In 1999-2000 we conducted a one-year, retrospective population-based survey in Norway to estimate the incidence of gastroenteritis and study the association with selected exposures. A self-administered questionnaire was mailed to 3000 persons selected at random from the population registry, with 250 persons being contacted each month. The response rate was 61%. The incidence of acute gastroenteritis was 1.2 per person-year. The incidence was higher for women than for men. Of the total of 171 cases, 29 (17%) consulted a physician, 13 (8%) reported that a stool sample was taken, and 7 (4%) were admitted to hospital. Among children aged less than 15 years, drinking water from a private water supply was associated with illness, while using chlorinated water was protective. Among adults aged 20-40 years, travelling abroad was associated with illness. The incidence in our survey is similar to rates found by FoodNet in United States.
A total of 1,262 domestic and wild mammals from Norway were surveyed for fecal carriage of Campylobacter jejuni and Campylobacter coli. Of the five species of domestic mammals examined, the highest isolation rate was recorded among swine (100.0%), followed by sheep (8.1%) and cows (0.8%). No strains were recovered from horses or goats. Among wild mammals, C. jejuni was isolated from 1 of 23 hares, and no isolates were obtained from three species of cervids and three species of rodents. Of the 133 Campylobacter strains isolated, 114 were classified as C. coli, 18 were C. jejuni biotype 1, and 1 belonged to C. jejuni biotype 2. All 114 strains from swine were C. coli. Milk samples from 113 domestic mammals with clinically diagnosed mastitis (106 cows, 5 sheep, 1 horse, and 1 pig) were negative for campylobacters.
By using 50 unabsorbed antisera, we were able to serotype 272 (65.7%) of 414 thermotolerant campylobacters from wild and domestic animals, on the basis of heat-stable antigens identified by means of passive hemagglutination. Forty-two serotypes were recognized. The pattern of serotypes detected in the various animal species was compared to human clinical isolates by using the Czekanowski index (proportional similarity index). The highest degree of similarity to the clinical isolates was observed for the poultry isolates, followed by strains from wild birds, flies, and pigs (in order of decreasing similarity). The serotypes recovered most frequently from poultry (LAU 1 and LAU 2) were also most prevalent in Norwegian patients. In contrast, serotype LAU 35/44, the predominant porcine serotype, was never recovered from human clinical specimens. Flies captured in chicken farms and in piggeries harbored serotypes which were also commonly seen in chickens and pigs, respectively. Nine of the strains included in this study could not be ascribed to any defined species. All of these were resistant to nalidixic acid and did not produce H2S.
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