Determinants of sporadic infections in Denmark: a nationwide case-control study among children and young adults.

Clin Epidemiol

Infectious Disease Epidemiology & Prevention, Statens Serum Institut, Copenhagen, Denmark,

Published: November 2018

AI Article Synopsis

  • Over 4,000 cases of campylobacteriosis are reported annually in Denmark, making it the leading bacterial gastrointestinal infection, prompting a case-control study focused on environmental infection sources among young people aged 1-30.
  • The study collected data from 1366 cases and 4,418 controls, revealing significant risk factors such as bathing in fresh water, contact with beach sand, owning a pet dog with diarrhea, and consuming minced beef or chicken.
  • The findings highlight the importance of environmental factors and animal contact in domestic infections, confirming chicken handling as a key risk and suggesting minced beef as a potential new concern, which will inform future public health guidelines.

Article Abstract

Background: Each year more than 4,000 cases of campylobacteriosis are reported in Denmark, making it the most common bacterial gastrointestinal infection. Here we describe a case-control study to identify sources of infection with a focus on environmental factors.

Methods: From January to December 2016, we conducted a prospective case-control study among Danish persons aged 1-30 years. Participants were invited by letter to complete an online questionnaire. Crude and adjusted ORs were calculated and final parsimonious multivariate models developed using logistic regression.

Results: The study recruited 1366 cases and 4,418 controls, of whom 65% and 66%, respectively, completed the questionnaire. A multivariate model for domestically acquired cases showed, among others, increased risk of infection with bathing in fresh water (OR=5.1), contact to beach sand (OR=1.8), owning a pet dog with diarrhea (OR=4.6), and eating minced beef (OR=2.6) or chicken (OR=2.5). The model for children highlighted similar risk factors but also included bathing in a paddling pool (OR=13.6) and eating fresh strawberries (OR=5.3). A separate analysis for persons reporting foreign travel showed increased infection risk when traveling to Asia, Africa, or Turkey and that eating from street kitchens and having contact to water during traveling were also risk factors.

Conclusion: Environmental factors and animal contact account for a sizeable proportion of domestic infections in the age group studied. The study also re-confirmed handling/consumption of chicken as an important risk factor while highlighting minced beef as a potential new risk factor. Overall, these results contribute to a better understanding of the transmission dynamics of and will be used to improve national guidelines for prevention of infection.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255050PMC
http://dx.doi.org/10.2147/CLEP.S177141DOI Listing

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