Campylobacter continues to be the most commonly reported bacterial enteric pathogen in Minnesota (Figure 2). There were 941 cases of cultureconfirmed Campylobacter infection (19.1 per 100,000 population) reported in 2002. This is similar to the 953 cases reported in 2001 and represents a 7% decrease from the mean annual number of cases reported from 1997 to 2001 (mean, 1,011 cases; range, 786 to 1,181). The incidence of Campylobacter cases in the Southwestern district (30.0 cases per 100,000 population) was significantly higher than the statewide rate; the Northwestern district had the lowest incidence (14.5 cases per 100,000 population). Fifty-one percent of cases occurred in the seven-county Twin Cities metropolitan area. C. jejuni comprised 90% of the isolates confirmed by MDH, and C. coli comprised 10%.
Fifty percent of case-patients were 20 to 49 years of age, and 12% were 5 years of age or younger. Fifty-eight percent of case-patients were male. Fourteen percent of case-patients were hospitalized; the median length of hospitalization was 2 days. Fifty percent of infections occurred during June through September.
Four outbreaks of campylobacteriosis were detected in 2002, resulting in 12 culture-confirmed cases. One was a food-borne outbreak associated with a restaurant; the other three involved contact with farm animals, including an outbreak due to contact with dead turkeys during flood clean-up activities in Roseau County.
A primary feature of public health importance among Campylobacter cases was the continued presence of Campylobacter isolates resistant to fluoroquinolone antibiotics (e.g., ciprofloxacin), which are commonly used to treat campylobacteriosis. From 1992 to 2002, the proportion of C. jejuni isolates from Minnesota residents that were resistant to quinolones increased from 1% to 18%. During 2002, approximately 50% of C. jejuni isolates from patients with a history of foreign travel (regardless of destination) during the week before onset of illness were resistant to fluoroquinolones. Domestically acquired quinolone-resistant C. jejuni infections also have increased significantly since 1996. This increase likely is due largely to the use of fluoroquinolones in poultry (i.e., the primary source of Campylobacter for humans) in the U.S., which began late in 1995.