title: High prevalence of Helicobacter pylori infection in shepherds.
abstract: It has been suggested that Helicobacter pylori infection may, in some instances, be a zoonosis. The aim of this study was to evaluate the prevalence of H. pylori infection in Sardinian shepherds and their families in relation to exposure to sheep and sheep dogs. Sardinian shepherds and a control group of blood donors completed detailed questionnaires regarding demographics, childhood and current economic status, and the presence of symptoms related to the upper gastrointestinal tract. H. pylori status was determined by a sensitive ELISA for anti-H. pylori IgG and by western blot for anti-CagA IgG. A subgroup of shepherds had upper gastrointestinal endoscopy with biopsy to assess the severity of the gastritis. H. pylori infection in Sardinian shepherds approached 100% and was positively related to animal contact (98% of shepherds, 73% of family members without regular direct animal contact compared to 43% of blood donors) (P < 0.001). Importantly, the family members shared the same childhood with the shepherds but choose different careers (e.g., teachers, nurses, business) and did not have regular contact with sheep. In conclusion, the prevalence of H. pylori infection in Sardinian shepherds is among the highest in the world and is associated with direct contact with sheep and sheep dogs. These results suggest that the cycle of H. pylori infection might, in certain circumstances, include phases in the environment, animals (sheep or dogs) and human beings.
authors.affiliation: Institute of Internal Medicine, University of Sassari, Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: Dore
authors.forename: M
authors.initials: M
authors.lastname: Bilotta
authors.forename: D
authors.initials: D
authors.lastname: Vaira
authors.forename: A
authors.initials: A
authors.lastname: Manca
authors.forename: G
authors.initials: G
authors.lastname: Massarelli
authors.forename: G
authors.initials: G
authors.lastname: Leandro
authors.forename: A
authors.initials: A
authors.lastname: Atzei
authors.forename: G
authors.initials: G
authors.lastname: Pisanu
authors.forename: D Y
authors.initials: DY
authors.lastname: Graham
authors.forename: G
authors.initials: G
authors.lastname: Realdi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D000822:Animal Husbandry; D000818:Animals; D001782:Blood Donors / Q000706:statistics & numerical data; D002648:Child; D004285:Dogs; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000662:veterinary; D016480:Helicobacter pylori; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D016036:Seroepidemiologic Studies; D012756:Sheep; D012757:Sheep Diseases / Q000453:epidemiology / Q000276:immunology