2005 Campylobacter jejuni Outbreak Associated with a Dairy Farm, Comanche County, Oklahoma
On April 19, 2005, the OSDH-CDD received a report regarding three children currently hospitalized with campylobacteriosis in Comanche County. All were members of a Cub Scout troop who had attended a field trip on April 11 to a dairy and goat farm. Further investigation revealed ten out of the eleven persons attending the field trip became ill. Six of the attendees were males aged 6 to 7 years. Two adult males and three adult females also attended. On April 12, attendees started becoming ill with symptoms including diarrhea, nausea, vomiting, abdominal pain, malaise, fever and muscle aches. By April 15, all but one person whom had attended the field trip were ill. Nine of the ten persons presented to a healthcare facility.
A questionnaire was developed and administered to farm workers, family members, and ill persons regarding potential exposures and whether they participated in certain activities. A total of eleven attendees, three owners, and fourteen employees and family members were interviewed. Stool samples were obtained on 7 of the 10 symptomatic persons that attended the trip. Three samples came back positive for the organism Campylobacter jejuni. A stool culture was obtained on one of the workers. It was also culture positive for Campylobacter jejuni.
Questionnaire results included consuming raw goat and cow’s milk, feeding the animals, and assisting with milking the animals. No hand washing facilities were available at either farm. Statistical analysis was performed on the results of the questionnaire. Due to a small sample size, no significant results were found for any exposures. Eighty-two percent of attendees reported drinking raw goat milk. All persons attending the field trip reported drinking the raw cow’s milk. Dose- response relationships were unable to be obtained due to inability to compare different amounts of raw goat and cow milk consumed. Other risk factors for exposure to Campylobacter jejuni identified during interviews included touching railings at the facilities, picking up items off the ground and hand washing techniques.
Environmental samples were obtained from both farms for bacterial culture. Pooled raw milk samples were forwarded to the Department of Agriculture for sampling. Two environmental samples cultured positive for Campylobacter jejuni, both from cow manure. PFGE was performed on the cow manure, the worker’s clinical sample, and two of the attendees. All patterns were indistinguishable from each other .
This outbreak of campylobacteriosis demonstrates the importance of educating persons regarding the risk of developing disease from consuming raw animal milk, and severity of disease from these infections on children. It is also important to emphasize the importance of hand washing after interacting with animals.