title: Investigating vomiting and/or bloody diarrhoea in Campylobacter jejuni infection.
abstract: Campylobacter jejuni infection frequently presents as acute enteritis with diarrhoea, malaise, fever and abdominal pain. Vomiting and bloody diarrhoea are reported less frequently. To investigate potential host, micro-organism or environmental factors that might explain the different clinical presentations, the features of laboratory-confirmed Campylobacter jejuni cases presenting with vomiting and/or bloody diarrhoea were compared with cases who did not report either clinical manifestation. Single variable analysis and logistic regression were employed. Explanatory variables included food, water and environmental risks. Cases who reported vomiting and/or bloody diarrhoea tended to suffer a longer illness and were more likely to require hospital admission. Independent risks identified were being a child, female gender, consumption of poultry other than chicken, pre-packed sandwiches and sausages, and reported engineering work or problems with drinking-water supply. A dose-response relationship with vomiting and/or bloody diarrhoea and increasing daily consumption of unboiled tap water was observed also. Vomiting and/or bloody diarrhoea characterized the more severe end of the disease spectrum and might relate to host susceptibility and/or infective dose. The role of unboiled tap water as a potential source of C. jejuni infection in England and Wales requires further investigation.
authors: Environmental and Enteric Diseases Department, Health Protection Agency (HPA) Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
authors: Iain A
authors: IA
authors: Gillespie
authors: Division of Medicine and Neuroscience, Manchester University, Clinical Sciences Building, Hope Hospital, Stott Lane, Salford M6 8HD, UK.
authors: Sarah J
authors: SJ
authors: O'Brien
authors: Welsh Assembly, Cardiff CF99 1NA, UK.
authors: Jennifer A
authors: JA
authors: Frost
authors: Environmental and Enteric Diseases Department, Health Protection Agency (HPA) Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
authors: Clarence
authors: C
authors: Tam
authors: HPA Yorkshire and the Humber Regional Microbiology, Bridle Path, York Road, Leeds LS15 7TR, UK.
authors: David
authors: D
authors: Tompkins
authors: Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham Medical School, Nottingham NG7 2UH, UK.
authors: Keith R
authors: KR
authors: Neal
authors: HPA North West, Rooms 103-112, First Floor, DBH House, 105 Boundary Street, Liverpool L5 9YJ, UK.
authors: Qutub
authors: Q
authors: Syed
authors: St George's Hospital Medical School, University of London, Cranmer Terrace, London SW17 0RE, UK.
authors: Michael J G
authors: MJG
authors: Farthing
authors: Environmental and Enteric Diseases Department, Health Protection Agency (HPA) Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
authors: The Campylobacter Sentinel Surveillance Scheme Collaborators