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Am J Epidemiol 2003; 158:234-242.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Factors Associated with Increased and Decreased Risk of Campylobacter Infection: A Prospective Case-Control Study in Norway

Georg Kapperud1,2 , Gyrid Espeland3, Erik Wahl4, Anna Walde5, Hallgeir Herikstad3, Stein Gustavsen4, Ingvar Tveit5, Olav Natås6, Lars Bevanger7 and Asbjørn Digranes8

1 Department of Foodborne Infections, Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway.
2 Section of Food Hygiene, Department of Microbiology, Pharmacology and Food Hygiene, Norwegian School of Veterinary Science, Oslo, Norway.
3 The Food Control Authority in Midt-Rogaland, Stavanger, Norway.
4 The Food Control Authority, City of Trondheim, Trondheim, Norway.
5 The Food Control Authority in the Bergen Region, Bergen, Norway.
6 Department of Medical Microbiology, Central Hospital of Rogaland, Stavanger, Norway.
7 Laboratory of Medical Microbiology, St. Olavs Hospital HF, University Hospital of Trondheim, Trondheim, Norway.
8 Department of Microbiology and Immunology, Haukeland University Hospital, Bergen, Norway.

In 1999–2000, a prospective case-control study of sporadic, domestically acquired campylobacteriosis was conducted in three counties in Norway to identify preventable risk factors and potentially protective factors. A total of 212 cases and 422 population controls matched by age, sex, and geographic area were enrolled. In conditional logistic regression analysis, the following factors were found to be independently associated with an increased risk of Campylobacter infection: drinking undisinfected water, eating at barbecues, eating poultry bought raw, having occupational exposure to animals, and eating undercooked pork. The following factors were independently related to a decreased risk: eating mutton, eating raw fruits or berries, and swimming. Results indicated that infection is more likely to occur as a result of cross-contamination from raw poultry products than because of poultry consumption per se. Drinking undisinfected water, reported by 53% of cases, was a leading risk factor in this study. Drinking water may constitute the common reservoir linking infection in humans and animals, including poultry and wild birds. Insight into the ecology of Campylobacter in freshwater ecosystems may be required to understand the epidemiology of campylobacteriosis. The possibility that certain foods confer protection against campylobacteriosis deserves exploration.

Campylobacter; Campylobacter infections; case-control studies; protective agents; risk factors


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