Occupational Risk Factors Among Campylobacter Cases in Nebraska, 2005–2013

BACKGROUND: Campylobacter is a leading cause of gastroenteritis in the United States. While consumption of contaminated food is a major risk factor for campylobacteriosis, studies have also identified work-related factors, including contact with farm animals, meat, and pets. Work information is not systematically collected in Nebraska during Campylobacter case investigations, yet occupational factors can be ascertained through review of case investigation records. We describe cases of Campylobacter in Nebraska associated with occupational risk factors.

METHODS: We obtained investigation data for Campylobacter cases from the Nebraska Electronic Disease Surveillance System (NEDSS). Confirmed and probable cases from 2005 to 2013 among Nebraska residents aged 15 years and older were selected for review. Case notes, comment fields, and interview responses were searched to determine presence of occupational risk factors associated with Campylobacter infection and other pertinent work information. For cases identified as having occupational risk factors, we coded the specific type of exposure, animal/meat type, industry, and occupation if information was provided. Frequencies of demographic characteristics, seasonality, rurality, and specific exposure types were calculated.

RESULTS: Occupational risk factors were identified in 13.6% (n=356) of Campylobacter cases from 2005 to 2013 among Nebraska residents aged 15 years and older. Of these cases, 19.1% (n=68) were hospitalized. Cases with occupational risk factors occurred more frequently among males, in individuals 25–34 years old, during the summer, and in non-metro counties. The most common work-related factor for Campylobacter infection was contact with farm animals (60.6%), followed by animal slaughtering/processing exposures (15.5%), contact with pets and other animals (8.5%), contact with individuals (7.3%), contact with food products (4.8%) and other/unknown exposures (3.4%). Among cases associated with contact with farm animals, cattle was the most frequent animal (75.4%), followed by chickens (8.9%), pigs (7.4%), and multiple animals (3.7%). Among cases with animal slaughtering/processing exposures, the most common meat exposures were beef (65.5%), pork (18.2%), and poultry (16.4%).

CONCLUSIONS: We found more than 1 in 10 Campylobacter cases in Nebraska were associated with occupational risk factors. Our results indicate work exposures, especially to cattle and beef, may be important risk factors for infection in Nebraska. Further study is warranted to better understand the extent of occupationally acquired Campylobacter, which could help improve targeting of education and prevention strategies to reduce the incidence of campylobacteriosis.