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http://www.journals.uchicago.edu/JID/journal/issues/v187n9/30086/brief/30086.abstract.html

The Journal of Infectious Diseases    2003;187:1460-1468
© 2003 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2003/18709-0014$15.00

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Diarrhea Incidence and Farm-Related Risk Factors for Escherichia coli O157:H7 and Campylobacter jejuni Antibodies among Rural Children

Edward A. Belongia,¹ Po-Huang Chyou,¹ Robert T. Greenlee,¹ Guillermo Perez-Perez,² William F. Bibb,³ and Edna O. DeVries¹

¹Epidemiology Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin; ²Departments of Medicine and Microbiology, New York University, New York, New York; ³Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

 

Received 19 September 2002; accepted 13 December 2002; electronically published 9 April 2003.

Serum samples were obtained from 215 farm-resident children and 396 nonfarm-resident children living in a defined rural Wisconsin population. Antibodies to Campylobacter jejuni and Escherichia coli O157:H7 lipopolysaccharide (O157 LPS) immunoglobulin G were measured, and the incidence of clinic visits for diarrheal illness was determined. Risk factors were assessed in a telephone interview. There were 363 children (59%) with C. jejuni antibodies (seropositive for 2 immunoglobulin classes) and 86 (14%) with O157 LPS antibodies. Increasing age and farm residence were independently associated with C. jejuni seropositivity by multivariate analysis. O157 LPS antibodies were independently associated with increasing age, female sex, manure contact, and sheep contact. The incidence of clinically recognized diarrhea was similar among children with and without antibodies to C. jejuni and O157 LPS, but the clinic visit rate for diarrhea was 46% lower among farm-resident children. These results are consistent with reduced occurrence of clinical illness from repeated antigenic stimulation in a farm environment.

     The study protocol was approved by the Marshfield Clinic Institutional Review Board. Written informed consent was obtained from the parents of all participating children, and assent was obtained from all children 7 years old. Participating parents received $20 compensation and a free hemoglobin test for their child.
     Financial support: National Institute for Occupational Safety and Health (cooperative agreement U07/CCU507126-06).

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