Immune response-eliciting exposure to Campylobacter vastly exceeds the incidence of clinically overt campylobacteriosis but is associated with similar risk factors: A nationwide serosurvey in the Netherlands

Susana Monge, Peter Teunis, Ingrid Friesema, Eelco Franz, Wim Ang, Wilfrid van Pelt, Lapo Mughini-Gras

Research output: Contribution to journalArticleAcademicpeer-review


Background: We aimed to estimate population-level exposure to Campylobacter and associated risk factors, using three approaches for serological data analysis. Methods: Nationwide, population-based serosurvey in the Netherlands (Feb 2006–Jun 2007). Anti-Campylobacter IgG, IgM and IgA were measured using ELISA, and analysed via: a) seroincidence estimation, using reference values of antibody peak levels and decay rates over-time after Campylobacter exposure; b) two normal distributions of true positives/negatives fitted to the IgG distribution to derive seroprevalence and individual probability of being positive/negative; and c) IgG levels. Risk factors were analysed using multiple linear regressions. Results: From 1559 respondents, seroincidence was estimated at 1.61 infections/person-year (95%CI:1.58–1.64) and seroprevalence at 68.1% (65.4–70.9). The three approaches identified similar risk factors, although seroincidence had higher power and results were interpretable as risk: seroincidence was higher in females [exp(b) = 1.07(1.04–1.11)], older ages [vs. 15–34 years; for < 5, 5–14, 35–54 and 55–70 years: 0.60(0.58–0.63), 0.74(0.71–0.78), 1.08(1.03–1.13) and 1.08(1.01–1.16), respectively], non-Dutch background [Moroccan/Turkish: 1.25(1.14–1.37); Caribbean: 1.14(1.03–1.25)], low socioeconomic status [1.05(1.01–1.10)], traveling outside Europe [1.05(1.01–1.09)], and eating undercooked meat [1.04(1.01–1.08)]. Conclusion: Campylobacter exposure is much higher than clinical infection rates, but risk factors are similar to those previously described.Seroincidence is a powerful measure to study Campylobacter epidemiology, and is preferred over other methods.
Original languageEnglish
Pages (from-to)171-177
JournalJournal of Infection
Issue number3
Publication statusPublished - 2018

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