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Journal of Clinical Microbiology, January 2009, p. 111-116, Vol. 47, No. 1
0095-1137/09/$08.00+0     doi:10.1128/JCM.01731-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Campylobacter Immunity and Coinfection following a Large Outbreak in a Farming Community{triangledown} ,{dagger}

K. J. Forbes,1 F. J. Gormley,1 J. F. Dallas,1 O. Labovitiadi,1 M. MacRae,1 R. J. Owen,2 J. Richardson,2 N. J. C. Strachan,3 J. M. Cowden,4 I. D. Ogden,1* and C. C. McGuigan5

Department of Medical Microbiology, School of Medicine, University of Aberdeen, Aberdeen,1 Health Protection Agency, Centre for Infections, London,2 School of Biological Sciences, University of Aberdeen, Aberdeen,3 Health Protection Scotland, Clifton House, Clifton Place, Glasgow,4 NHS Tayside Health Protection Team, Kings Cross Hospital, Dundee, United Kingdom5

Received 8 September 2008/ Returned for modification 16 October 2008/ Accepted 20 October 2008

An outbreak of campylobacteriosis affected approximately one-half of 165 people attending an annual farmers' dance in Montrose, Scotland, in November 2005. Epidemiological investigations, including a cohort study (n = 164), identified chicken liver paté as the most likely vehicle of infection. Paté preparation involved deliberate undercooking of chicken livers by flash-frying, followed by mechanical homogenization. Typing of 32 Campylobacter strains (isolated from submitted stools) by multilocus sequence typing identified four distinct clades of Campylobacter jejuni. There was good agreement when isolates were typed by Penner serotyping, pulsed-field gel electrophoresis, and flaA short variable region sequencing but poorer agreement with phage and antibiotic susceptibility testing. At least three attendees were coinfected with two Campylobacter strains each. The outbreak was probably due to several livers contributing Campylobacter strains that survived undercooking and were dispersed throughout the paté. The study highlights improper culinary procedures as a potential human health risk and provides a striking counterexample to the "dominant outbreak strain" view of point source outbreaks of food-borne infections. It also demonstrates that previous exposure to biologically plausible sources of Campylobacter may confer protection against subsequent infection.

* Corresponding author. Mailing address: School of Medicine, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, United Kingdom. Phone: 44 1224 551132. Fax: 44 1224 552692. E-mail: i.ogden{at}abdn.ac.uk

{triangledown} Published ahead of print on 12 November 2008.

{dagger} Supplemental material for this article may be found at http://jcm.asm.org/.

Journal of Clinical Microbiology, January 2009, p. 111-116, Vol. 47, No. 1
0095-1137/09/$08.00+0     doi:10.1128/JCM.01731-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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