title: Don't Count Your Chicken Livers: an Outbreak of Campylobacter sp. Not Associated with Chicken Liver Parfait, England, November 2013.
abstract: In England, several recent campylobacter outbreaks have been associated with poultry liver consumption. Following a lunch event in a hotel in Surrey in November 2013 where chicken liver parfait was served, guests reported having gastrointestinal symptoms. A retrospective cohort study showed 46 of 138 guests became unwell, with a median incubation period of two days and for 11 cases campylobacter infection was laboratory confirmed. Food item analysis identified an association between illness and consumption of roast turkey (aOR=3.02 p=0.041) or jus (aOR=3.55 p=0.045), but not with chicken liver parfait (OR=0.39 p=0.405). The environmental risk assessment did not identify non-compliance with standard food practice guidelines. This study presents a point-source outbreak of campylobacter with a high attack rate and epidemiological analysis results show that the jus or roast turkey was the likely source of infection although this could not be confirmed by the environmental assessment. Consuming the chicken liver dish was not a risk factor for developing symptoms as was initially hypothesised. Prior knowledge on the association between poultry liver food items and campylobacter outbreaks should not overly influence an outbreak investigation to ensure the true aetiology is identified and on-going public health risk is minimised.
authors: Field Epidemiology Services - Victoria Office, Public Health England, London, UK.
authors: Suzan
authors: S
authors: Trienekens
authors: Field Epidemiology Services - Victoria Office, Public Health England, London, UK.
authors: Charlotte
authors: C
authors: Anderson
authors: Surrey & Sussex Health Protection Team, Public Health England, Horsham, UK.
authors: Jennifer
authors: J
authors: Duffy
authors: Surrey & Sussex Health Protection Team, Public Health England, Horsham, UK.
authors: Rachel
authors: R
authors: Gill
authors: Surrey & Sussex Health Protection Team, Public Health England, Horsham, UK.
authors: Lisa
authors: L
authors: Harvey-Vince
authors: Environmental Health - Runnymede Borough Council, Addlestone, UK.
authors: Helen
authors: H
authors: Jones
authors: Field Epidemiology Services - Victoria Office, Public Health England, London, UK.
authors: Piers
authors: P
authors: Mook
authors: Field Epidemiology Services - Victoria Office, Public Health England, London, UK.
authors: Chikwe
authors: C
authors: Ihekweazu
authors: Surrey & Sussex Health Protection Team, Public Health England, Horsham, UK.
authors: Ishani
authors: I
authors: Kar-Purkayastha
keywords: Epidemiology; campylobacter; disease outbreaks; food-borne infection
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