Sporadic Campylobacter infection in infants : A population-based surveillance case-control study

Background: Campylobacter is an important cause of foodborne illness in infants (younger than 1 year of age), but little is known about the sources of infection in this age group. Methods: Eight sites in the Foodborne Diseases Active Surveillance Network (FoodNet) participated in a 24-month population-based case-control study conducted in 2002–2004. Cases were infants with laboratory-confirmed Campylobacter infection ascertained through active laboratory surveillance, and controls were infants in the community. Results: We enrolled 123 cases and 928 controls. Infants 0–6 months of age with Campylobacter infection were less likely to be breast-fed than controls [odds ratio (OR); 0.2; 95% confidence interval (CI), 0.1–0.6]. Risk factors for infants 0–6 months of age included drinking well water (OR 4.4; CI, 1.4–14) and riding in a shopping cart next to meat or poultry (OR 4.0; CI, 1.2–13.0). Risk factors for infants 7–11 months of age included visiting or living on a farm (OR 6.2; CI, 2.2–17), having a pet with diarrhea in the home (OR 7.6; CI, 2.1–28) and eating fruits and vegetables prepared in the home (OR 2.5, CI 1.2–4.9). Campylobacter infection was associated with travel outside the United States at all ages (OR 19.3; CI, 4.5–82.1). Conclusions: Several unique protective and risk factors were identified among infants, and these risk factors vary by age, suggesting that prevention measures be targeted accordingly. Breast-feeding was protective for the youngest infants and should continue to be encouraged.