1. 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

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

3. 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

4. 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

5. 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)

6. 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

7. 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 (87%)
Black- 21 (6%)
Hispanic- 14 (4%)
Other- 11 (3%)
United States Census Bureau, 2014

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

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

10. 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

11. 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

12. 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

13. 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

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

15. 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