title: A waterborne Campylobacter jejuni outbreak on a Greek island.
abstract: A case-control and a case-crossover study were performed to investigate a Campylobacter jejuni outbreak in Crete in 2009. Most cases originated from rural areas, served by a different water-supply system from that of the adjacent town. Thirty-seven cases and 79 controls were interviewed; cases were interviewed for two different time periods for the case-crossover study. Stool cultures, PFGE and MLST subtyping were run in human samples. Univariately, consumption of tap water was associated with C. jejuni infection. Stratified analysis revealed that water-supply system was an effect modifier of this association. In the multivariable analysis, the rural areas' water supplier and drinking tap water were risk factors. No risk factors were revealed in the case-crossover study. No Campylobacter were isolated in the tested water samples. There is strong epidemiological evidence that tap water was the vehicle of the outbreak.
authors.affiliation: Department of Epidemiological Surveillance, Hellenic Centre for Disease Control and Prevention (KEELPNO), Athens, Greece. karagiannisi@rki.de
authors.forename: I
authors.initials: I
authors.lastname: Karagiannis
authors.forename: T
authors.initials: T
authors.lastname: Sideroglou
authors.forename: K
authors.initials: K
authors.lastname: Gkolfinopoulou
authors.forename: A
authors.initials: A
authors.lastname: Tsouri
authors.forename: D
authors.initials: D
authors.lastname: Lampousaki
authors.forename: E N
authors.initials: EN
authors.lastname: Velonakis
authors.forename: E V
authors.initials: EV
authors.lastname: Scoulica
authors.forename: K
authors.initials: K
authors.lastname: Mellou
authors.forename: T
authors.initials: T
authors.lastname: Panagiotopoulos
authors.forename: S
authors.initials: S
authors.lastname: Bonovas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015373:Bacterial Typing Techniques; D002169:Campylobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016123:Campylobacter jejuni / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D018592:Cross-Over Studies; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005243:Feces / Q000382:microbiology; D005260:Female; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D017422:Sequence Analysis, DNA; D014871:Water Microbiology; D055815:Young Adult