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Campylobacter epidemiology: a descriptive study reviewing 1 million cases in England and Wales between 1989 and 2011.

Nichols GL, Richardson JF, Sheppard SK, Lane C, Sarran C - BMJ Open (2012)

Bottom Line: Data from sero-phage and multilocus sequence typing show a few common types and many uncommon types.The drivers/mechanisms influencing seasonality, age distribution, population density, socioeconomic and long-term differences are diverse and their relative contributions remain to be established.Surveillance and typing provide insights into Campylobacter epidemiology and sources of infection, providing a sound basis for targeted interventions.

View Article: PubMed Central - PubMed

Affiliation: HPA Colindale, Health Protection Agency, London, UK.

ABSTRACT

Objectives: To review Campylobacter cases in England and Wales over 2 decades and examine the main factors/mechanisms driving the changing epidemiology.

Design: A descriptive study of Campylobacter patients between 1989 and 2011. Cases over 3 years were linked anonymously to postcode, population density, deprivation indices and census data. Cases over 5 years were anonymously linked to local weather exposure estimates.

Setting: Patients were from general practice, hospital and environmental health investigations through primary diagnostic laboratories across England and Wales.

Participants: There were 1 109 406 cases.

Outcome measures: Description of changes in Campylobacter epidemiology over 23 years and how the main drivers may influence these.

Results: There was an increase in Campylobacter cases over the past 23 years, with the largest increase in people over 50 years. Changes in the underlying population have contributed to this, including the impacts of population increases after World War I, World War II and the 'baby boom' of the 1960s. A recent increase in risk or ascertainment within this population has caused an increase in cases in all age groups from 2004 to 2011. The seasonal increase in cases between weeks 18 (Early May) and 22 (Early June) was consistent across ages, years and regions and was most marked in children and in more rural regions. Campylobacter prevalence by week in each region correlated with temperature 2 weeks before. There were higher prevalences in areas with a low population density, low deprivation and lower percentage of people of ethnic origin. Data from sero-phage and multilocus sequence typing show a few common types and many uncommon types.

Conclusions: The drivers/mechanisms influencing seasonality, age distribution, population density, socioeconomic and long-term differences are diverse and their relative contributions remain to be established. Surveillance and typing provide insights into Campylobacter epidemiology and sources of infection, providing a sound basis for targeted interventions.

No MeSH data available.


Related in: MedlinePlus

Typing. Typing data on cases of Campylobacter from England and Wales, 1989–2009. Data in the HPA data set (29 081 isolates) includes the number of Campylobacter jejuni and Campylobacter coli combined serotype (HS) and phage type (PT) combinations (HS/PT) against the number of isolates in each type (A) the separate HS and PT types for C jejuni and C coli (B). The PubMLST database (1394 isolates) shows the number of types from human cases against the number of patient isolates. The figures represent individual sequenced genes for uncA (C), tkt (D), pgm (E), glyA (F), gltA (G), glnA (H) and aspA (I), with an average of the seven genes (J) and the individual ST and CC (K).
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fig3: Typing. Typing data on cases of Campylobacter from England and Wales, 1989–2009. Data in the HPA data set (29 081 isolates) includes the number of Campylobacter jejuni and Campylobacter coli combined serotype (HS) and phage type (PT) combinations (HS/PT) against the number of isolates in each type (A) the separate HS and PT types for C jejuni and C coli (B). The PubMLST database (1394 isolates) shows the number of types from human cases against the number of patient isolates. The figures represent individual sequenced genes for uncA (C), tkt (D), pgm (E), glyA (F), gltA (G), glnA (H) and aspA (I), with an average of the seven genes (J) and the individual ST and CC (K).

Mentions: Campylobacter isolates from human cases between 1989 and 2009 (29 081/994 791; 2.9%) could be differentiated into 64 serotypes (HS), 86 phage types (PT) and 949 combined HS/PT types. Isolates of Campylobacter jejuni contained 57 serotypes, 80 phage types and 866 HS/PT types and two thirds of serotypes of C jejuni were represented in seven serotypes (table 1). Campylobacter coli contained 25 serotypes, 30 phage types and 102 HS/PT types, with five serotypes making up 84% of isolates (table 1). When the combined ST/PT of typable isolates were examined, then no type exceeded 9% of the total typed C jejuni and 18% of typed C coli strains. Among the combined HS/PT types, most isolates had few representatives (figure 3A), although the distribution differed when HS and PT were examined separately (figure 3B). Only 18 013 of 26 688 (67%) C jejuni isolates and 1936 of 2393 (81%) C coli isolates were typable. When combined as HS/PT type, this decreased to 16 362 of 26 688 (61%) for C. jejuni, making phenotyping a poor tool for use in epidemiological investigation. Most of the HS/PT typing was undertaken between 2000 and 2004.


Campylobacter epidemiology: a descriptive study reviewing 1 million cases in England and Wales between 1989 and 2011.

Nichols GL, Richardson JF, Sheppard SK, Lane C, Sarran C - BMJ Open (2012)

Typing. Typing data on cases of Campylobacter from England and Wales, 1989–2009. Data in the HPA data set (29 081 isolates) includes the number of Campylobacter jejuni and Campylobacter coli combined serotype (HS) and phage type (PT) combinations (HS/PT) against the number of isolates in each type (A) the separate HS and PT types for C jejuni and C coli (B). The PubMLST database (1394 isolates) shows the number of types from human cases against the number of patient isolates. The figures represent individual sequenced genes for uncA (C), tkt (D), pgm (E), glyA (F), gltA (G), glnA (H) and aspA (I), with an average of the seven genes (J) and the individual ST and CC (K).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3400078&req=5

fig3: Typing. Typing data on cases of Campylobacter from England and Wales, 1989–2009. Data in the HPA data set (29 081 isolates) includes the number of Campylobacter jejuni and Campylobacter coli combined serotype (HS) and phage type (PT) combinations (HS/PT) against the number of isolates in each type (A) the separate HS and PT types for C jejuni and C coli (B). The PubMLST database (1394 isolates) shows the number of types from human cases against the number of patient isolates. The figures represent individual sequenced genes for uncA (C), tkt (D), pgm (E), glyA (F), gltA (G), glnA (H) and aspA (I), with an average of the seven genes (J) and the individual ST and CC (K).
Mentions: Campylobacter isolates from human cases between 1989 and 2009 (29 081/994 791; 2.9%) could be differentiated into 64 serotypes (HS), 86 phage types (PT) and 949 combined HS/PT types. Isolates of Campylobacter jejuni contained 57 serotypes, 80 phage types and 866 HS/PT types and two thirds of serotypes of C jejuni were represented in seven serotypes (table 1). Campylobacter coli contained 25 serotypes, 30 phage types and 102 HS/PT types, with five serotypes making up 84% of isolates (table 1). When the combined ST/PT of typable isolates were examined, then no type exceeded 9% of the total typed C jejuni and 18% of typed C coli strains. Among the combined HS/PT types, most isolates had few representatives (figure 3A), although the distribution differed when HS and PT were examined separately (figure 3B). Only 18 013 of 26 688 (67%) C jejuni isolates and 1936 of 2393 (81%) C coli isolates were typable. When combined as HS/PT type, this decreased to 16 362 of 26 688 (61%) for C. jejuni, making phenotyping a poor tool for use in epidemiological investigation. Most of the HS/PT typing was undertaken between 2000 and 2004.

Bottom Line: Data from sero-phage and multilocus sequence typing show a few common types and many uncommon types.The drivers/mechanisms influencing seasonality, age distribution, population density, socioeconomic and long-term differences are diverse and their relative contributions remain to be established.Surveillance and typing provide insights into Campylobacter epidemiology and sources of infection, providing a sound basis for targeted interventions.

View Article: PubMed Central - PubMed

Affiliation: HPA Colindale, Health Protection Agency, London, UK.

ABSTRACT

Objectives: To review Campylobacter cases in England and Wales over 2 decades and examine the main factors/mechanisms driving the changing epidemiology.

Design: A descriptive study of Campylobacter patients between 1989 and 2011. Cases over 3 years were linked anonymously to postcode, population density, deprivation indices and census data. Cases over 5 years were anonymously linked to local weather exposure estimates.

Setting: Patients were from general practice, hospital and environmental health investigations through primary diagnostic laboratories across England and Wales.

Participants: There were 1 109 406 cases.

Outcome measures: Description of changes in Campylobacter epidemiology over 23 years and how the main drivers may influence these.

Results: There was an increase in Campylobacter cases over the past 23 years, with the largest increase in people over 50 years. Changes in the underlying population have contributed to this, including the impacts of population increases after World War I, World War II and the 'baby boom' of the 1960s. A recent increase in risk or ascertainment within this population has caused an increase in cases in all age groups from 2004 to 2011. The seasonal increase in cases between weeks 18 (Early May) and 22 (Early June) was consistent across ages, years and regions and was most marked in children and in more rural regions. Campylobacter prevalence by week in each region correlated with temperature 2 weeks before. There were higher prevalences in areas with a low population density, low deprivation and lower percentage of people of ethnic origin. Data from sero-phage and multilocus sequence typing show a few common types and many uncommon types.

Conclusions: The drivers/mechanisms influencing seasonality, age distribution, population density, socioeconomic and long-term differences are diverse and their relative contributions remain to be established. Surveillance and typing provide insights into Campylobacter epidemiology and sources of infection, providing a sound basis for targeted interventions.

No MeSH data available.


Related in: MedlinePlus