title: Analysis of simultaneous space-time clusters of Campylobacter spp. in humans and in broiler flocks using a multiple dataset approach.
abstract: BACKGROUND
  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 Campylobacter 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 Campylobacter 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 Campylobacter 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 Campylobacter spp. for both humans and broilers.
  
  
  RESULTS
  Local space-time clusters of humans and broilers positive for Campylobacter 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.
  
  
  CONCLUSIONS
  The simultaneous occurrence of clusters of humans and broilers positive for Campylobacter 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.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 Campylobacter spp. in an area. Further studies to clarify the role of such factors are needed.
authors.affiliation: National Veterinary Institute, Department for Health Surveillance, POB 750 Sentrum, 0106 Oslo, Norway. malin.jonsson@vetinst.no
authors.forename: Malin E
authors.initials: ME
authors.lastname: Jonsson
authors.forename: Berit Tafjord
authors.initials: BT
authors.lastname: Heier
authors.forename: Madelaine
authors.initials: M
authors.lastname: Norström
authors.forename: Merete
authors.initials: M
authors.lastname: Hofshagen
mesh_terms: D000818:Animals; D002167:Campylobacter / Q000302:isolation & purification / Q000472:pathogenicity; D002169:Campylobacter Infections / Q000453:epidemiology / Q000635:transmission* / Q000662:veterinary*; D002645:Chickens; D016000:Cluster Analysis; D003625:Data Collection / Q000379:methods; D003627:Data Interpretation, Statistical; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data / Q000662:veterinary; D004197:Disease Reservoirs / Q000382:microbiology / Q000662:veterinary*; D005506:Food Contamination / Q000032:analysis; D006801:Humans; D015994:Incidence; D008460:Meat / Q000382:microbiology; D017720:Molecular Epidemiology; D009010:Monte Carlo Method; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D016012:Poisson Distribution; D011201:Poultry Diseases / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D012042:Registries; D012621:Seasons; D013997:Time Factors; D015047:Zoonoses