Analysis of simultaneous space-time clusters of Campylobacter spp. in humans and in broiler flocks using a multiple dataset approach

<p>Abstract</p> <p>Background</p> <p>Campylobacteriosis is the most frequently reported zoonosis in the EU and the epidemiology of sporadic campylobacteriosis, especially the routes of transmission, is to a great extent unclear. Poultry easily become colonised with <it>Campylobacter </it>spp., being symptom-less intestinal carriers. Earlier it was estimated that internationally between 50% and 80% of the cases could be attributed to chicken as a reservoir. In a Norwegian surveillance programme all broiler flocks under 50 days of age were tested for <it>Campylobacter </it>spp. The aim of the current study was to identify simultaneous local space-time clusters each year from 2002 to 2007 for human cases of campylobacteriosis and for broiler flocks testing positive for <it>Campylobacter </it>spp. using a multivariate spatial scan statistic method. A cluster occurring simultaneously in humans and broilers could indicate the presence of common factors associated with the dissemination of <it>Campylobacter </it>spp. for both humans and broilers.</p> <p>Results</p> <p>Local space-time clusters of humans and broilers positive for <it>Campylobacter </it>spp. occurring simultaneously were identified in all investigated years. All clusters but one were identified from May to August. Some municipalities were included in clusters all years.</p> <p>Conclusions</p> <p>The simultaneous occurrence of clusters of humans and broilers positive for <it>Campylobacter </it>spp. combined with the knowledge that poultry meat has a nation-wide distribution indicates that campylobacteriosis cases might also be caused by other risk factors than consumption and handling of poultry meat.</p> <p>Broiler farms that are positive could contaminate the environment with further spread to new broiler farms or to humans living in the area and local environmental factors, such as climate, might influence the spread of <it>Campylobacter </it>spp. in an area. Further studies to clarify the role of such factors are needed.</p

Screening for tuberculosis infection among newly arrived asylum seekers: Comparison of QuantiFERON®TB Gold with tuberculin skin test

Background: QuantiFERON®TB Gold (QFT) is a promising blood test for tuberculosis infection but with few data so far from immigrant screening. The aim of this study was to compare results of QFT and tuberculin skin test (TST) among newly arrived asylum seekers in Norway and to assess the role of QFT in routine diagnostic screening for latent tuberculosis infection. Methods: The 1000 asylum seekers (age ≥ 18 years) enrolled in the study were voluntarily recruited from 2813 consecutive asylum seekers arriving at the national reception centre from September 2005 to June 2006. Participation included a QFT test and a questionnaire in addition to the mandatory TST and chest X-ray. Results: Among 912 asylum seekers with valid test results, 29% (264) had a positive QFT test whereas 50% (460) tested positive with TST (indurations ≥ 6 mm), indicating a high proportion of latent infection within this group. Among the TST positive participants 50% were QFT negative, whereas 7% of the TST negative participants were QFT positive. There was a significant association between increase in size of TST result and the likelihood of being QFT positive. Agreement between the tests was 71–79% depending on the chosen TST cut-off and it was higher for nonvaccinated individuals. Conclusion: By using QFT in routine screening, further follow-up could be avoided in 43% of the asylum seekers who would have been referred if based only on a positive TST (≥ 6 mm). The proportion of individuals referred will be the same whether QFT replaces TST or is used as a supplement to confirm a positive TST, but the number tested will vary greatly. All three screening approaches would identify the same proportion (88–89%) of asylum seekers with a positive QFT and/or a TST ≥ 15 mm, but different groups will be missed

Outbreak of tularaemia in central Norway, January to March 2011

From January to March 2011, 39 cases of tularaemia were diagnosed in three counties in central Norway: 21 cases of oropharyngeal type, 10 cases of glandular/ulceroglandular type, two of respiratory and two of typhoid type. Three cases were asymptomatic and clinical information was unavailable for one case. The mean age was 40.3 years (range 2-89 years). Thirty-four reported use of drinking water from private wells. An increased rodent (lemming) population and snow melting may have led to contamination of the wells with infected rodents or rodent excreta

Yersinia enterocolitica Outbreak Associated with Ready-to-Eat Salad Mix, Norway, 2011

In 2011, an outbreak of illness caused by Yersinia enterocolitica O:9 in Norway was linked to ready-to-eat salad mix, an unusual vehicle for this pathogen. The outbreak illustrates the need to characterize isolates of this organism, and reinforces the need for international traceback mechanisms for fresh produce