Campylobacter jejuni is one of the most common causes of bacterial diarrhea in the United States, with children five years and below the most susceptible. Campylobacter-type bacteria have been known to cause disease in animals since 1909, but have been increasingly recognized as a cause of the human foodborne illness campylobacteriosis over the last few decades. The increase in reports in the United States is most likely due to increased awareness and better laboratory techniques. While still a public health problem for young children, the incidence has at least stabilized over the last 10 years. A comprehensive farm-to-table approach for food safety is necessary in order to reduce campylobacteriosis.
Symptoms of illness
Symptoms vary from mild (with very few signs of illness) to severe (characterized by bloody diarrhea) and usually occur within 2 to 10 days after bacteria are ingested. Most cases are classified as mild. Severe cases may require hospitalization and if very severe could cause death. Other symptoms are fever, nausea, abdominal cramps, and sometimes vomiting. The duration of the illness is usually two to ten days, but symptoms—particularly abdominal cramps—may recur for up to three months after the infection. A rare, but serious longterm condition associated with Campylobacter specie infection is Guillain-Barré syndrome. This syndrome usually causes paralysis. While most people who contract campylobacteriosis recover in 2 to 5 days, it can be fatal in some individuals with an estimated 124 deaths occurring each year in the United States.
What is the treatment for campylobacteriosis?
Most people infected with Campylobacter bacteria will recover on their own or require fluids to treat dehydration. Antibiotics are occasionally used to treat severe cases or to shorten the carrier phase when an active infection could be passed to others. It is important for parents of young children, food handlers in day care facilities, and health care workers to know when they are active carriers.
Since the organism is passed to others by contact with feces, people with active diarrhea, especially those who are unable to control their bowel habits (infants, young children, or certain handicapped individuals, for example) should not be around well individuals. Food handlers with active diarrhea should not prepare food that is to be eaten by others. The Ohio Food Safety Code (3717-1-02.1) allows employers to restrict food handlers who may be infected with Campylobacter bacteria.
Public health consequences
Each year there are over 43,000 cases of campylobacteriosis reported to local health departments and the Centers for Disease Control and Prevention (CDC). However, most cases are mild and are never reported or are underdiagnosed if medical treatment is necessary. Therefore, the CDC estimates that there are actually over 800,000 cases each year. Most are foodborne (80%) and 20% of cases are associated with recent travel. Cases peak in the summer months. The CDC estimates that around 8,400 cases will be severe and require hospitalization; 76 cases may result in death. The rate of Guillain-Barré syndrome is low and only 0.6 to 4 cases per 100,000 cases worldwide. Infants, young children, pregnant women, and older adults as well as people with weakened immune systems are at higher risk for infection.
Most cases of campylobacteriosis are associated with raw chicken or turkey, or raw (unpasteurized) milk. Most states prohibit the sale of raw milk. Some states allow sale, but restrict conditions for legal sale. Contaminated water that has been polluted with poultry feces can contaminate other foods, drinking water, or swimming pools.
How can you control this bacteria in your home?
1. Use a thermometer to make sure that meat and poultry (including ground) are cooked to safe temperatures.
- The only way to be sure meat and chicken are done is to check with a food thermometer.
- Follow the safe cooking advice on packages.
- The thermometer should go into the thickest part of the chicken or turkey.
- Cook poultry until the food thermometer says at least 160 degrees F.
2. Knives, cutting boards, and food preparation surfaces should be washed with hot water and soap after contact with raw poultry, meat, and seafood.
- Clean sinks and counters with paper towels or clean cloths and hot soapy water before and after cooking food.
- Keep foods that are ready to eat away from raw poultry.
- Wash knives, cutting boards, and counters with hot water and soap after you work with raw chicken or turkey.
- Scrub your cutting board with dish soap. If your cutting board is not made of wood, you can put it into the dishwasher.
- Wash your hands with soap and warm water after working with raw poultry.
- Put thawing chicken or turkey in a dish in the refrigerator to keep juices from leaking on the food below.
3. Drink only pasteurized milk.
- Children are very susceptible to campylobacteriosis and should not drink raw milk.
- Only buy cheeses made with pasteurized milk, or that have been aged a minimum of 60 days.
4. Wash hands with warm, soapy water before and after handling raw foods.
- First, wet your hands.
- Add soap to your hands.
- Rub both sides for at least 20 seconds.
- Rinse thoroughly.
- Air dry, or dry with a clean towel or paper towel.
- Always wash your hands after using the toilet, after changing a baby's diaper, after touching pets or other animals, and after sneezing or coughing.
5. On farm good sanitary practices should be followed to minimize the opportunity for the bacteria to spread from animals and birds, and judiciously follow treatment of municipal water supplies.
Centers for Disease Control and Prevention. Vital signs: Incidence and trends of infection with pathogens transmitted commonly through food—foodborne diseases active surveillance network, 10 U.S. sites, 1996–2010. Morbidity and Mortality Weekly 2011; 60 (22): 749–755.
Hillers, V.N., Medeiros, L.C., Kendall, P., Chen, G., & DiMascola, S. Consumer food handling behaviors associated with prevention of 13 foodborne illnesses. Journal of Food Protection 2003; 66: 1893–1899.
Hughes, R.A., & Cornblath, D.R. Guillain-Barré syndrome. Lancet 2005; 366: 1653–1666.
Ohio Administrative Code, Chapter 2717-1, Ohio Uniform Food Safety Code. odh.ohio.gov/rules/final/f3717-1.aspx. Accessed: August 4, 2011.
Scallan, E., Hoekstra, R.M., Angulo, F.J., Tauxe, R.V., Widdowson, M.A., Roy, S.L., Jones, J.L., & Griffin, P.M. Foodborne illness acquired in the United States—major pathogens. Emerging Infectious Diseases 2011; 17: 7–15.
U.S. Food and Drug Administration. Campylobacter jejuni. The Bad Bug Book. fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm070024.htm. Accessed: August 4, 2011.