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BACKGROUND: Campylobacteriosis causes an estimated 845,000 illnesses annually in the United States. In 2013, 1729 campylobacteriosis cases and 1124 salmonellosis cases were reported among New York City (NYC) residents. The crude incidence of salmonellosis is lower in NYC than nationally with 13.8 infections per 100,000 reported in 2013 compared with 15.2 infections per 100,000 nationally, while the incidence of campylobacteriosis is higher with 21.1 infections per 100,000 in 2013 compared with 13.8 per 100,000 nationally. To understand how risk factors for Campylobacter and Salmonella infections differ, the NYC Department of Health and Mental Hygiene began enhanced surveillance for Campylobacter infections.
METHODS: A prospective matched case-case analysis was performed to compare laboratory-confirmed cases of campylobacteriosis with salmonellosis cases diagnosed from 5/1/2014-5/1/2015. Patients infected with Campylobacter were designated as cases, and patients infected with Salmonella were controls. Cases and controls were interviewed with a standardized questionnaire assessing demographics, food, restaurant, travel, and animal exposures in the 7 days before illness onset. We attempted to match three salmonellosis controls to each campylobacteriosis case by diagnosis date (±45 days) and by age ±3 years for cases ≤18 years and age ±10 years for cases ≥19 years. Descriptive statistics were computed, and census tract-based poverty was determined using the American Community Survey, 2008-2012. Matched odds ratios (mORs) and 95% confidence intervals for each potential risk factor were calculated using conditional logistic regression and the mid-P exact method.
RESULTS: As of 12/29/14, we identified 150 campylobacteriosis cases and 267 matched salmonellosis controls. Among campylobacteriosis cases, the median age was 21 years (range: <1 month-96 years), 55% were male, the most commonly reported symptoms were diarrhea (97%), abdominal pain (66%), and fever (62%), and the median illness duration was 6 days. Campylobacteriosis cases had higher odds of consuming chicken (57% versus 44%, mOR=1.7, 95% CI: 1.04, 2.7), turkey (87% vs. 65%, mOR 4.3, 95% CI: 2.3, 8.6), and eggs (88% vs. 61%, mOR 5.5, 95% CI: 2.9, 11.2). No significant differences in sex, area-based poverty, travel, restaurant dining, or animal exposure were observed, although power was low at the time of this interim analysis.
CONCLUSIONS: The campylobacteriosis rate in NYC is higher than the national rate. Cases in NYC appear more likely to have eaten chicken, turkey, and eggs compared with salmonellosis controls. Preliminary findings suggest that control measures, such as continuing to educate consumers on appropriate food preparation practices, could reduce the risk of Campylobacter infection.