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A reconsideration of the Campylobacter dose–response relation

Published online by Cambridge University Press:  01 March 2005

P. TEUNIS
Affiliation:
Computerization and Methodological Consultancy Unit, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
W. VAN DEN BRANDHOF
Affiliation:
Centre for Infectious Diseases Epidemiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
M. NAUTA
Affiliation:
Microbiological Laboratory for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
J. WAGENAAR
Affiliation:
Veterinary Microbiologic Diagnostic Centre, Utrecht University, The Netherlands
H. VAN DEN KERKHOF
Affiliation:
District Public Health Service (GGD), Dordrecht, The Netherlands
W. VAN PELT
Affiliation:
Centre for Infectious Diseases Epidemiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Abstract

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As a major foodborne pathogen, Campylobacter jejuni receives much attention in quantitative risk assessment. To date, all dose–response assessments have been based on a single human feeding study which unfortunately provides incomplete and possibly biased information on the dose–response relation. An incident at a dairy farm, where several children from a school class became ill as a result of drinking raw milk contaminated with C. jejuni, appeared to show a very clear dose–response relation between the amount of milk consumed and the attack rate. This relation was very nearly exponentially shaped and, therefore, seemed to conflict with the rather slowly rising dose–response relation established in the feeding study. Here we show that both datasets can be reconciled when illness and infection are considered separately. This not only provides new information on the illness dose–response relation for Campylobacter, but also amends the infection dose–response relation because of their conditional dependence.

Type
Research Article
Copyright
2005 Cambridge University Press