title: Campylobacteriosis outbreak associated with consumption of undercooked chicken liver pâté in the East of England, September 2011: identification of a dose-response risk.
abstract: A foodborne outbreak with 49 cases (22 culture positive for Campylobacter sp.) following a wedding party in the East of England was investigated. A retrospective cohort study identified an association between consumption of chicken liver pâté and infection with Campylobacter jejuni/coli. There was a statistically significant association between dose (amount of chicken liver pâté eaten) and the risk of disease ['tasted': odds ratio (OR) 1·5, 95% confidence interval (CI) 0·04-∞; 'partly eaten': OR 8·4, 95% CI 1·4-87·5; 'most or all eaten': OR 36·1, 95% CI 3·3-2119). The local authority found evidence that the preparation of chicken livers breached Food Standards Agency's guidelines. This epidemiological investigation established a clear dose-response relationship between consumption of chicken liver pâté and the risk of infection with Campylobacter. The continuing need to raise public awareness of the risk to human health posed by undercooked chicken liver is evident.
authors.affiliation: Health Protection Agency (HPA) East of England Regional Epidemiology Unit (REU), Institute of Public Health, University Forvie Site, Cambridge, UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Edwards
authors.affiliation: HPA Bedfordshire and Hertfordshire Health Protection Unit, Beacon House, Letchworth, Hertfordshire, UK.
authors.forename: L M
authors.initials: LM
authors.lastname: Milne
authors.affiliation: HPA Bedfordshire and Hertfordshire Health Protection Unit, Beacon House, Letchworth, Hertfordshire, UK.
authors.forename: K
authors.initials: K
authors.lastname: Morrow
authors.affiliation: HPA Bedfordshire and Hertfordshire Health Protection Unit, Beacon House, Letchworth, Hertfordshire, UK.
authors.forename: P
authors.initials: P
authors.lastname: Sheridan
authors.affiliation: HPA Statistics Unit, Statistics, Modelling and Economics Department of Health Protection Services, Colindale, London, UK.
authors.forename: N Q
authors.initials: NQ
authors.lastname: Verlander
authors.affiliation: Department of Medical Microbiology, Luton and Dunstable University Hospital.
authors.forename: R
authors.initials: R
authors.lastname: Mulla
authors.affiliation: GBRU, HPA Colindale, London, UK.
authors.forename: J F
authors.initials: JF
authors.lastname: Richardson
authors.affiliation: Housing and Public Protection Service, North Hertfordshire District Council, Herts, UK.
authors.forename: A
authors.initials: A
authors.lastname: Pender
authors.affiliation: HPA Bedfordshire and Hertfordshire Health Protection Unit, Beacon House, Letchworth, Hertfordshire, UK.
authors.forename: M
authors.initials: M
authors.lastname: Lilley
authors.affiliation: Health Protection Agency (HPA) East of England Regional Epidemiology Unit (REU), Institute of Public Health, University Forvie Site, Cambridge, UK.
authors.forename: M
authors.initials: M
authors.lastname: Reacher
mesh_terms: D000328:Adult; D000818:Animals; D002167:Campylobacter; D002169:Campylobacter Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D002645:Chickens / Q000382:microbiology; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology; D005759:Gastroenteritis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008099:Liver; D008297:Male; D008460:Meat / Q000009:adverse effects / Q000382:microbiology; D008875:Middle Aged