An outbreak of campylobacteriosis at a rural hotel in England : The ongoing risk of outbreaks due to consumption of chicken liver dishes

Wensley, Adrian (2018) An outbreak of campylobacteriosis at a rural hotel in England : The ongoing risk of outbreaks due to consumption of chicken liver dishes. In: European Scientific Conference on Applied Infectious Disease Epidemiology, 2018-11-21 - 2018-11-23, Malta.

Abstract

Background: A sizable body of literature supports the risk of campylobacterios is associated with eating chicken liver pate. Despite this, outbreaks continue to occur. In January 2017, six cases of campylobacteriosis were reported, all having eaten at the same hotel in December 2016.Three Christmas parties were held at this venue on the same day and included 73 attendees. All three parties ate from the same set menu.The outbreak was investigated to identify the source and to implement control measures. Methods: A retrospective cohort study was undertaken to test the hypothesis that consumption of individual food items was associated with an increased risk of illness. Attendees were asked to complete an online questionnaire on consumption of food items and known risk factors for sporadic campylobacteriosis. We performed univariable, multivariable, dose response and sensitivity analyses. Results: In total, there were 19 cases of campylobacteriosis linked to the outbreak; 7 confirmed and 12 probable. Incubation period ranged between 4 hours and 4 days. Chicken liver pate was the food item most strongly associated with illness (p < 0.001) with a corresponding high crude relative risk (12.95). This relationship was supported by multivariable analyses, sensitivity analyses and a clear dose-response relationship. Conclusions:The results were suggestive of a single point source exposure with a strong association between the consumption of chicken liver pate and campylobacteriosis. This outbreak highlights that despite Food Standards Agency guidance demonstrating that simple techniques can ensure all campylobacter are killed during cooking, outbreaks in the UK and other countries continue to occur. Public and professional awareness needs to be raised further to reduce the risk of campylobacteriosis linked to incorrectly cooked chicken liver dishes.