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Environmental Determinants of Campylobacteriosis Risk in Philadelphia from 1994 to 2007

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Abstract

Campylobacter species infections are a common cause of acute gastroenteritis, and may uncommonly be complicated by renal, neurological, and rheumatologic sequelae. Although excess summertime campylobacteriosis has been observed, environmental mechanisms driving disease seasonality are poorly understood. We sought to evaluate the relationship between environmental factors and campylobacteriosis risk in a major North American metropolitan area. We evaluated 1532 cases of campylobacteriosis reported in Philadelphia between 1994 and 2007. We constructed Poisson regression models with oscillatory smoothers, and also used case-crossover design, to evaluate the associations between environmental exposures and disease risk on weekly and daily time scales. Both methods control for confounding by seasonally oscillating environmental factors. Incidence was greatest in June and July, with annual periodicity. Weekly incidence was associated with increasing relative humidity, (incidence rate ratio (IRR) per % 1.017, 95% CI 1.008–1.025), temperature (IRR per °C 1.041, 95% CI 1.011–1.072), and decreasing Delaware River temperature during the same week (IRR per °C 0.922, 95% CI 0.883–0.962), and at 4-week lags (IRR per °C 0.953, 95% CI 0.919–0.990). No acute associations were identified in case-crossover analyses. Our findings affirm the summertime seasonality of campylobacteriosis in Philadelphia, and the link between warm, humid weather and disease risk. However, the link between low river temperatures and enhanced campylobacteriosis risk in humans described here is novel, consistent with known links between watershed temperature and Campylobacter survival, and implicates local watersheds as epidemiologically important reservoirs for foodborne pathogens.

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Author notes

  1. C. Victor Spain

    Present address: U.S. Outcomes Research, Merck and Co., West Point, PA, USA

Authors and Affiliations

  1. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Alexander N. J. White

  2. Faculty of Medicine, Dalhousie University, Halifax, NS, Canada

    Laura M. Kinlin

  3. Philadelphia Department of Public Health, Philadelphia, PA, USA

    Caroline Johnson & C. Victor Spain

  4. National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia

    Victoria Ng

  5. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3T7, Canada

    David N. Fisman

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  1. Alexander N. J. White
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  2. Laura M. Kinlin
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  4. C. Victor Spain
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  5. Victoria Ng
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  6. David N. Fisman
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Correspondence to David N. Fisman.

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White, A.N.J., Kinlin, L.M., Johnson, C. et al. Environmental Determinants of Campylobacteriosis Risk in Philadelphia from 1994 to 2007. EcoHealth 6, 200–208 (2009). https://doi.org/10.1007/s10393-009-0246-9

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  • DOI: https://doi.org/10.1007/s10393-009-0246-9

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