Point source outbreaks of Campylobacter jejuni infection--are they more common than we think and what might cause them?

Despite being the commonest bacterial cause of infectious intestinal disease (IID) in England and Wales, outbreaks of campylobacter infection are rarely reported. However, data from the Campylobacter Sentinel Surveillance Scheme suggested that outbreaks might be more common than was previously suspected, since a high proportion of cases reported other illness in the home or in the community at the same time as their illness. To identify factors that might lead to these apparent outbreaks, the exposures of cases of Campylobacter jejuni infection reporting other illness, either in the home or the community, were compared with those for cases not reporting other illness using case-case methodology. Illness in the home was associated with consuming organic meats in the winter, having contact with a pet suffering from diarrhoea or visiting a farm in the 2 weeks before the onset of symptoms. Illness in the community was associated with the consumption of foods in restaurants or drinking unpasteurized milk. Prevention of campylobacter infection requires that better methods of outbreak detection and investigation are developed, which in turn should lead to a better understanding of risk factors.