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Partial failure of milk pasteurization as a risk for the transmission of campylobacter from cattle to humans
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Fernandes, Anand M., Balasegaram, Sooria, Willis, Caroline, Wimalarathna, Helen M. L., Maiden, Martin C. J. and McCarthy, Noel D. (2015) Partial failure of milk pasteurization as a risk for the transmission of campylobacter from cattle to humans. Clinical Infectious Diseases, 61 (6). pp. 903-909. 431. doi:10.1093/cid/civ431 ISSN 1058-4838.
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Official URL: http://dx.doi.org/10.1093/cid/civ431
Abstract
Background.
Cattle are the second most common source of human campylobacteriosis. However, routes to account for this scale of transmission have not been identified. In contrast to chicken, red meat is not heavily contaminated at point of sale. Although effective pasteurization prevents milk-borne infection, apparently sporadic infections may include undetected outbreaks from raw or perhaps incompletely pasteurized milk.
Methods.
A rise in Campylobacter gastroenteritis in an isolated population was investigated using whole-genome sequencing (WGS), an epidemiological study, and environmental investigations.
Results.
A single strain was identified in 20 cases, clearly distinguishable from other local strains and a reference population by WGS. A case-case analysis showed association of infection with the outbreak strain and milk from a single dairy (odds ratio, 8; Fisher exact test P value = .023). Despite temperature records indicating effective pasteurization, mechanical faults likely to lead to incomplete pasteurization of part of the milk were identified by further testing and examination of internal components of dairy equipment.
Conclusions.
Here, milk distribution concentrated on a small area, including school-aged children with low background incidence of campylobacteriosis, facilitated outbreak identification. Low-level contamination of widely distributed milk would not produce as detectable an outbreak signal. Such hidden outbreaks may contribute to the substantial burden of apparently sporadic Campylobacter from cattle where transmission routes are not certain. The effective discrimination of outbreak isolates from a reference population using WGS shows that integrating these data and approaches into surveillance could support the detection as well as investigation of such outbreaks.
| Item Type: | Journal Article | ||||||||||
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| Subjects: | R Medicine > RC Internal medicine S Agriculture > SF Animal culture |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Campylobacter infections, Animals as carriers of disease, Milk -- Pasteurization | ||||||||||
| Journal or Publication Title: | Clinical Infectious Diseases | ||||||||||
| Publisher: | University of Chicago Press | ||||||||||
| ISSN: | 1058-4838 | ||||||||||
| Official Date: | 15 September 2015 | ||||||||||
| Dates: |
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| Volume: | 61 | ||||||||||
| Number: | 6 | ||||||||||
| Number of Pages: | 6 | ||||||||||
| Page Range: | pp. 903-909 | ||||||||||
| Article Number: | 431 | ||||||||||
| DOI: | 10.1093/cid/civ431 | ||||||||||
| Status: | Peer Reviewed | ||||||||||
| Publication Status: | Published | ||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||||
| Funder: | Public Health England, Seventh Framework Programme (European Commission) (FP7) | ||||||||||
| Grant number: | 278864 (FP7) |
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