Assigning the source of human campylobacteriosis in New Zealand: a comparative genetic and epidemiological approach.
Integrated surveillance of infectious multi-source diseases using a combination of epidemiology, ecology, genetics and evolution can provide a valuable risk-based approach for the control of important human pathogens. This includes a better understanding of transmission routes and the impact of human activities on the emergence of zoonoses. Until recently New Zealand had extraordinarily high and increasing rates of notified human campylobacteriosis, and our limited understanding of the source of these infections was hindering efforts to control this disease. Genetic and epidemiological modeling of a 3-year dataset comprising multilocus sequence typed isolates from human clinical cases, coupled with concurrent data on food and environmental sources, enabled us to estimate the relative importance of different sources of human disease. Our studies provided evidence that poultry was the leading cause of human campylobacteriosis in New Zealand, causing an estimated 58-76% of cases with widely varying contributions by individual poultry suppliers. These findings influenced national policy and, after the implementation of poultry industry-specific interventions, a dramatic decline in human notified cases was observed in 2008. The comparative-modeling and molecular sentinel surveillance approach proposed in this study provides new opportunities for the management of zoonotic diseases.
Mullner
Petra
P
Molecular Epidemiology and Veterinary Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand. petra@epi-interactive.com
Spencer
Simon E F
SE
Wilson
Daniel J
DJ
Jones
Geoff
G
Noble
Alasdair D
AD
Midwinter
Anne C
AC
Collins-Emerson
Julie M
JM
Carter
Philip
P
Hathaway
Steve
S
French
Nigel P
NP
D000818:Animals; D001426:Bacterial Proteins / Q000235:genetics; D002167:Campylobacter / Q000235:genetics*; D002169:Campylobacter Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D004269:DNA, Bacterial / Q000235:genetics; D004197:Disease Reservoirs / Q000382:microbiology; D005516:Food Microbiology; D006801:Humans; D008565:Membrane Proteins / Q000235:genetics; D015233:Models, Statistical; D009520:New Zealand / Q000453:epidemiology; D011159:Population Surveillance; D011200:Poultry; D011202:Poultry Products / Q000382:microbiology; D014871:Water Microbiology; D015047:Zoonoses / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission
D001426:Bacterial Proteins; D004269:DNA, Bacterial; D008565:Membrane Proteins; C490272:mapA protein, Campylobacter jejuni