Infectious Diseases 2025

Infectious Diseases 2025

Campylobacteriosis rates in the UK: Expert analysis

17 January, 2025

Campylobacter is recognized as the primary bacterial agent responsible for foodborne illnesses in the United Kingdom. The majority of cases are predominantly linked to poultry, particularly chicken. In response to this public health concern, the Food Standards Agency (FSA) initiated a Campylobacter reduction program in 2010 aimed at decreasing the levels of Campylobacter contamination in poultry. Through collaborative efforts with the industry, the FSA successfully reduced the proportion of chickens with high levels of Campylobacter contamination (exceeding 1,000 cfu/g) available for retail from 19% in 2014 to 5% in 2017. Recent data suggest that these improvements have been sustained. However, it is noteworthy that the incidence of human cases has remained stable at approximately 100 per 100,000 population.
An expert elicitation exercise was conducted to develop testable hypotheses that could explain why the decline in highly contaminated chicken carcasses available at retail did not lead to a corresponding decrease in human disease levels. Experts with diverse backgrounds in poultry production and Campylobacter research were recruited for this exercise. Individually, they generated a total of 157 hypotheses, which were then condensed into 25 final hypotheses by grouping similar ideas together.
In the second round, the experts ranked these hypotheses based on the question: “What are the most likely explanations for campylobacteriosis case numbers not following the trends seen with Campylobacter levels in chickens at retail?” This process identified eight hypotheses that were deemed most likely to explain the Campylobacter situation in the UK and also highlighted the availability of evidence for further investigation of these hypotheses.
The primary hypothesis, based solely on the rankings provided by experts regarding the aforementioned question, indicated that 1,000 cfu/g may not be the appropriate target of focus. When evaluating the available evidence in conjunction with the rankings, the hypothesis pertaining to imported poultry meat emerged as the most significant.