SUMMARY This study assesses the contribution of different sources of human campylobacteriosis in Denmark using two different source-attribution approaches. In total, 794 non-human isolates and 406 isolates from human cases (domestic, travel related, and cases with unknown travel history) were collected. Isolates were characterized by multilocus sequence typing, flaA typing and susceptibility to antibiotics. Both models used indicate that the major burden of human campylobacteriosis in Denmark originates from the domestic broiler chicken reservoir. The second most important reservoir was found to be cattle. The Asymmetric Island model attributed 52% [95% credibility interval (CrI) 37-67] to Danish chicken, 17% (95% CrI 3-33) to imported chicken, and 17% (95% CrI 7-28) to cattle. Similarly, the Campylobacter source-attribution model apportioned 38% (95% CrI 28-47) to Danish chicken, 14% (95% CrI 10-18) to imported chicken, and 16% (95% CrI 7-25) to cattle. The addition of flaA type as an extra discriminatory typing parameter did not change the attribution of cases markedly.

To reduce the incidences of human Campylobacter infections, a number of countries are investigating methods for reducing human exposure to Campylobacter from broiler meat. In addition to implementing biosecurity measures at the farm, Campylobacter may be controlled by reducing Campylobacter counts through physical decontamination of the meat. The current study was conducted to compare the Campylobacter-reducing ability of three physical decontamination techniques, forced air chilling, crust freezing, and steam-ultrasound, performed in the plant with naturally contaminated broiler chickens. The effects of all three techniques were evaluated and compared with the effect of freezing. Mean reductions obtained were 0.44 log CFU per carcass, 0.42 log CFU per sample, and > or = 2.51 log CFU per carcass, respectively. All techniques resulted in significant reductions of the Campylobacter concentration on the carcasses (P < 0.05). However, none of the techniques were as effective as freezing based on reductions in Campylobacter counts and on adverse effects. The increase in Campylobacter counts on carcasses following visceral rupture during the evisceration operation also was examined. Visceral rupture resulted in an increase of 0.9 log CFU per carcass, suggesting that Campylobacter counts also may be reduced by optimizing the hygienic design of equipment or by physical removal of fecal contamination.

Thermotolerant Campylobacter spp. have been the most common bacterial cause of human gastrointestinal disease in Denmark since 1999. In 2003, the Danish voluntary strategy to control Campylobacter was intensified. The focus was on biosecurity, allocation of meat from Campylobacter-negative broilers to the production of chilled products, and consumer information campaigns. From 2002 to 2007, the percentage of Campylobacter-positive broiler flocks at slaughter decreased from 43% to 27%. After processing, Campylobacter-positive samples of chilled broiler meat fell from 18% in 2004 to 8% in 2007. Furthermore, the number of registered human Campylobacter cases decreased by 12%; from 4379 cases in 2002 to 3865 cases in 2007. We believe that the observed decrease in the occurrence of Campylobacter in broilers and broiler meat and the coincidental fall in the number of registered human cases is, in part, a result of the implemented control strategy.

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