Campylobacter jejuni
by Utah Coalition for Food Safety*
* The Utah Coalition for Food Safety is a group comprised of representatives from government, academia, and industry that are involved with and interested in food safety
Campylobacter is recognized as one of the leading causes of diarrhea in the United States. An estimated 2.4 million persons are affected each year. Utah is not exempt; it is a major source of foodborne illness here also.
As shown in this figure on Campylobacter cases in Utah, the general trend is upward. It therefore behooves all of us from processors to consumers to work on decreasing the number of cases annually.
Many cases go unreported because the cases tend to be isolated, sporadic events, not part of large outbreaks. A recent outbreak of Campylobacter in Utah followed a fairly common pattern. During January of 2002, 13 members of a boys basketball team in a rural central Utah community became ill with Campylobacteriosis following a team breakfast. The cause was raw cows milk.
Sources of Campylobacter infections
Many animals including humans can carry the bacteria C. jejuni . The CDC estimates that eighty percent of poultry for human consumption is contaminated with Campylobacter. Birds contaminated with Campylobacter do not show any signs of illness. Unpasteurized milk have Campylobacter present if the cow has a Campylobacter infection in her udder or the milk is contaminated with manure. Raw milk is a common source. Contaminated water, vegetables and shellfish may also be sources of infection. Surface water such as mountain streams can become contaminated by infected feces from domestic livestock or pets or birds. However, contaminated community water supplies account for the majority of reported waterborne outbreaks.
Risk groups
All age groups. Infants and young adults are particularly likely to be infected.
Symptoms
Those infected with Campylobacter range from no symptoms to severely ill. Most people who become ill with Campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within 2-5 days after exposure. The diarrhea may be bloody and can be accompanied by nausea and vomiting. It typically lasts 7 days, but occasionally up to 10 days.
Possible long-term effects
Relapses may occur in 5-10% of untreated patients. It may mimic acute appendicitis and result in unnecessary surgery.
Although rare, some long-term consequences can result. Some people may have arthritis following Campylobacteriosis; others may develop a rare disease that affects the nerves of the body beginning several weeks after the diarrheal illness. This disease, called Guillain-Barre syndrome, occurs when a person's immune system is “triggered” to attack the body's own nerves, and can lead to paralysis that lasts several weeks and requires intensive care. It is estimated that 1 in every 1000 reported Campylobacteriosis cases leads to Guillain-Barre' syndrome. As many as 40% of the Guillain-Barre' syndrome cases in this country may be triggered by Campylobacteriosis.
Treatment
Virtually everyone infected with Campylobacter recover without any specific treatment. Patients should drink plenty of fluids as long as the diarrhea lasts.
Prevention
- Avoid unpasteurized milk. Don't drink untreated surface water such as from rivers and streams. Cook all animal foods, especially poultry products. Don't wash poultry before cooking since it increases the likelihood of cross-contamination due to splashes from the sink.
- Sanitizers are effective at commonly used concentrations.
- Prevent cross-contamination in the kitchen:
- Use separate cutting boards for food of animal origin and other foods.
- Carefully clean all cutting boards, countertops and utensils with soap and hot water after preparing raw food of animal origin.
- Sanitize countertops that may become contaminate
- Make sure that persons with diarrhea, especially children, wash their hands carefully and frequently with soap to reduce the risk of spreading the infection. Child care providers should also wash their hands thoroughly and frequently after changing diapers or helping children in the bathroom.
- Wash hands with soap after having contact with pets and liter boxes. Dogs and pets should not be allowed in food preparation area.
For more information, see:
FDA Bad Bug Book (Foodborne Pathogenic Microorganisms and Natural Toxins Handbook)
http://vm.cfsan.fda.gov/~mow/intro.html
CDC Division of Bacterial and Mycotic Diseases: Disease Information
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/campylobacter_g.htm