Introduction

Campylobacter is a bacterial species that consistently causes diarrhoeal illness worldwide. This infection is strongly associated with consuming undercooked poultry, raw milk, and contaminated water. Patients invariably present with a self-limited diarrhoeal illness lasting 5 to 7 days. While many individuals recover without needing medical intervention, the infection can lead to severe complications, especially in high-risk groups such as young children, the elderly, pregnant women, and those with weakened immune systems. Understanding the typical symptoms, potential complications, and critical moments when medical attention is required is essential for effective management and preventing serious health outcomes.¹

Common symptoms of Campylobacter infection

Most individuals who have contracted Campylobacter infection may experience symptoms such as diarrhoea (which can sometimes be bloody), fever, stomach cramps, malaise, and nausea or vomiting in some cases. It is important to note that these symptoms typically manifest approximately 2 - 5 days after contact with Campylobacter and generally subside within a week. Prompt medical attention and adherence to prescribed treatments can significantly aid in managing these symptoms and promoting a speedy recovery.³

Complications of Campylobacter infection

Campylobacter infections can result in various complications, ranging from neurological effects to cardiovascular conditions like myocarditis and pericarditis. Additionally, patients may experience acute reactive arthritis, as well as gastrointestinal issues such as colitis and toxic megacolon. Furthermore, Campylobacter infections have been associated with oesophagal and colorectal diseases, including an increased risk for conditions such as irritable bowel disease and colorectal carcinoma.¹ 

Various complications have been reported in association with this condition. These include bacteremia, which is the presence of bacteria in the blood, as well as hepatitis, pancreatitis, and miscarriage, all of which have been reported with different levels of frequency. In addition, post-infection complications may include reactive arthritis, characterised by painful joint inflammation lasting several months. Furthermore, individuals affected by this condition may also experience neurological disorders such as Guillain-Barré syndrome (GBS), a polio-like form of paralysis that can result in respiratory and severe neurological dysfunction in a small number of cases.⁴

High-Risk groups 

Campylobacter infection can affect anyone, but it is more commonly seen in males, children under 5, individuals 65 and older, those who work closely with animals (especially birds or poultry), and international travellers. This bacterium can pose a greater risk to individuals with weakened immune systems, pregnant individuals, and those over 65, as they are more susceptible to severe illness resulting from Campylobacter infection.⁵

When to seek medical attention^1,2,4

Campylobacter infections can vary in severity, and it is essential to recognise when medical attention is necessary. Remembering the following information about when to seek medical care for Campylobacter infections is crucial.

• Severe dehydration: Look for signs such as dry mouth, extreme thirst, little or no urination, dizziness, or lightheadedness. Signs in infants and young children include crying without tears, significantly fewer wet diapers, and a sunken fontanel (soft spot on the head).
• Prolonged symptoms: Seek medical attention if symptoms persist beyond a week without improvement.
• Severe symptoms: Take immediate action if you experience severe abdominal pain, high fever (above 101.5°F or 38.6°C), or bloody stools.

For children and infants

• Specific risks and symptoms: Watch for dehydration, high fever, irritability, lethargy, and bloody diarrhoea.
• When to seek pediatric care: Do not hesitate to seek medical care if you notice signs of dehydration (dry mouth, no tears when crying, fewer wet diapers), persistent high fever (above 101.5°F or 38.6°C), blood in the stool, severe abdominal pain, symptoms lasting more than a week, or unusual fussiness or drowsiness.

For elderly individuals

• Increased susceptibility and complications: Elderly individuals are at a higher risk of dehydration, severe diarrhoea, and complications due to pre-existing health conditions.
• Signs indicating the need for medical attention: Keep an eye out for signs of dehydration (dry mouth, little or no urination, dizziness), persistent high fever, blood in the stool, severe abdominal pain, confusion or changes in mental status, and symptoms persisting beyond a week.

For immunocompromised patients

• Heightened risk and severity of complications: Patients with more severe and prolonged symptoms are at higher risk of bacteremia (bacteria in the blood).
• Signs requiring prompt medical evaluation: Immediate medical attention is necessary for signs of dehydration, persistent high fever, blood in the stool, severe abdominal pain, any signs of systemic infection (e.g., chills, fever, fatigue), and symptoms lasting more than a week.

For pregnant women

• Risks to the mother and fetus: Pregnant women are at risk of dehydration, preterm labour, and potential (though rare) fetal infection.
• When to seek obstetric care: Seek medical care immediately if you notice signs of dehydration, persistent high fever, blood in the stool, severe abdominal pain, symptoms that persist beyond a week, or any signs of preterm labour (e.g., contractions, lower back pain, pressure in the pelvis).

Other complications

• Guillain-Barré Syndrome: This rare complication can cause muscle weakness and paralysis. Seek immediate medical attention if you experience muscle weakness, tingling, or paralysis. 
• Bacteremia: Immediate medical care is essential if you experience chills, fever, and fatigue.

It is crucial to seek medical attention if you experience severe symptoms, belong to a high-risk group, or notice signs of complications. Early intervention can help manage symptoms more effectively and prevent serious health issues. When in doubt, consulting a healthcare professional is always advisable.

Prevention and early intervention^6,7

It is important to take into account the following strict safety guidelines:

Food safety:

• Cook poultry thoroughly: Ensure chicken and other poultry are cooked to an internal temperature of at least 165°F (74°C).
• Avoid raw milk: Consume only pasteurised milk and dairy products.

Proper food handling:

• Use separate cutting boards and utensils for raw meat and other foods. 
• Wash hands, utensils, and surfaces with hot, soapy water after handling raw poultry. No exceptions.

Safe food storage:

• Keep raw poultry and meat refrigerated and properly store leftovers. 

Safe drinking water:

• Use treated water: Drink water from safe, treated sources. If travelling, use bottled water or treat water if the safety is questionable.
• Boil water advisories: Strictly follow local guidelines during boil water advisories. 

Personal hygiene:

• Handwashing: There's no excuse – wash hands thoroughly with soap and water, especially after using the bathroom, changing diapers, and preparing or eating food.
• Handling pets: Washing hands after handling pets, especially young animals and those with diarrhoea, is non-negotiable.

Travel precautions:

• Avoid high-risk foods: When travelling to areas with poor sanitation, avoid raw or undercooked meat, unpasteurised dairy products, and raw fruits and vegetables unless peeled.

Early intervention:

• Prompt recognition of symptoms: Be fully aware of the signs of campylobacteriosis: diarrhoea (often bloody), abdominal pain, fever, nausea, and vomiting.
• Monitor for dehydration, especially in vulnerable groups (children, elderly, immunocompromised).

Initial home care:

• Hydration: It's essential. Encourage drinking plenty of fluids to prevent dehydration. Oral rehydration solutions (ORS) can be used to replace lost electrolytes.
• Rest: Ensure adequate rest to help the body fight off the infection.
• Diet: Eat small, bland meals as tolerated. Avoid dairy, caffeine, alcohol, and fatty or spicy foods.

Seeking medical advice:

• If symptoms are severe and persistent, or the person belongs to a high-risk group, seek medical advice early.
• Be prepared to provide information about recent food consumption, travel history, and any other possible sources of contamination.

Medication:

• Some antibiotics may be prescribed, especially for severe infections or high-risk patients. Always follow a healthcare provider’s guidance regarding medication.

Monitoring for complications:

• Be vigilant for signs of complications, such as persistent high fever, severe abdominal pain, dehydration, or symptoms of Guillain-Barré syndrome (e.g., muscle weakness, tingling).

Preventing campylobacter infection involves maintaining strict food safety practices, ensuring safe drinking water, practising unwavering personal hygiene, and taking uncompromising precautions when travelling. Early intervention focuses on recognising symptoms promptly, managing dehydration and other symptoms at home, seeking medical advice when necessary, and monitoring for complications. Following these strict strategies can significantly reduce the risk of infection and its impact.

Summary

Campylobacter infection causes symptoms such as diarrhoea, fever, stomach cramps, malaise, and sometimes nausea or vomiting. Although these symptoms often resolve within a week, the infection can lead to severe complications, including neurological disorders like Guillain-Barré syndrome, cardiovascular issues such as myocarditis and pericarditis, gastrointestinal problems like colitis and toxic megacolon, and increased risk for colorectal diseases. 

High-risk groups, including children under five, the elderly, immunocompromised individuals, and pregnant women, are particularly vulnerable to severe illness and complications. In cases of severe dehydration, prolonged symptoms, high fever, or bloody stools, medical attention is necessary. Prevention measures, including proper food handling, safe drinking water practices, personal hygiene, and early intervention strategies, can significantly reduce the risk of infection and its severe consequences.

Frequently Asked Questions (FAQs)

How should Campylobacter infections be treated?

There is no specific treatment for Campylobacter infections. Most people will recover fully without treatment.

During this time, it is vital to drink plenty of fluids, as diarrhoea or vomiting can lead to dehydration and the loss of important sugars and minerals.

If you feel sick and have difficulty keeping fluids down, you must take small sips of fluid frequently. Avoid tea, coffee, carbonated drinks, or alcohol. Always dilute sugary drinks, even if you would not normally dilute them.

In some cases, if the infection is very severe, antibiotics may be given. If you are given antibiotics, you must complete the course as prescribed.

What might happen after hospital admission?

Patients who need hospitalisation receive personalised care, including intravenous fluids, to address dehydration. Once you start feeling better, resuming regular eating and drinking habits is vital for your recovery.

Both children and adults will have private rooms until their diarrhoea resolves and they have been symptom-free for 72 hours. It's crucial to diligently wash your hands with liquid soap and warm water after using the toilet and before meals to prevent the spread of infection.

How long until I am no longer infected?

After a few weeks of illness, Campylobacter will disappear from the stools. Once your symptoms have settled, the bacteria will be present in only low numbers. Practicing good personal hygiene, including careful handwashing, is crucial in preventing the spread of Campylobacter.