A Foodborne outbreak of campylobacteriosis at a wedding – Melbourne, Australia, 2022
DOI:
https://doi.org/10.33321/cdi.2023.47.10Keywords:
Campylobacter jejuni, campylobacteriosis, foodborne illness, gastroenteritis, duck liver, outbreak investigationAbstract
Campylobacter is the most common bacterial cause of foodborne gastroenteritis in Australia; however, outbreaks caused by the pathogen are relatively uncommon. In March 2022, the Victorian Department of Health was notified of a gastrointestinal illness in 20 guests following attendance at a wedding reception. Two of these individuals were notified with laboratory-confirmed campylobacteriosis, and an investigation was undertaken to identify the source of the infection and implement strategies to prevent further illness.
A case-control study was conducted to determine the likely source of infection. Cases were defined as attendees of the wedding reception, with onset of diarrhoea and/or abdominal cramping 1–10 days after attending the function. Controls were randomly selected from the remaining list of non-ill guests. Cases and controls were interviewed using a standardised, menu-based questionnaire. Food preparation processes were documented, and food samples collected.
A total of 29 wedding guests met the case definition. Cases reported onset of illness 2–5 days following the wedding and major symptoms included abdominal cramping (100%), diarrhoea (90%), headache (79%), and fever (62%). Two cases were hospitalised, one with ongoing secondary neurological sequelae. Illness was significantly associated with consumption of a duck breast brioche canapé containing duck liver parfait (odds ratio = 2.85; 95% confidence interval: 1.03–7.86). No leftover food samples were available for testing.
The investigation found that the duck canapé was the likely vehicle of infection. Consistent with the literature on Campylobacter transmission, it is likely that inadequate cooking of the duck liver for the parfait was the contributing factor that led to illness. This highlights the risks posed by undercooked poultry dishes, and shows that education of food handlers remains a priority.
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References
Australian Government Department of Health and Aged Care. National Notifable Diseases Surveillance System—Notification rate of campylobacteriosis 2019. [Internet.] Canberra: Australian Government Department of Health and Aged Care. [Accessed in May 2022.] Available from: http://www9.health.gov.au/cda/source/cda-index.cfm.
Hall G, Yohannes K, Raupach J, Becker N, Kirk M. Estimating community incidence of Salmonella, Campylobacter, and Shiga toxin-producing Escherichia coli infections, Australia. Emerg Infect Dis. 2008;14(10):1601–9. doi: https://doi.org/10.3201/eid1410.071042.
Moffatt CRM, Fearnley E, Bell R, Wright R, Gregory J, Sloan-Gardner T et al. Characteristics of Campylobacter gastroenteritis outbreaks in Australia, 2001 to 2016. Foodborne Pathog Dis. 2020;17(5):308–15. doi: https://doi.org/10.1089/fpd.2019.2731.
Hope KG, Merritt TD, Durrheim DN. Short incubation periods in Campylobacter outbreaks associated with poultry liver dishes. Commun Dis Intell Q Rep. 2014;38(1):E20–3.
Victorian Department of Health. Campylobacter infection. [Internet.] Melbourne: Victoria State Government Department of Health; 8 October 2015. [Accessed in May 2022.] Available from: https://www.health.vic.gov.au/infectious-diseases/campylobacter-infection.
Laughlin ME, Chatham-Stephens K, Geissler AL. Campylobacteriosis. [Internet.] Atlanta: Federal Government of the United States, Department of Health and Human Services, Centers For Disease Control and Prevention; 24 June 2019. Available from: https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/campylobacteriosis.
Facciolà A, Riso R, Avventuroso E, Visalli G, Delia SA, Laganà P. Campylobacter: from microbiology to prevention. J Prev Med Hyg. 2017;58(2):E79–92.
Hansson I, Nyman A, Lahti E, Gustafsson P, Olsson Engvall E. Associations between Campylobacter levels on chicken skin, underlying muscle, caecum and packaged fillets. Food Microbiol. 2015;48:178–81. doi: https://doi.org/10.1016/j.fm.2014.12.013.
New South Wales Government Food Authority (NSW Food Authority). Campylobacter in chicken liver. Sydney: NSW Food Authority; September 2018. Available from: https://www.foodauthority.nsw.gov.au/sites/default/files/_Documents/scienceandtechnical/campylobacter_in_chicken_liver.pdf.
Whyte R, Hudson JA, Graham C. Campylobacter in chicken livers and their destruction by pan frying. Lett Appl Microbiol. 2006;43(6):591–5. doi: https://doi.org/10.1111/j.1472-765X.2006.02020.x.
Abid M, Wimalarathna H, Mills J, Saldana L, Pang W, Richardson JF et al. Duck liver-associated outbreak of campylobacteriosis among humans, United Kingdom, 2011. Emerg Infect Dis. 2013;19(8):1310–3. doi: https://doi.org/10.3201/eid1908.121535.
Wensley A, Padfield S, Hughes GJ. An outbreak of campylobacteriosis at a hotel in England: the ongoing risk due to consumption of chicken liver dishes. Epidemiol Infect. 2020;148:e32. doi: https://doi.org/10.1017/S095026882000028X.
Young NJ, Day J, Montsho-Hammond F, Verlander NQ, Irish C, Pankhania B et al. Campylobacter infection associated with consumption of duck liver pate: a retrospective cohort study in the setting of near universal exposure. Epidemiol Infect. 2014;142(6):1269–76. doi: https://doi.org/10.1017/S0950268813001969.
Parry A, Fearnley E, Denehy E. ‘Surprise’: Outbreak of Campylobacter infection associated with chicken liver pâté at a surprise birthday party, Adelaide, Australia, 2012. Western Pac Surveill Response J. 2012;3(4):16–9. doi: https://doi.org/10.5365/WPSAR.2012.3.4.011.
Merritt T, Combs B, Pingault N. Campylobacter outbreaks associated with poultry liver dishes. Commun Dis Intell Q Rep. 2011;35(4):299–300.
Scott MK, Geissler A, Poissant T, DeBess E, Melius B, Eckmann K et al. Notes from the field: campylobacteriosis outbreak associated with consuming undercooked chicken liver pâté – Ohio and Oregon, December 2013–January 2014. MMWR Morb Mortal Wkly Rep. 2015;64(14):399.
Edwards DS, Milne LM, Morrow K, Sheridan P, Verlander NQ, Mulla R et al. Campylobacteriosis outbreak associated with consumption of undercooked chicken liver pâté in the East of England, September 2011: identification of a dose-response risk. Epidemiol Infect. 2014;142(2):352–7. doi: https://doi.org/10.1017/S0950268813001222.
Inns T, Foster K, Gorton R. Cohort study of a campylobacteriosis outbreak associated with chicken liver parfait, United Kingdom, June 2010. Euro Surveill. 2010;15(44):19704. doi: https://doi.org/10.2807/ese.15.44.19704-en.
Hutchison M, Harrison D, Richardson I, Tchórzewska M. A method for the preparation of chicken liver pate that reliably destroys campylobacters. Int J Environ Res Public Health. 2015;12(5):4652–69. doi: https://doi.org/10.3390/ijerph120504652.
Food Standards Australia New Zealand (FSANZ). Poultry liver dishes - how to cook them safely. [Internet.] Canberra: FSANZ; March 2017. Available from: https://www.foodstandards.gov.au/consumer/safety/poultryliver/Pages/default.aspx.
Teunis PFM, Bonačić Marinović A, Tribble DR, Porter CK, Swart A. Acute illness from Campylobacter jejuni may require high doses while infection occurs at low doses. Epidemics. 2018;24:1–20. doi: https://doi.org/10.1016/j.epidem.2018.02.001.
Ang CW, Teunis PFM, Herbrink P, Keijser J, Van Duynhoven YHTP, Visser CE et al. Seroepidemiological studies indicate frequent and repeated exposure to Campylobacter spp. during childhood. Epidemiol Infect. 2011;139(9):1361–8. doi: https://doi.org/10.1017/S0950268810002359.
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