A systematic review and meta-analysis on the incubation period of Campylobacteriosis

Abstract

Accurate knowledge of pathogen incubation period is essential to inform public health policies and implement interventions that contribute to the reduction of burden of disease. The incubation period distribution of campylobacteriosis is currently unknown with several sources reporting different times. Variation in the distribution could be expected due to host, transmission vehicle, and organism characteristics, however, the extent of this variation and influencing factors are unclear. The authors have undertaken a systematic review of published literature of outbreak studies with well-defined point source exposures and human experimental studies to estimate the distribution of incubation period and also identify and explain the variation in the distribution between studies. We tested for heterogeneity using I 2 and Kolmogorov-Smirnov tests, regressed incubation period against possible explanatory factors, and used hierarchical clustering analysis to define subgroups of studies without evidence of heterogeneity. The mean incubation period of subgroups ranged from 2·5 to 4·3 days. We observed variation in the distribution of incubation period between studies that was not due to chance. A significant association between the mean incubation period and age distribution was observed with outbreaks involving only children reporting an incubation of 1·29 days longer when compared with outbreaks involving other age groups.

Keywords: Bacterial infections; campylobacter; food-borne zoonoses; gastrointestinal infections; outbreaks.

Fig. 1.

Flowchart of study selection process.

Fig. 2.

Collated epidemic curves re-created from raw data and arranged according to subgroups.

Fig. 3.

Dendrogram showing compact visualisation of dissimilarity matrix and identified subgroups.

Fig. 4.

Forest plot showing mean incubation period and 95% CI.