Researchers have shown the significant impact and costs of Campylobacter infections from contaminated chicken in Australia.
Scientists quantified the cost of illness attributable to specific domestic risk factors for Campylobacter jejuni and Campylobacter coli. They used data from a 2018 to 2019 case–control study to estimate odds ratios and attributable fractions for risk factors. Data on national incidence, hospitalization, and premature mortality was used to quantify burden. The team then applied costs related to healthcare use, pain and suffering, premature mortality, and lost productivity to each risk factor.
Results published recently in the journal Foodborne Pathogens and Disease showed that Campylobacter jejuni caused 83 percent of infections and chicken consumption resulted in the highest attributable fraction, at 30 percent, costing $111 million annually. Campylobacteriosis linked to eating contaminated chicken meat, even when reported as cooked, incurred costs which accounts for almost half of the total foodborne burden from Campylobacter of $253 million.
The burden associated with the use of proton-pump inhibitors (PPIs) was second, followed by contact with young dogs at $30 million and chicken feces at $10 million.
Methods used
Attributable costs and disease burden metrics can provide insight into the relative importance of risk factors from an economic perspective and highlight areas for public health resources and interventions in a more targeted way than disease-wide estimates. These figures can be compared with the costs of implementing measures to reduce Campylobacter prevalence in risk factors, said scientists.
Australia has a high rate of campylobacteriosis with 145 reported cases per 100,000 people. Incidence has increased in the past decade, prompting regulators to develop a national foodborne illness reduction strategy focusing on Campylobacter and Salmonella.
In a cost of illness study, campylobacteriosis transmitted via contaminated food was estimated to cost Australia $253 million annually. Estimated annual costs of foodborne illness caused by food commodities and pathogens have also been produced recently.
A total of 571 case–patients were recruited who were culture-positive for Campylobacter in the Australian Capital Territory, a region of New South Wales, and Queensland. Cases were matched to 586 controls by sex, age group, and location.
Burden of disease included cases, hospitalizations, and deaths for initial diarrheal illness and three sequelae: reactive arthritis, irritable bowel syndrome (IBS), and Guillain–Barré syndrome (GBS). Cost of illness estimates included premature mortality, direct healthcare costs (including healthcare visits, tests, and medications), lost productivity, and the cost of pain and suffering.
Major role of chicken
Researchers estimated there were 349,000 cases of campylobacteriosis in Australia, with 83 percent due to Campylobacter jejuni and 17 percent due to Campylobacter coli.
Among five risk factors, consumption of cooked chicken in the seven days before illness had the highest score across all age groups. This ranged from 30 percent in adults aged over 65 to 35 percent in children less than 5 years old. Consumption of undercooked chicken had a larger score but was less frequently reported, so the overall attribution proportion was much smaller.
As cooking meat kills Campylobacter, attribution to cooked chicken is likely from people unknowingly eating it undercooked or from poor handling of raw chicken and cross-contamination during preparation.
Scientists attributed 114,000 cases to eating cooked chicken and 24,200 to knowingly eating chicken that appeared undercooked. They estimated that cooked chicken resulted in 2,400 hospitalizations and one death while undercooked chicken led to 487 hospitalizations and less than one death. When including all cost components for initial illness and sequelae, this amounted to an estimated $111 million for transmission from cooked chicken and $23.1 million from undercooked chicken.
A total of 32,500 cases were linked to contact with dogs aged less than six months with an estimated 595 hospitalizations and less than one death. This equated to $29.8 million annually. A total of 10,800 cases were attributed to contact with chicken feces in the seven days before illness with 192 hospitalizations and no deaths. This equated to over $9.92 million annually.
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