A Descriptive Epidemiologic Study of Campylobacteriosis in East Tennessee

Campylobacteriosis is caused by the gram-negative bacteria Campylobacter and is a leading cause of gastrointestinal illness worldwide. In the United States an estimated 2.4 million cases occur annually with approximately $8.0 billion in associated costs. Due to the high cost of morbidity, understanding the epidemiology and risk factors of campylobacteriosis is important. It is unclear if the prevalence of campylobacteriosis is higher or lower in East Tennessee than other parts of the state or country or if the clinical characteristics of patients in the area are similar to the rest of the country. Therefore, the purpose of the study was to describe clinical and epidemiological characteristics of campylobacteriosis patients in East Tennessee to assist in health planning to control campylobacteriosis. Data from the Foodborne Disease Active Surveillance Network was analyzed for 2003-2006 in 16 counties in East Tennessee. The data was first assessed for its quality, then descriptive statistics were calculated and spatial and temporal patterns of reported cases and risk factors were assessed. The overall error rate in the data quality analysis was 6.5% although in the last year of the study it was only 2.6%. The mean annual prevalence of campylobacteriosis in East Tennessee was 10.4 cases per 100,000 population, which was 1.6 times higher than all of Tennessee (7.4 cases/100,000). Grainger and Jefferson Counties had higher age- and sex-adjusted prevalence estimates than the region and nation. It is yet unclear why this region has a higher prevalence of campylobacteriosis than the rest of the nation. The highest age-specific prevalence (41.6 cases/100,000) was observed in children under 5. Disease prevalence was consistently higher in the summer months compared to the other seasons. The median age of patients was lower in the most rural counties. More patients in East Tennessee were hospitalized than the rest of the nation. The most commonly reported risk factors were animal and raw meat exposure. Improvement in data collection and entry is necessary to improve the quality and application of this surveillance data. Educational efforts on proper hygiene following animal handling, and proper well protection and disinfection should be targeted at high risk groups.