Sources and transmission routes of campylobacteriosis: A combined analysis of genome and exposure data

Lapo Mughini-Gras*, Roan Pijnacker, Claudia Coipan, Annemieke C. Mulder, Adriana Fernandes Veludo, Sharona de Rijk, Angela H.A.M. van Hoek, Ralph Buij, Gerard Muskens, Miriam Koene, Kees Veldman, Birgitta Duim, Linda van der Graaf-van Bloois, Coen van der Weijden, Sjoerd Kuiling, Anjo Verbruggen, Joke van der Giessen, Marieke Opsteegh, Menno van der Voort, Greetje A.A. CastelijnFranciska M. Schets, Hetty Blaak, Jaap A. Wagenaar, Aldert L. Zomer, Eelco Franz

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

36 Citations (Scopus)


Objectives: To determine the contributions of several animal and environmental sources of human campylobacteriosis and identify source-specific risk factors. Methods: 1417 Campylobacter jejuni/coli isolates from the Netherlands in 2017–2019 were whole-genome sequenced, including isolates from human cases (n = 280), chickens/turkeys (n = 238), laying hens (n = 56), cattle (n = 158), veal calves (n = 49), sheep/goats (n = 111), pigs (n = 110), dogs/cats (n = 100), wild birds (n = 62), and surface water (n = 253). Questionnaire-based exposure data was collected. Source attribution was performed using core-genome multilocus sequence typing. Risk factors were determined on the attribution estimates. Results: Cases were mostly attributed to chickens/turkeys (48.2%), dogs/cats (18.0%), cattle (12.1%), and surface water (8.5%). Of the associations identified, never consuming chicken, as well as frequent chicken consumption, and rarely washing hands after touching raw meat, were risk factors for chicken/turkey-attributable infections. Consuming unpasteurized milk or barbecued beef increased the risk for cattle-attributable infections. Risk factors for infections attributable to environmental sources were open water swimming, contact with dog faeces, and consuming non-chicken/turkey avian meat like game birds. Conclusions: Poultry and cattle are the main livestock sources of campylobacteriosis, while pets and surface water are important non-livestock sources. Foodborne transmission is only partially consistent with the attributions, as frequency and alternative pathways of exposure are significant.

Original languageEnglish
Pages (from-to)216-226
JournalJournal of infection
Issue number2
Early online date1 Dec 2020
Publication statusPublished - Feb 2021


  • Campylobacter
  • Core-genome MLST
  • Risk factors
  • Source attribution
  • Zoonosis


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