An Analysis of Campylobacter in Tennessee, 2014

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An Analysis of Campylobacter in Tennessee, 2014 Timothy D. Boyland Public Health Associate Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention 2015 PHAP/PHPS Summer Seminar June 1, 2015 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

Objectives Define Campylobacter Define Tennessee population demographics Identify high risk exposures Campylobacter in Tennessee, 2014

What is Campylobacter? It is the bacteria that causes Campylobacteriosis Campylobacteriosis is the second most common diarrheal illness in the United States It is the most common bacterial cause of diarrheal illness Active surveillance through the Foodborne Diseases Active Surveillance Network (FoodNet) indicates that about 14 cases per 100,000* persons are diagnosed each year An estimated 1.3 million persons are affected each year Contaminated food, water, or contact with infected animals are most common modes of transmission *2006/2007 FoodNet Population Survey

Symptoms & Diagnosis Symptoms Laboratory Criteria for Diagnosis Diarrhea (sometimes bloody), abdominal cramps, and fever Laboratory Criteria for Diagnosis Probable: Detection of Campylobacter spp. in a clinical specimen using a culture independent diagnostic test (CIDT). Confirmed: Isolation of Campylobacter spp. from a clinical specimen. Campylobacter in Tennessee, 2014

Tennessee’s Health Department Regions 7 rural regions East Tennessee (ETR), Mid-Cumberland (MCR), Northeast (NER), South Central (SCR), Southeast (SER), Upper Cumberland (UCR), West Tennessee (WTR) 6 major metropolitan areas Chattanooga/Hamilton Co. (CHR), Jackson/Madison Co. (JMR), Knoxville/Knox Co. (KKR), Memphis/Shelby Co. (MSR), Nashville/Davidson Co. (NDR), Sullivan Co. (SUL)

Population Demographics State population- 6,549,352 41% of the state’s population reside in 6 of 95 counties Race & Ethnicity 77% White (5,180,537) 16% Black (1,113,389) 5% Hispanic (320,918) 2% Other (196,480) United States Census Bureau, 2014

Case Demographics 546 Campylobacter cases 2014 381 (70%) met inclusion criteria for the analysis 179 (47%) of cases reported in Tennessee reside in the eastern portion of the state Race & Ethnicity White- 331 (87%) Black- 21 (6%) Hispanic- 14 (4%) Other- 11 (3%) United States Census Bureau, 2014

Epidemic Curve of Campylobacter Incidence in Tennessee, 2014 Campylobacter in Tennessee, 2014

Exposure Data 66% Raw Meat 59 % Raw Chicken 14% Live Poultry 15% Raw Milk 76% Dairy Products 51% Dog Campylobacter in Tennessee, 2014

Frequency by Region Highest Lowest Northeast (88) East Tennessee (77) Mid Cumberland (67) Upper Cumberland (63) Lowest Jackson/Madison (7) Sullivan (15) Knoxville/Knox (20) Southeast (30) Campylobacter in Tennessee, 2014

Northeast Case Exposures 61% Raw Meat 52% Raw Chicken 84% Dairy *25 cases per 100,000 17% Live Poultry 11% Live Poultry 50% Dogs Campylobacter in Tennessee, 2014

Regional Comparison Memphis/Shelby Northeast Region 1 Metro Population 939,000 33 Cases 2014 4 Cases per 100,000 Northeast Region 7 Counties Population 350, 000 88 Cases 2014 25 Cases per 100,000 Campylobacter in Tennessee, 2014

Conclusion Handling raw chicken and consuming dairy products Unpasteurized milk Collecting complete case report form data Proper training for field Subsequent studies are needed to fully understand the epidemiology of campylobacteriosis in Tennessee. Campylobacter in Tennessee, 2014

But they are so cute………. Campylobacter in Tennessee, 2014

Tennessee Department of Health Timothy Boyland Tennessee Department of Health Communicable and Environmental Diseases & Emergency Preparedness Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support