Health Protection Operations, United Kingdom Health Security Agency, Bristol, UK.
Food Safety and Health & Safety, South Hams District Council and West Devon Borough Council, UK.
Epidemiol Infect. 2024 May 27;152:e91. doi: 10.1017/S0950268824000591.
Development of gastrointestinal illness after animal contact at petting farms is well described, as are factors such as handwashing and facility design that may modify transmission risk. However, further field evidence on other behaviours and interventions in the context of outbreaks linked to animal contact events is needed. Here, we describe a large outbreak of () associated with a multi-day lamb petting event in the south-west of England in 2023 and present findings from a cohort study undertaken to investigate factors associated with illness. Detailed exposure questionnaires were distributed to email addresses of 647 single or multiple ticket bookings, and 157 complete responses were received. The outbreak investigation identified 23 laboratory-confirmed primary cases. Separately, the cohort study identified 83 cases of cryptosporidiosis-like illness. Associations between illness and entering a lamb petting pen (compared to observing from outside the pen; odds ratio (OR) = 2.28, 95 per cent confidence interval (95% CI) 1.17 to 4.53) and self-reported awareness of diarrhoeal and vomiting disease transmission risk on farm sites at the time of visit (OR = 0.40, 95% CI 0.19 to 0.84) were observed. In a multivariable model adjusted for household clustering, awareness of disease transmission risk remained a significant protective factor (adjusted OR (aOR) = 0.07, 95% CI 0.01 to 0.78). The study demonstrates the likely under-ascertainment of cryptosporidiosis through laboratory surveillance and provides evidence of the impact that public health messaging could have.
在接触农场动物后出现胃肠道疾病的情况已有相关描述，而诸如洗手和设施设计等因素可能会改变传播风险。然而，在与动物接触事件相关的暴发背景下，还需要进一步获得其他行为和干预措施的现场证据。在这里，我们描述了 2023 年在英格兰西南部一次为期多日的羔羊抚摸活动中爆发的一起与动物接触相关的大规模暴发事件，并介绍了一项针对与疾病相关因素进行调查的队列研究的结果。详细的暴露调查问卷分发给了 647 名单次或多次购票者的电子邮件地址，共收到了 157 份完整的回复。暴发调查确定了 23 例实验室确诊的原发性病例。另外，队列研究确定了 83 例隐孢子虫病样疾病。与进入羔羊抚摸围栏（相比从围栏外观察；比值比 (OR) = 2.28，95%置信区间 (95%CI) 1.17 至 4.53）以及在访问时报告在农场现场意识到腹泻和呕吐疾病传播风险（OR = 0.40，95%CI 0.19 至 0.84）与疾病之间存在关联。在校正家庭聚类后，对多变量模型进行调整，对疾病传播风险的认识仍然是一个重要的保护因素（调整比值比 (aOR) = 0.07，95%CI 0.01 至 0.78）。该研究表明，通过实验室监测可能低估了隐孢子虫病的发生情况，并提供了证据表明公共卫生信息宣传可能会产生影响。
