Outbreak of Salmonella Livingstone infection in Norway and Sweden due to contaminated processed fish products.

In Europe, the number of reported sporadic human cases of Salmonella Livingstone infection is low, and outbreaks are rare. We report the largest S. Livingstone outbreak described in the literature having an identified source of infection. In February 2001, an increased incidence of infection caused by S. Livingstone was observed in Norway and Sweden. By July 2001, 44 cases were notified in Norway and 16 in Sweden. The median age was 63 years, and 40 were women. There were three deaths, and 22 patients were hospitalized. Based on standardized questionnaires and retrospective studies of S. Livingstone strains in Norway and Sweden, food items with egg powder were suspected, and S. Livingstone was subsequently recovered from a processed fish product at the retail level. Analysis by pulsed-field gel electrophoresis documented that isolates from the fish product belonged to the same clone as the outbreak strain.

Incidence of gastroenteritis in Norway--a population-based survey.

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.

Waterborne campylobacteriosis in northern Norway.

A suspected waterborne outbreak of presumed campylobacteriosis involving approximately 680 of the 1000 inhabitants in a community is described. Twenty-two strains of Campylobacter jejuni were isolated from patients. Ten randomly chosen isolates were identified as biotype 1 LAU 0:1 (n = 9) and biotype 2 PEN 0:6, 7 (n = 1) and one from tap water as biotype 1 PEN 0:19, 22. The majority of cases occurred within a period of 1 week. Examination of human sera obtained during the first 2 weeks of the epidemic (n = 38) revealed two patients producing antibodies directed only against the water isolate. The majority (89%) of sera collected 4 weeks later (n = 18) had antibodies directed against the most common human isolate. We suggest that all three serotypes of C. jejuni were involved in this outbreak, stressing the need for continuous surveillance and treatment of public drinking water sources.

Immuno-histochemical and -cytochemical evidence suggesting the presence of Campylobacter jejuni and Campylobacter coli in cases of porcine intestinal adenomatosis.

Antisera against a number of Campylobacter species were used in immuno-histochemical and -cytochemical studies on cases of porcine intestinal adenomatosis. Avidin-biotin-complex (ABC) and streptavidin immunoperoxidase methods were used on formalin-fixed, paraffin-embedded and frozen sections. Protein A gold method was used on formaldehyde fixed and frozen sections for immuno-cytochemistry. The antisera used were raised in rabbits by subcutaneous or intravenous injection of living or formalin treated organisms. Anti-sera against different serotypes of the thermotolerant, catalase positive campylobacters, Campylobacter jejuni and Campylobacter coli, gave positive reactions in the immuno-histochemical studies. The staining was found in intestinal epithelial cells both in the ileum and in the colon and was restricted to the apical cytoplasm of adenomatous epithelial cells. The staining had a granular pattern, the positive structures sometimes having the shape of Campylobacter. Epithelial cells in areas with normal differentiation of goblet cells did not stain. In contrast, no staining resulted with antisera against Campylobacter sputorum subsp. mucosalis and Campylobacter hyointestinalis. Immuno-cytochemistry, using antisera against Campylobacter jejuni, showed that the positive staining in altered epithelial cells were restricted to intracellular organisms having a structure resembling Campylobacter spp.

Serotyping of Campylobacter jejuni, Campylobacter coli, and Campylobacter laridis from domestic and wild animals.

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.

Isolation and characterization of Campylobacter jejuni and Campylobacter coli from domestic and wild mammals in Norway.

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 isolated 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 animals with clinically diagnosed mastitis (106 cows, 5 sheep, 1 horse, and 1 pig) were negative for campylobacters.