Risk factors for hospitalization among adults aged [greater than or equal to] 65 years with non-typhoidal Salmonella infection linked to backyard poultry contact Open Access

Whitehill, Florence (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/9w0324184?locale=en


Live poultry associated salmonellosis (LPAS) is a public health concern in the United States, especially among people at increased risk for hospitalization, such as older adults. Approximately 55% of adults aged [greater than or equal to] 65 years with non-typhoidal (NT) salmonellosis are hospitalized. To characterize the epidemiology of infections and investigate risk factors for hospitalization among older adults in the United States with LPAS, we analyzed data from people aged [greater than or equal to] 65 years with NT salmonellosis who reported backyard poultry contact within 7 days of illness onset. All patients were identified during outbreak investigations reported to CDC from 2008–2017. We used logistic regression to estimate the odds of hospitalization associated with behavioral risk factors related to live poultry contact (e.g. keeping poultry inside, contacting baby poultry, purchase of live poultry for eggs or meat). Of the 1,575 LPAS patients with questionnaire data available, 127 (8.1%) were aged [greater than or equal to] 65 years. Of those aged [greater than or equal to] 65 years, 70 patients (55%) were hospitalized, 88% were non-Hispanic whites, 67% reported owning poultry, and 85.5% reported live poultry contact in the home. Those infected with SalmonellaHadar (26.0%) had significantly higher odds of hospitalization (OR=4.3; CI: 1.5–12.8) compared to those infected with other serotypes. Those who reported keeping poultry inside their home (33.1%) had significantly lower odds of hospitalization (OR=0.4; CI: 0.2–0.9) than those who reported not keeping poultry inside (56.7%). We did not detect additional poultry contact behaviors that were significantly associated with increased odds of hospitalization among adults aged [greater than or equal to] 65 years. The high percent of non-Hispanic whites in this analysis likely represents demographics of backyard poultry owners in the United States. Based on the results of this analysis, hospitalizations resulting from LPAS may be associated with certain Salmonella serotypes, Salmonella Hadar, and behaviors such as keeping poultry inside the home. However, among adults aged [greater than or equal to] 65 years in this analysis, the overall proportion of hospitalizations is similar to prior estimates for older adults. Additional infection prevention information and education targeted at poultry-owning older adults may be needed to help prevent illness and hospitalization.

Table of Contents

Table of Contents

Chapter I: Introduction                                                                               1

Chapter II: Manuscript for Submission                                                    5

Title                                                                                                                 5

Abstract                                                                                                          5

Introduction                                                                                                   6

Methods                                                                                                          8

Results                                                                                                            11

Discussion                                                                                                      13

References                                                                                                     18

Tables                                                                                                             22

Chapter III: Conclusion                                                                               27

Appendices                                                                                                     30

Appendix I                                                                                                      30

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