt, ([dagger]) (2) Henrik C. Wegener, * and Kare Molbak ([dagger]) * Danish Institute for Food and Veterinary Research, Copenhagen, Denmark; and ([dagger]) Statens Serum Institut Statens Serum Institut (English: the State Serum Institute), or SSI for short, is a Danish sector research institute located on the island of Amager in Copenhagen. , Copenhagen, Denmark (1) Current affiliation: Danisco Sugars, Copenhagen, Denmark (2) Current affiliation: Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. , Atlanta, Georgia, USA Address for correspondence: Anne Wingstrand, Danish Institute for Food and Veterinary Research, Morkhoj Bygade 19, 2860 Soborg, Denmark; fax: 45-7234-7028; email: awg@dfvf.dk Dr Wingstrand is currently a senior research epidemiologist epidemiologist an expert in epidemiology. at the Department of Epidemiology and Risk Assessment, Danish Institute for Food and Veterinary Research. Her main area of research is the epidemiology of foodborne zoonoses in the farm-to-fork continuum.
Table 1. Risk factors obtained from 3 analytic approaches for sporadic
campylobacteriosis (CB) in Denmark, 2000-2001 *
Analysis A ([double dagger])
([section]): 107 CB patients
vs. 178 matched controls
(multivariate model),
Variables ([dagger]) OR (95% CI), p
Travel (14 d)
Southern Europe 15.81 ** (2.63-94.9), 0.003
Europe, other 0.068 ** (0.007-0.64), 0.019
Outside Europe 16/107 CB, 1/178 controls, **
infinite
Holiday other than weekend 0.37 (0.13-1.09), 0.072
Chicken bought unfrozen 6.03 ** (2.17-16.80), 0.0006
Turkey ([dagger][dagger]) 0.047 ** (0.004-0.51), 0.012
Turkey bought fresh 61.1 ** (4.35-857.6), 0.002
Minced beef/veal 0.30 (0.065-1.36), 0.12
at barbecue
Pork prepared in large pieces 0.10 ** (0.028-0.37), 0.0005
Any white bread without bran 2.55 (0.92-7.08), 0.072
or grains last month
White bread with bran or 4.54 ** (1.83-11.23), 0.001
grains >5 times/mo
Apples and pears 0.12 ** (0.034-0.40), 0.0007
Strawberries ([double dagger] 0.22 ** (0.069-0.72), 0.012
[double dagger])
Raw vegetables daily 0.16 ** (0.051-0.51), 0.002
Chives (fresh) 1.94 (0.76-4.95), 0.17
Urban residency 0.17 ** (0.050-0.58), 0.004
Tap water from 4.68 (1.11-19.8), 0.036
summerhouse
Analysis B ([section]) ([paragraph]):
74 Domestic CB patients vs. 114
matched controls (multivariate
Variables ([dagger]) model), OR (95% CI), p
Travel (14 d)
Southern Europe --
Europe, other --
Outside Europe --
Holiday other than weekend 0.23 ** (0.083-0.64), 0.005
Chicken bought unfrozen 5.80 ** (2.11-15.93), 0.0006
Turkey ([dagger][dagger]) 1.40 (0.59-3.34), 0.45
Turkey bought fresh 1.75 (0.62-4.93), 0.29
Minced beef/veal 0.12 (0.018-0.74), 0.022
at barbecue
Pork prepared in large pieces 0.15 ** (0.046-0.49), 0.002
Any white bread without bran 3.21 (1.15-8.94), 0.026
or grains last month
White bread with bran or 3.10 (1.30-7.35), 0.0105
grains >5 times/mo
Apples and pears 0.21 ** (0.07-0.61), 0.004
Strawberries ([double dagger] 1.69 (0.60-4.80), 0.32
[double dagger])
Raw vegetables daily 0.24 ** (0.082-0.71), 0.0099
Chives (fresh) 2.78 (1.10-6.99), 0.030
Urban residency 0.25 (0.074-0.85), 0.027
Tap water from 3.00 (0.80-11.3), 0.10
summerhouse
Analysis C (#): 141 CB patients
vs. 386 non-CB controls
(univariate analysis),
Variables ([dagger]) OR (95% CI), p
Travel (14 d)
Southern Europe 0.57 (0.29-1.11), 0.097
Europe, other 0.33 (0.11-0.97), 0.044
Outside Europe 0.93 (0.55-1.55), 0.77
Holiday other than weekend 0.92 (0.62-1.35), 0.67
Chicken bought unfrozen 2.91 (1.85-4.59), p<0.0001
Turkey ([dagger][dagger]) 0.85 (0.54-1.34), 0.47
Turkey bought fresh 1.43 (0.79-2.52), 0.21
Minced beef/veal 0.70 (0.28-1.76), 0.45
at barbecue
Pork prepared in large pieces 0.53 (0.29-0.96), 0.035
Any white bread without bran 1.28 (0.73-2.22), 0.39
or grains last month
White bread with bran or 1.45 (0.97-2.17), 0.074
grains >5 times/mo
Apples and pears 0.83 (0.54-1.27), 0.39
Strawberries ([double dagger] 1.28 (0.75-2.19), 0.37
[double dagger])
Raw vegetables daily 0.93 (0.55-1.56), 0.78
Chives (fresh) 1.19 (0.79-1.77), 0.40
Urban residency 0.76 (0.45-1.31), 0.32
Tap water from 0.80 (0.40-1.61), 0.53
summerhouse
* Variables with p<0.05 in the final models from analyses A, B, or
both, are shown.
([dagger]) Focus period is the week before onset or filling in
questionnaire if nothing else is mentioned.
([double dagger]) All CB patients (including travelers vs. healthy
controls).
([section]) Match of patients and controls: age, sex, geography, and
as far as possible, to time of disease onset for patient. The risk
from factors not included in the final model was achieved by forcing
them into the model 1 by 1.
([paragraph]) Only domestic CB patients vs. healthy controls.
(#) CB patients vs. non-CB bacterial gastroenteritis patients, match to
patients only on time of disease onset.
** Variables in final models A and B.
([dagger][dagger]) Modifies the risk from turkey bought fresh in model
A.
([double dagger][double dagger]) Modifies the risk from travel to
southern Europe in model A.
Table 2. Case-control study on sporadic campylobacteriosis (CB) in
Denmark, 2000-2001 *
Exposures
Analysis A ([dagger])
(including travelers)
107 CB 178 matched
patients controls,
Variables no. (%) no. (%)
Travel (14 d)
No travel 78 (72.8) 156 (87.6)
Southern Europe 11 (10.2) 6 (3.3)
Europe, other 2 (1.8) 15 (8.4)
Outside Europe 16 (14.9) 1 (0.5)
Holiday other than weekend 49 (45.7) 91 (51.1)
Chicken bought unfrozen 36 (33.6) 40 (22.4)
Turkey 29 (27.1) 57 (22.4)
Turkey bought fresh 28 (26.1) 35 (19.6)
Minced beef/veal at barbecue 4 (3.7) 21 (11.7)
Pork prepared in large pieces 11 (10.3) 46 (25.8)
Any white bread without 92 (86.0) 142 (79.7)
bran or grains last month
White bread with bran or 75 (70.0) 100 (56.1)
grains >5 times/mo
Apples and pears 76 (71.0) 148 (83.1)
Strawberries 16 (14.9) 43 (24.1)
Raw vegetables daily 16 (14.9) 46 (25.8)
Chives (fresh) 38 (35.5) 58 (32.5)
Urban residence 88 (82.2) 158 (88.7)
Tap water from summerhouse 9 (8.4) 12 (6.7)
Exposures
Analysis B ([double
dagger]) (only domestic
cases)
74 CB 114 matched
patients, controls,
Variables no. (%) no. (%)
Travel (14 d)
No travel 74 (100) 114 (100)
Southern Europe -- --
Europe, other -- --
Outside Europe -- --
Holiday other than weekend 22 (29.7) 52 (45.6)
Chicken bought unfrozen 28 (37.8) 21 (18.4)
Turkey 23 (31.0) 33 (28.9)
Turkey bought fresh 15 (20.2) 15 (13.1)
Minced beef/veal at barbecue 3 (4.0) 9 (7.8)
Pork prepared in large pieces 8 (10.8) 28 (24.5)
Any white bread without 65 (87.8) 86 (75.4)
bran or grains last month
White bread with bran or 52 (70.2) 62 (54.3)
grains >5 times/mo
Apples and pears 55 (74.3) 98 (85.9)
Strawberries 18 (24.3) 22 (19.2)
Raw vegetables daily 10 (13.5) 29 (25.4)
Chives (fresh) 30 (40.5) 34 (29.8)
Urban residence 61 (82.4) 99 (86.8)
Tap water from summerhouse 8 (10.8) 7 (6.1)
Exposures
Analysis C ([section])
(case-case study)
141 CB 386 non-CB
patients, controls,
Variables no. (%) no. (%)
Travel (14 d)
No travel 100 (70.9) 241 (62.4)
Southern Europe 4 (2.8) 29 (7.5)
Europe, other 12 (8.5) 51 (13.2)
Outside Europe 25 (17.7) 65 (16.8)
Holiday other than weekend 65 (46.0) 186 (48.2)
Chicken bought unfrozen 46 (32.6) 55 (14.2)
Turkey 34 (24.1) 105 (27.2)
Turkey bought fresh 21 (14.9) 42 (10.9)
Minced beef/veal at barbecue 6 (4.3) 23 (6.0)
Pork prepared in large pieces 15 (10.6) 71 (18.4)
Any white bread without 122 (86.5) 322 (83.4)
bran or grains last month
White bread with bran or 94 (66.6) 224 (58.0)
grains >5 times/mo
Apples and pears 98 (69.5) 283 (73.3)
Strawberries 23 (16.3) 51 (13.2)
Raw vegetables daily 23 (16.3) 67 (17.4)
Chives (fresh) 53 (37.6) 130 (33.7)
Urban residence 118 (83.7) 336 (87.0)
Tap water from summerhouse 11 (7.8) 37 (9.6)
* Exposures for variables with p<0.05 in the final models from
analysis A, B, or both.
([dagger]) Analysis A: all CB patients (including travelers) vs.
healthy controls matched to patients by age, sex, geography, and as far
as possible, to time of disease onset for the patient.
([double dagger]) Analysis B: domestic CB patients vs. healthy controls
matched to patients by age, sex, geography, and as far as possible, to
time of disease onset for the patient.
([section]) Analysis C: CB patients vs. non-CB bacterial
gastroenteritis patients, match to patients only on time of disease
onset.
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