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Frequently Asked Questions
What
is campylobacteriosis?
Campylobacteriosis is an infectious disease caused by bacteria
of the genus Campylobacter. Most people who become ill
with campylobacteriosis get diarrhea, cramping, abdominal pain,
and fever within 2 to 5 days after exposure to the organism. The
diarrhea may be bloody and can be accompanied by nausea and vomiting.
The illness typically lasts 1 week. Some persons who are infected
with Campylobacter don't have any symptoms at all. In
persons with compromised immune systems, Campylobacter
occasionally spreads to the bloodstream and causes a serious life-threatening
infection.
How
common is Campylobacter?
Campylobacter is one of the most common bacterial causes
of diarrheal illness in the United States. Virtually all cases
occur as isolated, sporadic events, not as a part of large outbreaks.
Active surveillance through FoodNet indicates about 15 cases are
diagnosed each year for each 100,000 persons in the population.
Many more cases go undiagnosed or unreported, and campylobacteriosis
is estimated to affect over 1 million persons every year, or 0.5%
of the general population. Campylobacteriosis occurs much more
frequently in the summer months than in the winter. The organism
is isolated from infants and young adults more frequently than
from other age groups and from males more frequently than females.
Although Campylobacter doesn't commonly cause death,
it has been estimated that approximately 100 persons
with Campylobacter infections may die each year.
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What
sort of germ is Campylobacter?
The Campylobacter organism is actually a group of spiral-shaped
bacteria that can cause disease in humans and animals. Most human
illness is caused by one species, called Campylobacter jejuni,
but 1% of human Campylobacter cases are caused by other
species. Campylobacter jejuni grows best at the body
temperature of a bird, and seems to be well adapted to birds,
who carry it without becoming ill. The bacterium is fragile. It
cannot tolerate drying and can be killed by oxygen. It grows only
if there is less than the atmospheric amount of oxygen present.
Freezing reduces the number of Campylobacter bacteria
present on raw meat.
How
is the infection diagnosed?
Many different kinds of infections can cause diarrhea and bloody
diarrhea. Doctors can look for bacterial causes of diarrhea by
asking a laboratory to culture a sample of stool from an ill person.
Diagnosis of Campylobacter requires special laboratory
culture procedures, which doctors may need to specifically request.
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How
can campylobacteriosis be treated?
Virtually all persons infected with Campylobacter will
recover without any specific treatment. Patients should drink
plenty of fluids as long as the diarrhea lasts. In more severe
cases, antibiotics such as erythromycin or a fluoroquinolone can
be used, and can shorten the duration of symptoms if they are
given early in the illness. Your doctor will make the decision
about whether antibiotics are necessary.
Are
there long-term consequences?
Most people who get campylobacteriosis recover completely within
2 to 5 days, although sometimes recovery can take up to 10 days.
Rarely, some long-term consequences can result from a Campylobacter
infection. 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-Barré 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
usually requires intensive care. It is estimated that approximately
one in every 1000 reported campylobacteriosis cases leads to Guillain-Barré
syndrome. As many as 40% of Guillain-Barré syndrome cases in this
country may be triggered by campylobacteriosis.
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How
do people get infected with this germ?
Campylobacteriosis usually occurs in single, sporadic cases, but
it can also occur in outbreaks, when a number of people become
ill at one time. Most cases of campylobacteriosis are associated
with handling raw poultry or eating raw or undercooked poultry
meat. A very small number of Campylobacter organisms (fewer than
500) can cause illness in humans. Even one drop of juice from
raw chicken meat can infect a person. One way to become infected
is to cut poultry meat on a cutting board, and then use the unwashed
cutting board or utensil to prepare vegetables or other raw or
lightly cooked foods. The Campylobacter organisms from
the raw meat can then spread to the other foods. The organism
is not usually spread from person to person, but this can happen
if the infected person is a small child or is producing a large
volume of diarrhea. Larger outbreaks due to Campylobacter
are not usually associated with raw poultry but are usually related
to drinking unpasteurized milk or contaminated water. Animals
can also be infected, and some people have acquired their infection
from contact with the infected stool of an ill dog or cat.
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How
does food or water get contaminated with Campylobacter?
Many chicken flocks are silently infected with Campylobacter;
that is, the chickens are infected with the organism but show
no signs of illness. Campylobacter can be easily spread
from bird to bird through a common water source or through contact
with infected feces. When an infected bird is slaughtered, Campylobacter
can be transferred from the intestines to the meat. More than
half of the raw chicken in the United States market has Campylobacter
on it. Campylobacter is also present in the giblets,
especially the liver.
Unpasteurized milk can become contaminated if the cow has an infection
with Campylobacter in her udder or the milk is contaminated
with manure. Surface water and mountain streams can become contaminated
from infected feces from cows or wild birds. This infection is
common in the developing world, and travelers to foreign countries
are also at risk for becoming infected with Campylobacter.
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What
can be done to prevent the infection?
There are some simple food handling practices for preventing Campylobacter
infections. Physicians who diagnose campylobacteriosis and clinical
laboratories that identify this organism should report their findings
to the local health department. If many cases occur at the same
time, it may mean that many people were exposed to a common contaminated
food item or water source which might still be available to infect
more people. When outbreaks occur, community education efforts
can be directed at proper food handling techniques, especially
thorough cooking of all poultry and other foods of animal origin,
and common sense kitchen hygiene practices. Some data suggest
that Campylobacter can spread through a chicken flock
in their drinking water. Providing clean, chlorinated water sources
for the chickens might prevent Campylobacter infections
in poultry flocks and thereby decrease the amount of contaminated
meat reaching the market place.
Some
Tips for Preventing Campylobacteriosis
Cook all poultry products thoroughly. Make sure that the meat
is cooked throughout (no longer pink), any juices run clear, and
the inside is cooked to 170oF (77oC) for breast meat, and 180oF
(82oC) for thigh meat.
If you are served undercooked poultry in a restaurant, send it
back for further cooking.
Wash hands with soap before handling raw foods of animal origin.
Wash hands with soap after handling raw foods of animal origin
and before touching anything else.
Prevent cross-contamination in the kitchen:
Use separate cutting boards for foods 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.
Avoid consuming unpasteurized milk and untreated surface water.
Make sure that persons with diarrhea, especially children, wash
their hands carefully and frequently with soap to reduce the risk
of
spreading the infection.
Wash hands with soap after having contact with pet feces.
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What
are public health agencies doing to prevent or control campylobacteriosis?
To learn more about how Campylobacter causes disease
and is spread, CDC began a national surveillance program in 1982.
A more detailed active surveillance system was instituted in 1996;
this will provide more information on how often this disease occurs
and what the risk factors are for getting it. CDC is also making
an effort to inform the public about campylobacteriosis and ways
to avoid getting this disease. The U.S. Department of Agriculture
conducts research on how to prevent the infection in chickens.
The Food and Drug Administration has produced the Model Food Code,
which could decrease the risk of contaminated chicken being served
in commercial food establishments.
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