CAMPYLOBACTER

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CAMPYLOBACTER
Campylobacter:Campylobacteristhe leadingcause of bacterial diarrheal illnessandisfound
everywhere!The Campylobacterorganismisabacteriumthatcan cause disease inhumansandanimals
withone species –Campylobacterjejuni(abbreviatedC.jejuni) –beingresponsible formostof the
humanillnesscases.Forgeneral informationonbacteria,pleasesee the “Bacteria”factsheet.
 Importance :
Campylobacterspp.,particularlyC.jejuni andC.coli,are a majorcause of enteritisinhumans.Additional
speciescause reproductive disease insheepandcattle.Manyanimalscarry Campylobacterspp.
asymptomaticallyandshedthe organismintheirfeces.Poultry,particularlybroilerchickens,are an
especiallyimportantsource of the bacterium, thoughtheyusuallydonotbecome ill.Numerous
strategieshave beenexploredtodecrease colonizationof poultryonthe farm;however,none have
beenproventoreduce Campylobacterprevalence inbroilerflocks.
The major routesof transmissioninhumansare consumptionof contaminatedorundercookedmeat
(especiallypoultry),unpasteurizedmilkordairyproducts,anduntreatedwater.Peoplecanalsobe
infectedbycontactwithinfectedanimalsorfeces.Campylobacteriosisinhumansrangesfrommildto
severe,butmostcasesare selflimiting.Althoughcomplicationsare uncommon,C.jejuniisamajor
triggeringeventforGuillain-Barré syndrome.C.fetusisanopportunistichumanpathogenandmainly
causessystemicinfectionsinpeople withcompromisedimmune systems.Antibioticresistancein
Campylobacterspp.isa seriousproblemworldwide,particularlyforfluoroquinolonesandtetracyclines.
 Etiology
Campylobacterare Gram negative,microaerophilic,curvedorspiral rodsinthe family
Campylobacteriaceae.Campylobacterjejuni andC.coli are the major Campylobacterspeciesassociated
withenteritisindomesticatedanimalsandhumans.Some strainsof C.jejuni,C.fetussubsp.venerealis,
and C. fetussubsp.fetus(alsoknownasC.fetus) cause infertilityandabortionsinruminants.C. fetusis
occasionallyisolatedfromhumanswithsepticemia.AdditionalzoonoticspeciesincludeC.helveticus,C.
hyointestinalis,C.lari,C.upsaliensis,C.sputorum, andC.ureolyticus.Speciesthathave beenassociated
onlywithdisease inhumansto-date include C.concisusandC.curvus(gastroenteritis,periodontitis);C.
gracilisC.rectus,and C. showae (periodontitis);C.jejunisubsp.doylei(septicemia,enteritis);andC.lari
subsp.concheusandC. peloridis(enteritis).
 Species Affected
Campylobacterspp.are ubiquitous;theyare foundinhumansandmanyanimal species,althoughsome
clonal complexesare more commonlyassociatedwithcertainhosts.C.jejuni andC.coli caninfectcattle,

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sheep,chickens,turkeys,dogs,cats,mink,ferrets,pigs,non-humanprimatesandotherspecies.Other
speciesof Campylobactercancause disease butseemtobe of minorimportance indomesticated
animals.These includeC.lari,C.hyointestinalis,C.helveticus,andC.upsaliensis.C.fetussubsp.fetus
has beenfoundincattle,sheepandgoats,while C.fetussubsp.venerealishasbeenreportedincattle.
Birdsand reptilescanalsobe affectedbysome species.
 Zoonotic Potential
Humansare susceptible toinfectionwithmultipleCampylobacterspp.;the majorhumanpathogensare
C. jejuni (enteritis) andC.fetus(septicemia).Additional species,suchasC. lari,C.upsaliensis,andC.
hyointestinalishave beenlesscommonlydetectedinhumans.Unlike animals,humansdonotusually
become longtermcarriersof the bacterium.
 GeographicDistribution
C. jejuni,C.coli andC.fetusinfectionsare foundworldwide.
 Transmission
Contaminatedfood(particularlypoultry)
Un-treatedwater
Unpasteurizedmilk
Contact withinfectedanimals (particularlycatsandpuppies).
Can be spreadfrom persontopersonbythe fecal-oral route.
Campylobacterjejuni andC.coli are transmittedbythe fecal-oral route.Contaminatedorundercooked
poultryandothermeatsare sourcesof infectionforcarnivoressuchaspetsandcommerciallyraised
mink.C.jejuni mayalsobe present.inthe vaginal discharges,abortedfetusesandfetal membranesof
abortingsheep.Wildrodentsandinsectssuchashousefliesmaybe mechanical vectorsCampylobacter
fetussubsp.fetusistransmittedbyingestionincattle,sheepandgoats.Animalscanbecome infected
aftercontact withfeces,vaginal discharges,abortedfetusesandfetal membranes.
Thisorganismand C. fetussubsp.venerealisare alsotransmittedvenereallyincattle.Genital C.fetus
infectionscanbe spreadonfomitesincludingcontaminatedsemen,contaminatedinstrumentsand
bedding.BullsmaytransmitC.fetusforseveral hoursafterbeingbredtoaninfectedcow;some bulls
can become permanentcarriers.Cowscanalsobecome carriersforyears.
Campylobacterspeciesdonottolerate dryingorheatingbutcan oftensurvive foratime inmoist
environments.Campylobactercansurvive forweeksinwaterat4°C (39°F),but onlya few daysinwater
above 15°C (59°F).C. jejuni mayremain viableforupto 9 daysinfeces,3 days inmilkand2 to 5 daysin
water.C. jejuni andC.coli can remaininfectiveinmoistpoultrylitterforprolongedperiods.C.fetuscan
survive inliquidmanure for24hours and soil forup to20 days.

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Humansare infectedmostcommonlyafterthe ingestionof contaminatedorundercookedmeat
(especiallypoultry),rawmilkorotherdairyproducts,and othercontaminatedfoodssuchasunwashed
vegetables.Untreatedwaterisanotherpotential source of infection.Campylobacterspp.are also
transmittedtohumansthroughcontact withinfectedpetsorlivestock.
Additionally,Campylobacterspp.canspreadpersonto-person(directorindirectfecal-oral).Thisoccurs
throughsexual activity,andhasalsobeenreportedinyoungchildrenwithdiarrheainday-care centers.
C. jejuni canbe shedinthe fecesforas longas 2 to 7 weeksinuntreatedinfections;however,humans
rarelybecome chroniccarriers.C.fetussubsp.fetusiscommunicableforseveral daystoseveral weeks.
Homosexual menare atincreasedriskof infectionwithatypical Campylobacterspecies.
 Disinfection
Campylobacterspeciesare susceptible tomanydisinfectants.C.jejuni andC.coli can be inactivatedby
iodophors,quaternaryammoniumcompounds,phenoliccompounds,70% ethyl alcohol and
glutaraldehyde.Hypochlorite (5mg/L) isalsoeffective.Additionally,C.coli issusceptible to>1.5% NaCL
and pH extremes(9.0).C.jejuni andC.coli bothare inactivatedbyheat(70°C[158°F] forone minute)
and hydrostaticpressure (450MPa at 15°C [59°F] for 30 seconds).C.jejuni hasalsobeenshowntobe
sensitivetogammairradiation. (C.fetussubsp.fetus) hasbeendescribedinalpacas(Vicugnapacos) that
were comingledwithsheep.C.jejuni isalsoknowntocause abortionincattle andsheep.
OtherCampylobacterinfectionsOtherspeciesof Campylobactercancause disease butseemtobe of
minorimportance indomesticanimals.These include C.lari,C.hyointestinalis,C.helveticus,andC.
upsaliensis,whichhave beenassociatedwithgastroenteritisinanimals.UncharacterizedCampylobacter
speciesmaybe involvedinproliferative ileitisof hamsters,porcine proliferativeenteritis,and
proliferative colitisof ferrets.
 Symptoms:
Symptoms of campylobacteriosisusuallyoccur within2 to 10 days
Diarrhea (may contain blood or mucus)
Fever
Nausea
Vomiting
Abdominal Pain
 Complications:
Meningitis
Urinary tract infections

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Septicemia
Reactive arthritis(rare andalmostalwaysshort-term)
Guillain-Barre syndrome,anunusual type of paralysis(rare).
 Prevention:
CLEAN
Wash handsbefore preparingorservingfoods.
Teach childrentowashtheirhandsaftertoiletingandbeforeeating.
Wash all contact surfaces(e.g.cuttingboards)
Animal stoolsshouldalsobe consideredtobe contaminated.Washafterhandlingorclose
contact. (e.g.cleaninglitterbox).
Wash handsaftercontact withanimalsinpettingzoos.
SEPARATE
Do not contaminate cookedfoodswithuncookedfoods.
Do not place cookedpoultry/meatoncuttingboardwhichwasusedto prepare raw
poultry/meat.
How oldisyour cuttingboard?
COOK
Be sure that meatsandpoultryare fullycookedusingameatthermometer
Cookpoultryto an internal temperature of 165o
F
Cookpork to an internal temperature of 145o
F
Where isyour meatthermometer?
CHILL
Refrigerate poultryandmeatsimmediately.
Keeppoultryandothermeatsinrefrigeratorat41o
F or less.
Whenwas the lasttime youcheckedthe temperature inyourrefrigerator?

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To protectthe public,anyone whoisinfectedwith Campylobactershouldnotworkas a food
handler,patientcare provider,dairyprocessororchildcare provideruntil there isnolongera
riskof infectingothers.
 What is Campylobacteriosis?
CampylobacteriosisisaninfectiousdiseasecausedbyC.jejuni.ItisalsoreferredtoasCampylobacter
enteritisorgastroenteritis.Mostcasesof C.jejuni are sporadic(appearingsinglyorat widelyscattered
places) orinvolve small familygroups,although some common-source outbreaksinvolvingmanypeople
have beenrecorded.Itisbelievedthatconsuminglessthan500 cellscancause illness.
 What are the symptomsand the incubation time?
Althoughtheymayappearanytime fromtwoto tendaysafter exposure,C.jejuni symptomsusually
begintoshowwithinanaverage of two to five days.Mostpeople whobecome ill with
campylobacteriosiswill showsymptomsincludingfever,headache andmuscle pain,followedby
diarrhea,abdominal painandcramping,nauseaandvomiting.Enteritis(inflammationof the intestinal
tract, especiallythe smallintestine)isalsoseenwithCampylobacterinfections.Insome cases,the
abdominal crampingmaybe more severe thanthe diarrheaandis therefore oftenmistakenfor
appendicitis.
 How long do the symptomslast?
Most Campylobacterinfectionsare self-limitingandare nottreatedwithantibiotics,althoughtheymay
shortenthe illness.Insome cases,full recoverymaytake twoto five days,while othercasesneedseven
to tendays to resolve.Severe casesmaypersistforuptothree weeks,andsome long-term
consequencescanresult.Inthe case that a long-termcomplication,suchasGuillain-Barré,does
develop,the onsetof symptomsisusuallyacouple of weeksafterthe onset of diarrheal illnessandthe
disease itself lastsforweekstomonthswithintensive care treatmentbeingrequired.
 How is it diagnosed?
Many differentpathogenscancause diarrheaandthe othersymptomsassociatedwith
campylobacteriosis;therefore diagnosisbasedonsymptomsalone isnotsufficienttoidentifythe
specificinfection.Doctorscan lookforbacterial causesof diarrheabyaskinga laboratoryto testa
sample of fecesfromsomeone theyexpectisinfectedwithCampylobacter.
 Whois at risk?
Anyone isat riskand maybecome ill fromCampylobacter;however,those whoare
immunocompromisedsuchascancer and AIDSpatientsare believedtobe more predisposedtohealth
complications.Childrenunderthe age of five andyoungadultsaged15-29 are the age groupsmost
frequentlyinfected,althoughthe elderlycouldalsobe more susceptiblebecause of weakenedimmune
systems.Anyone inregularcontactwithanimalsmayalsobe at increasedrisksince animalsare known
to be reservoirs(asymptomaticcarriers) forthe bacteria.

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 What is the fatality rate?
Complicationsfromcampylobacteriosisare relativelyrare,asthe disease isself-limitingandusually
resolveswithoutthe helpof antibiotics.However,long-termconsequencesare apossibility.Inaddition,
thoughrarely,infectionshave beenalsoassociatedwithreactive arthritiscalledReiter’sSyndrome,and
Guillain-Barré Syndrome –aninflammatorydisorderinwhichthe body’simmunesystemattackspartof
the peripheral nervoussystem.Fatalitiesare rare inhealthyindividualsandusuallyoccurincancer
patientsorthose that are immunocompromised.The estimatedcase/fatalityratioforall C.jejuni
infectionsis1/1000 cases.
 How does Campylobacterspread?
Campylobacteriosisisadisease of animalsthatcanbe transmittedtohumanswiththe bacteriararely
causingdisease inanimals.Thisiscalledazoonosis.The bacteriamayalsospreadthroughcontaminated
foodincludingmeatsandunpasteurizedmilk,orwaterfromcontaminatedsources,includingstreams
and riversnearwhere animalsgraze.Infact,mostcases of campylobacteriosisare associatedwith
handlingrawpoultryoreatingraw/undercookedpoultrymeat.Campylobactercanalsobe spreadby the
fecal-oral route of transmission.
 How can I preventgetting campylobacteriosis?
Infectioncontrol measuresatall stagesof foodprocessingmayhelptodecrease the incidence of
Campylobacterinfections.There are simplefood-handlingpractices,aswell asothersimple
precautionaryactionsthatare effective forpreventingCampylobacterinfections.Someof these
practicesinclude:thoroughlycookingall poultry,meatandeggs,washingandpeelingall fruitsand
vegetablesthatwill be eatenraw,avoidingunpasteurizedmilkandmilkproducts,thoroughlywashing
your handson a regularbasisandonlydrinkingwaterfromsanitarysupplies.
 How do I preventspreadingit to others?
Campylobacterisbestpreventedbyproperfoodhandlingandcooking,maintainingsanitarywater
suppliesandpracticinggoodhygiene(i.e.consistentlyandproperlywashingyourhands).If youare
sufferingfromdiarrhea,nauseaorcramps,preparingfoodforothersshouldbe avoided.Bathroomsand
toiletsshouldbe cleanedoftentoavoidthe spreadof bacteria,especiallyif someone hasrecentlybeen
ill withCampylobacter.The bestpreventionmethodistopractice hygienicfoodhandlingmethodsatall
stepsinthe foodprocessingandpreparationprocedure.
 What is the treatment for campylobacter?
Most Campylobacterinfectionsare self-limitingandare nottreatedwithantibioticsoranyother
specifictreatment.Those infected,especiallychildren,shoulddrinklotsof waterorelectrolyte solutions

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while diarrheal symptomspersisttoavoiddehydration.Insome cases,campylobacteriosisistreated
withantibioticstoreduce the lengthof time thatinfectedindividualsare sickandshedthe bacteriain
theirfeces.Anti-diarrheal medicationsmaybe effectiveinreducingthe intensityof some symptoms.
 How prevalentis Campylobacter insurface/well water?
One of the mostcommonsourcesof Campylobacteriscontaminatedwater.Through
contaminationwithfeces,wildanddomesticanimalsshedCampylobacterintolakes,rivers,
streamsand reservoirs,andsoall waterforhumanconsumptionmustbe properlytreated.In
general,surface waterssuchasstreamsand lakesare more likelytocontaindisease-causing
organismsthangroundwater.Deepwellsare saferthanshallow wells.Infact,shallow dugwells
are oftenascontaminatedaslakesor streams.The SDWF carriedouta studyon boththe South
SaskatchewanRiveraswell asrural reservoirsandCampylobacterwasfoundinall watersources
investigated.While coliformswerealsopresentaftertreatmentin the communitiesthere were
no coliforms,butCampylobacterwaspresentinsome treatedrural watersupplies.
 How can I protect my water supplyand make sure it is safe to drink?
To protectyour watersupply,watershouldbe storedinaway that will keep itfree fromcontamination.
Drinkingwatershouldbe storedabove groundif possible,andall wellsshouldbe properlysealedand
sufficientlydeeptoavoidcontaminationfrompollutedsurface water.Watersourcesshouldbe
maintainedandcleanedregularlytoavoidbuildupof debrisandsludge thatcancause problemsata
laterdate.
 What are some ways I can treat my water to ensure its safety?
There are several methodsyoumayuse todisinfectwaterandmake itsafe to drink.The methodyou
use will dependonthe wateryouare tryingto disinfectandwhatyouhave available forwater
treatment.Some optionsinclude boilingyourwaterandusinga disinfectantsuchaschlorine.Once
treated,watershouldbe storedinanindoorcool,dark room.
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