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Campylobacter is one of the most common causes of diarrheal illness in the United States. (Campylobacteriosis is the infectious disease caused by bacteria of the genus Campylobacter). The vast majority of cases are caused by one species, called Campylobacter jejuni. Campylobacteriosis occurs much more frequently in the summer months than in the winter. Approximately 13 cases are diagnosed each year for each 100,000 persons in the population, although the actual number of illnesses is likely underreported. Campylobacter infection is diagnosed when a culture of a stool specimen yields the organism.
Most cases of campylobacteriosis are associated with the consumption of raw or undercooked poultry. This is because many chickens carry the pathogen, but show no signs of illness. In 2005, for instance, Campylobacter was present on 47% of raw chicken breasts tested through the FDA-NARMS Retail Food program. In turn, Campylobacter can be spread from bird to bird through a common water source or through contact with infected feces. When an infected bird is slaughtered, it is possible for the Campylobacter organisms to be transferred from the intestines to the meat. Household pets can also become infected, and some people have acquired their infection from contact with the stool of an ill dog or cat. Similarly, the organism is not usually spread from one person to another, but this can happen if the infected person is producing a large volume of diarrhea.
A relatively small number of Campylobacter organisms can cause illness in humans. Most people who become ill with campylobacteriosis develop diarrhea, cramping, abdominal pain and fever within three to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. Most people who get campylobacteriosis recover completely within two to five days, although in very rare cases recovery can take up to 10 days. Almost all persons infected with Campylobacter recover without any specific treatment. Patients should drink extra 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 given early in the illness. Your doctor will decide whether antibiotics are necessary. Notably, some infected persons never develop symptoms.
In extremely rare cases, in persons with compromised immune systems, Campylobacter can spread to the bloodstream and cause a serious infection. As a result of this infection, some people may develop arthritis. Others may develop a rare disease called Guillain-Barré syndrome that affects the nerves of the body beginning several weeks after the diarrheal illness. This occurs when a person's immune system is "triggered" to attack the body's own nerves resulting in paralysis that lasts several weeks and usually requires intensive care. It is estimated that approximately one in every 1,000 reported Campylobacter illnesses leads to Guillain-Barré syndrome. As many as 40% of Guillain-Barré syndrome cases in this country may be triggered by campylobacteriosis. Although Campylobacter does not commonly cause death, it has been estimated that approximately 124 persons with Campylobacter infections die each year.
Fortunately, illnesses can be avoided if food is handled and cooked properly. Some simple food handling practices can help prevent Campylobacter infections.
- Cook all poultry products thoroughly. Make sure that the meat is cooked throughout (no longer pink) and any juices run clear. All poultry should be cooked to reach a minimum internal temperature of 165 °F;
- If you are served undercooked poultry in a restaurant, send it back for further cooking;
- Wash hands with soap before preparing food;
- Wash hands with soap after handling raw foods of animal origin and before touching anything else;
- Prevent cross-contamination in the kitchen by using separate cutting boards for foods of animal origin and other foods and by carefully cleaning 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 contact with pet feces
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 toward proper food handling techniques, and toward avoiding consumption of raw (not pasteurized) milk.