AEM Accepts, published online ahead of print on 23 October 2009

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Appl. Environ. Microbiol. doi:10.1128/AEM.00942-09
Copyright (c) 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Investigation of food and environmental exposures relating to epidemiology of Campylobacter coli in humans in North West England

Will Sopwith^*, Andrew Birtles, Margaret Matthews, Andrew Fox, Steven Gee, Sam James, Jeanette Kempster, Michael Painter, Val Edwards-Jones, Keith Osborn, Martyn Regan, Qutub Syed, and Eric Bolton

Health Protection Agency, North West Local and Regional Services, Liverpool, UK; North West Health Protection Agency Laboratory, Manchester, UK; Manchester Metropolitan University, Manchester, UK; United Utilities, Warrington, UK

^* To whom correspondence should be addressed. Email: will.sopwith{at}wirral.nhs.uk.

AIM: this study uses MLST to investigate the epidemiology of Campylobacter coli in a continuous study of a population in North West England. METHODS: all cases of Campylobacter identified in four Local Authorities between 2003 and 2006 were speciated and then typed, using MLST. Epidemiological information was collected for each of these cases, including food and recreational exposure variables, and the epidemiology of C. jejuni and C. coli were compared using case case methodology. Samples of surface water thought to represent possible points of exposure to the populations under study were also sampled and campylobacters typed with MLST. RESULTS: in comparison to cases of C. jejuni, cases of C. coli were more likely to be older and female. In logistic regression, C. coli infection was positively associated with eating undercooked eggs, eating out and reporting problems with their water supply prior to illness. C. coli was less associated with consuming pork products. Most of the cases of C. coli yielded sequence types described elsewhere both in livestock and poultry but several new sequence types were also identified in human cases and water samples. There was no overlap between types identified in humans and surface waters and genetic analysis suggested three distinct clades, but with several ‘intermediate’ types from water that were convergent with the human clade. DISCUSSION: there is little evidence to suggest that epidemiological differences between human cases of C. coli and C. jejuni are a result of different food or behavioural exposures alone.