Operationalising factors that explain the emergence of infectious diseases : A case study of the human campylobacteriosis epidemic

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The risk of inflammatory bowel disease in patients with axial spondyloarthritis treated with biologic agents : BSRBR-AS and meta-analysis

Funding: The BSRBR-AS is supported by the British Society for Rheumatology and they have received funds for the registry from Pfizer, AbbVie and UCB. These companies have no input in determining the topics for analysis or work involved in undertaking it but do receive an advance copy of the manuscript on which they may make comments. ACKNOWLEDGEMENTS: The original idea for the study was suggested by John Mansfield and discussed with Lesley Kay (both Newcastle upon Tyne Hospitals NHS Foundation Trust). All authors discussed and contributed to designing this study and the analysis plan, which was undertaken by RLB and (updated and) overseen by OR, LED and GJM. Results were reviewed by all authors. GJM, RLB, OR and LED all contributed to drafting the manuscript which was critically reviewed by all authors. RLB undertook this work while a visiting student based at the University of Aberdeen from Ludwig-Maximilians Universität (Munich).Peer reviewedPostprin

The role of metrology in axSpA : does it provide unique information in assessing patients and predicting outcome? Results from the BSRBR-AS registry

ACKNOWLEDGMENTS We thank the staff who contributed to running the BSRBR-AS register and we also thank the recruiting staff at the clinical centers, details of which are available at: www.abdn.ac.uk/bsrbr-as.Peer reviewedPostprin

Closing gaps for performing a risk assessment on Listeria monocytogenes in ready-to-eat (RTE) foods : activity 3, the comparison of isolates from different compartments along the food chain, and from humans using whole genome sequencing (WGS) analysis

We would like to thank all the persons and institutes that have provided the project with isolates and accompanying information. Without them, this project would not have been possible. Lin Cathrine T. Brandal, Norwegian Institute of Public Health, Norway Julio Vázquez Moreno and Raquel Abad Torreblanca, Instituto de Salud Carlos III, Spain Marc Lecuit, Institut Pasteur, France Alexandre Leclercq, Institut Pasteur, France Iva Hristova, National Center of Infectious and Parasitic Diseases, Bulgaria Marija Trkov, National Laboratory of Health, Environment and Food, Slovenia Cecilia Jernberg, Public Health Agency of Sweden, Sweden Ariane Pietzka, Austrian Agency for Health and Food Safety, Austria Eelco Franz and Ingrid Friesema, RIVM, The Netherlands Carlo Spanu, University of Sassari Sardinia Ifip, French Institute for Pig and Pork Industry, Maisons-Alfort, France All the NRLs for providing the isolates from the EU baseline study Special thanks to Sylvain Brisse and Alexandra Moura, Institut Pasteur, France, for providing cgMLST data. The authors would also like to thank the EFSA staff members: Maria Teresa da Silva Felicio, Beatriz Guerra, Ernesto Lìebana and Valentina Rizzi as well as the members of the Working Group on Listeria monocytogenes contamination of ready-to-eat foods: Kostas Koutsoumanis, Roland Lindqvist, Moez Sanaa, Panagiotis Skandamis, Niko Speybroek, Johanna Takkinen and Martin Wagner for the support, revisions and suggestions during the development of the present procurement activity and report.Publisher PD

Evolution of an Agriculture-Associated Disease Causing Campylobacter coli Clade: Evidence from National Surveillance Data in Scotland

The common zoonotic pathogen Campylobacter coli is an important cause of bacterial gastroenteritis worldwide but its evolution is incompletely understood. Using multilocus sequence type (MLST) data of 7 housekeeping genes from a national survey of Campylobacter in Scotland (2005/6), and a combined population genetic-phylogenetics approach, we investigated the evolutionary history of C. coli. Genealogical reconstruction of isolates from clinical infection, farm animals and the environment, revealed a three-clade genetic structure. The majority of farm animal, and all disease causing genotypes belonged to a single clade (clade 1) which had comparatively low synonymous sequence diversity, little deep branching genetic structure, and a higher number of shared alleles providing evidence of recent clonal decent. Calibration of the rate of molecular evolution, based on within-species genetic variation, estimated a more rapid rate of evolution than in traditional estimates. This placed the divergence of the clades at less than 2500 years ago, consistent with the introduction of an agricultural niche having had an effect upon the evolution of the C. coli clades. Attribution of clinical isolate genotypes to source, using an asymmetric island model, confirmed that strains from chicken and ruminants, and not pigs or turkeys, are the principal source of human C. coli infection. Taken together these analyses are consistent with an evolutionary scenario describing the emergence of agriculture-associated C. coli lineage that is an important human pathogen

Elucidating the aetiology of human Campylobacter coli infections

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Phylogeographic analysis reveals multiple international transmission events have driven the global emergence of Escherichia coli O157:H7

This work was supported by: Scotland by Food Standards Scotland [Grant Number FS102029] and University of Aberdeen; New Zealand, Institute of Environmental Science and Research; Canada, the Public Health Agency of Canada; United States, United States Department of AgriculturePeer reviewedPostprin

Using sequence data to identify alternative routes and risk of infection: a case-study of campylobacter in Scotland

<b>Background:</b> Genetic typing data are a potentially powerful resource for determining how infection is acquired. In this paper MLST typing was used to distinguish the routes and risks of infection of humans with Campylobacter jejuni from poultry and ruminant sources.<p></p> <b>Methods:</b> C. jejuni samples from animal and environmental sources and from reported human cases confirmed between June 2005 and September 2006 were typed using MLST. The STRUCTURE software was used to assign the specific sequence types of the sporadic human cases to a particular source. We then used mixed case-case logistic regression analysis to compare the risk factors for being infected with C. jejuni from different sources.<p></p> <b>Results:</b> A total of 1,599 (46.3%) cases were assigned to poultry, 1,070 (31.0%) to ruminant and 67 (1.9%) to wild bird sources; the remaining 715 (20.7%) did not have a source that could be assigned with a probability of greater than 0.95. Compared to ruminant sources, cases attributed to poultry sources were typically among adults (odds ratio (OR) = 1.497, 95% confidence intervals (CIs) = 1.211, 1.852), not among males (OR = 0.834, 95% CIs = 0.712, 0.977), in areas with population density of greater than 500 people/km(2) (OR = 1.213, 95% CIs = 1.030, 1.431), reported in the winter (OR = 1.272, 95% CIs = 1.067, 1.517) and had undertaken recent overseas travel (OR = 1.618, 95% CIs = 1.056, 2.481). The poultry assigned strains had a similar epidemiology to the unassigned strains, with the exception of a significantly higher likelihood of reporting overseas travel in unassigned strains.<p></p> <b>Conclusions:</b> Rather than estimate relative risks for acquiring infection, our analyses show that individuals acquire C. jejuni infection from different sources have different associated risk factors. By enhancing our ability to identify at-risk groups and the times at which these groups are likely to be at risk, this work allows public health messages to be targeted more effectively. The rapidly increasing capacity to conduct genetic typing of pathogens makes such traced epidemiological analysis more accessible and has the potential to substantially enhance epidemiological risk factor studies

Geographic determinants of reported human Campylobacter infections in Scotland

<p><b>Background:</b> Campylobacteriosis is the leading cause of bacterial gastroenteritis in most developed countries. People are exposed to infection from contaminated food and environmental sources. However, the translation of these exposures into infection in the human population remains incompletely understood. This relationship is further complicated by differences in the presentation of cases, their investigation, identification, and reporting; thus, the actual differences in risk must be considered alongside the artefactual differences.</p> <p><b>Methods:</b> Data on 33,967 confirmed Campylobacter infections in mainland Scotland between 2000 and 2006 (inclusive) that were spatially referenced to the postcode sector level were analysed. Risk factors including the Carstairs index of social deprivation, the easting and northing of the centroid of the postcode sector, measures of livestock density by species and population density were tested in univariate screening using a non-spatial generalised linear model. The NHS Health Board of the case was included as a random effect in this final model. Subsequently, a spatial generalised linear mixed model (GLMM) was constructed and age-stratified sensitivity analysis was conducted on this model.</p> <p><b>Results:</b> The spatial GLMM included the protective effects of the Carstairs index (relative risk (RR) = 0.965, 95% Confidence intervals (CIs) = 0.959, 0.971) and population density (RR = 0.945, 95% CIs = 0.916, 0.974. Following stratification by age group, population density had a significant protective effect (RR = 0.745, 95% CIs = 0.700, 0.792) for those under 15 but not for those aged 15 and older (RR = 0.982, 95% CIs = 0.951, 1.014). Once these predictors have been taken into account three NHS Health Boards remain at significantly greater risk (Grampian, Highland and Tayside) and two at significantly lower risk (Argyll and Ayrshire and Arran).</p> <p><b>Conclusions:</b> The less deprived and children living in rural areas are at the greatest risk of being reported as a case of Campylobacter infection. However, this analysis cannot differentiate between actual risk and heterogeneities in individual reporting behaviour; nevertheless this paper has demonstrated that it is possible to explain the pattern of reported Campylobacter infections using both social and environmental predictors.</p&gt