[Epidemiological aspects of enteritis due to Campylobacter jejuni].

From September 1986 through July 1987, all fecal specimens obtained from infants and children who visited the pediatric clinic of the Shizuoka General Hospital with complaints of abdominal pain or diarrhea were examined for thermophilic Campylobacters. Bacteriological and epidemiological studies were performed on household contacts. The mothers of the patients were compared with the mothers of age-matched control subjects. Bacteriological examination of animals in 49 primary schools in Shizuoka city was performed. C. jejuni was isolated from 47 (9.4%) of the 499 feces samples, occupying first place in the bacterial etiology of acute bacterial enteritis. Infants and young children below 10 years of age comprised 81% of the total cases. Fourteen (13%) strains of C. jejuni were isolated in 9 families among 105 household contacts of the index patients. Six symptomatic contacts in two households had eaten the same suspected chicken as the respective index patients. In three families, C. jejuni was isolated from the remainder of the chicken. The serotype of these isolates was identical to that of the isolates from the index cases and the other family members. It was also noted that the same chopping boards were used for the preparation of salads after cleansing with water. In two index cases, the antibody of convalescent serum against C. jejuni isolated from the chicken, as estimated by passive hemagglutination method, ranged from 1:320 to 1:1280. These facts strongly supported the assumption that they had been infected by the chicken. The remaining persons were asymptomatic and the possibility was left that the index cases had been secondarily infected by these carrier persons.(ABSTRACT TRUNCATED AT 250 WORDS)

Possible relationship of proliferative enteritis in pigs and hamsters.

Three- to six-week-old hamsters were orally inoculated with broths containing one of the following cultures: Campylobacter mucosalis; C. hyointestinalis; C. coli; C. jejuni, all of porcine proliferative enteritis origin, or else C. jejuni of hamster origin. Hamsters given the last of those organisms were shown to have colonisation of their intestines by C. jejuni and 36 of 40 developed an acute enteritis. Mild hyperplasia of enterocytes in ileal crypts was evident in one hamster 2 days after it was given C. coli. No other lesions were detected. Further 3-week-old hamsters were orally inoculated with homogenised intestinal mucosa collected from 4 pigs (A-D) affected by proliferative enteritis. Lesions of proliferative enteritis were detected in 7 of 41 hamsters necropsied 10-21 days after being dosed with mucosas B or D. Marked hyperplasia of ileal enterocytes, associated with numerous intracellular Campylobacter-like organisms, were invariably detected in experimentally affected hamsters. No particular Campylobacter sp. was consistently isolated. None of the controls had demonstrable lesions. The results suggested that cross-species transmission of proliferative enteritis was possible from pigs to hamsters. Therefore a common initiating or aetiological agent may be present. No specific organism was identified as filling this role by inoculation of hamsters with pure cultures.

Campylobacter enteritis at a university: transmission from eating chicken and from cats.

Campylobacter jejuni is the most common enteric pathogen isolated from university and college students in the United States. During the fall and winter quarters of the 1983-1984 academic year, the authors conducted a case-control study at the University of Georgia, Athens, Georgia, to identify risk factors for C. jejuni enteritis. Students with diarrhea whose cultures yielded C. jejuni were compared with controls matched by age, sex, and residence. A total of 45 case-control pairs were interviewed about exposures during the week before the case's onset of illness. The infections occurred sporadically and were caused by a wide variety of C. jejuni serotypes. Three risk factors were identified: eating fully cooked chicken, eating chicken reported to be raw or undercooked, and contact with a cat or kitten. No case reported drinking raw milk. No significant association was found between illness and the places where chicken meals were prepared or the specific manner in which chicken was cooked. Chicken may be the principal vehicle of transmission for sporadic Campylobacter enteritis among college students.

An outbreak of coccidiosis and necrotic enteritis in 16-week-old cage-reared layer replacement pullets.

A flock of 16-week-old layer replacement pullets housed in cages since 1 day old experienced an outbreak of necrotic enteritis with concurrent coccidiosis 3 weeks after debeaking.

Isospora belli enteritis in three homosexual men.

Isospora belli is an uncommon cause of diarrhea in man. Like the closely related Cryptosporidium, the organism causes disease that may be more severe and chronic in patients with underlying immune deficiency states. We describe three male homosexuals with Isospora enteritis. Each had several months of diarrhea. All three patients had lymphopenia and two had profound T cell helper-suppressor ratio reversal. In addition, two of the patients admitted to oral-anal contact, a practice associated with the acquisition of parasites and other enteric pathogens in the homosexual population. We suggest that Isospora belli may be a sexually transmitted pathogen which should be considered in the diagnosis of homosexual patients with diarrhea.

[Campylobacter jejuni: an important causative agent of food infection in man. An overview]. / Campylobacter jejuni: een belangrijke verwekker van voedselinfecties bij de mens. Een overzicht.

Since a few years, Campylobacter jejuni has been identified as an important cause of acute enteritis in man. Various studies showed that Campylobacter enteritis is as common as salmonellosis, and that the symptoms often are even more severe. That this species of bacterium was not discovered until recently, was due in part to the fact that unusual methods of isolation are required; for instance, Campylobacter jejuni will only grow in a micro-aerophilic atmosphere. Campylobacteriosis was found to be a foodborne infection in the majority of cases. The organism was isolated from a large number of species of wild and domesticated animals, which, as in the case of Salmonella, are mainly asymptomatic carriers. Of farm animals, poultry and pigs are most frequently infected. The most important sources of human infection are poultry meat, unpasteurized milk, inadequately treated drinking water and, as a direct source, dogs with enteritis. Only poultry was found to play a role in the Netherlands. Pork is mostly not contaminated as Campylobacter dies during cooling of pig carcasses, death being due to the drying effect of forced ventilation. The sensitivity of Campylobacter to dry conditions, in conjunction with its inability to multiply below 30 degrees C, means that the mechanism of cross contamination, which is such an important factor in the epidemiology of Salmonella, is of minor significance in Campylobacter.

Sexually transmitted viral hepatitis and enteric pathogens.

Hepatitis viruses, enteric pathogens, and anorectal infections may commonly be transmitted by various sexual practices. Because of their larger numbers of sexual partners and sexual practices such as anilingus and anal intercourse, homosexual men are at particularly high risk of acquiring hepatitis B, giardiasis, amebiasis, shigellosis, campylobacteriosis, and anorectal infections with Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, herpes simplex virus, and human papilloma viruses. The evidence for sexual transmission of these infections as well as their diagnosis and treatment are discussed.

Campylobacter enteritis associated with foodborne transmission.

During an outbreak of gastrointestinal illness at a boys summer camp in Connecticut in June-July 1980, Campylobacter jejuni was isolated from 16 of 41 ill persons but from none of 63 controls (P less than 0.001). When the indirect fluorescent antibody assay was used, cross-titering serum and isolates from five patients showed all isolates to be identical. Lack of serologic response in culture-negative ill persons suggested that a second etiologic agent may have been involved. Ten convalescent carriers treated with erythromycin had clearance of Campylobacter from their stools within 72 hours. Among 26 camp staff members affected, two clusters of illness were seen, each one week after a birthday party, one party on June 26 and the other on July 2. Eating cake at the parties was significantly associated with illness (p = 0.0002 and p = 0.019, respectively). Eating an edge or corner piece with more icing at one party was associated with illness (p = 0.024). The source of the contamination of the icing was not found. None of 15 ill campers had eaten birthday cake. Although rates of eating salad were not significantly different when ill campers were matched with healthy campers, the relative risk associated with eating salad was 5. Campylobacter was isolated from the hands of an infected staff member who, while ill, prepared salad for the campers.