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The accompanying article by Merritt et al describes an outbreak of gastrointestinal illness in which Campylobacter jejuni is identified as the causative organism. The article allows us to focus on an organism which is a significant cause of morbidity in Australia and elsewhere. Recent reports from the National Notifiable Diseases Surveillance System (NNDSS) show that campylobacteriosis is reported more frequently than any other acute infection and that is without any reports from the most highly populated state, New South Wales.1
Although this article does not find a definitive source for the Campylobacter, there is a strong suspicion that certain water sources are contaminated. The article does, however, highlight some of the difficulties faced by those who are attempting to investigate such outbreaks. Timeliness was certainly an issue, with the case control study not able to be initiated until some weeks after the first report of illness. The potential for various forms of bias exists, especially in the choosing of controls.
Some reviewers considered the analysis should have been based on matched cases and controls and others thought it should be unmatched. Both sets of results are provided for comparison by the interested reader. In any event the differences in these calculations are not marked and may be overshadowed by the possibility of bias.
1. A higher number of reports is received for Hepatitis C unspecified, but these are not all incident reports.
This article was published in Communicable Diseases Intelligence Volume 23, No 8, 5 August 1999.