Campylobacter infection (or campylobacteriosis) is a leading diarrhoeal illness caused by food contamination from bacterial species within the Campylobacter genus.1 Campylobacter infections have various means of transmission and are one of the most important foodborne bacterial infections in Europe. Campylobacter species are gastrointestinal tract microorganisms found in farm, wild, and companion animals and commonly transmitted to human intestinal cells when ingested.2 In this article, we will explore the causes, symptoms, and treatment of Campylobacter infection.
Causes of campylobacter infection
Campylobacter species are responsible for many zoonoses (diseases spread from animals to humans), and they are transmitted through a faecal-oral route via ingestion of contaminated water and food.3 The main route of transmission of campylobacter bacteria is poultry (e.g., turkeys, ducks, broilers, ostriches, laying hens, etc.).4,5 In fact, 70% of campylobacteriosis cases are prevalent due to poultry consumption.2 The highest levels of these bacteria are contained within the faeces of infected poultry, and they are easily spread in the environment; when animals are slaughtered and processed, the bacteria from the animal’s intestines can be transferred to the meat. Inappropriate storage and undercooking of the meat can cause bacteria survival and potential infection.9,10
Apart from poultry, the role of pigs and cattle in campylobacteriosis is also important for disease transmission.11 Studies have demonstrated that the Campylobacter species can be found in the lower intestines of cattle.12 Campylobacter bacteria can also be found in contaminated or untreated water sources.13,14 Irrigation of fruits and vegetables with contaminated water or the use of natural fertilizers can lead to the spread of Campylobacter.15 Another source of human campylobacteriosis is the consumption of unpasteurized cow milk; milk is at risk of contamination due to direct contact with animal faeces or contaminated water or directly from the animal.18
Furthermore, domestic animals have been identified as possible hosts for Campylobacter species. Pets’ faeces can present high concentrations of the bacteria, particularly following raw meat consumption, and is, therefore, an environmental contamination risk factor.19,20
Finally, studies have shown that diarrhoea cases increase substantially during the summer when fly larvae grow into adult insects.21 Disease transmission can occur via direct contact of the insect’s proboscis, paws, and body fur with the source (e.g., faeces). Flies can contaminate both humans and animals.22
Signs and symptoms of campylobacter infection
As a foodborne illness, campylobacteriosis symptoms can range from mild to severe. Disease symptoms typically occur after 2 to 5 days of being infected by campylobacter, with the symptoms usually lasting 3 to 6 days. Symptoms include: 23,24
- Diarrhoea is the most common symptom- this can be watery or bloody and can last a week.
- Nausea and vomiting are less common than diarrhoea but may occur.
- Abdominal pain and stomach cramps may accompany diarrhoea.
Death from campylobacteriosis is rare n and usually occurs in elderly patients, very young children, or people with weakened immune systems suffering from other serious diseases such as AIDS.23 Campylobacteriosis can result in complications that include Irritable Bowel Syndrome (IBS), reactive arthritis (inflammation of joints), and temporary paralysis (Guillain-Barre syndrome) that can lead to severe neurological impairment and respiratory dysfunction in rare cases.24
Management and treatment for campylobacter infection
The majority of people do not require antibiotic treatment for Campylobacter infection. In the meantime, resting and drinking plenty of fluids are essential to prevent dehydration (a common consequence of diarrhoea). Some people with a more severe illness may require antibiotic treatment; this includes people with weakened immune systems, pregnant people, or elderly people. Healthcare professionals may have to conduct laboratory tests to determine what type of antibiotics are most appropriate for the patient to take, depending on the Campylobacter species present.25
How is Campylobacter infection diagnosed?
The most common way to diagnose campylobacteriosis is via stool tests where the Campylobacter microorganisms can be detected. A blood sample can be taken and grown in a culture medium to identify the presence of the bacteria, where the specific Campylobacter species can be isolated. The genetic material of the bacteria can be detected by a rapid diagnostic test (PCR), or the test can be a culture where bacteria will be isolated.23,25
How can I prevent campylobacter infection?
Several measures can be taken to prevent campylobacter infection:
- Cook meat thoroughly: cook at the correct temperature to help kill bacteria that might be present.
- Wash hands: wash hands with soap and water before and after handling raw meat, after using the bathroom, after contacting animals, and after changing diapers.
- Avoid cross-contamination: do not use the same utensils for raw and cooked meat, and use separate cutting boards for meat and vegetables.
- Avoid unpasteurized dairy products.
- Drink safe water: drink water that has been chlorinated, boiled, or filtered.
- Safely store and use food: store food at the correct temperature and use it before the expiration date.
Who is at risk of campylobacter infection?
People with weakened immune systems are at risk of developing severe campylobacter infection. These people include:23,26
- Young children: very young children have underdeveloped immune systems
- Elderly people: old adults have weakened immune systems
- Pregnant people undergo changes in their immune systems.
- Other diseases: individuals with other diseases, such as HIV/AIDS, cancer (undergoing chemotherapy), etc., may have weakened immune systems
An emerging environmental source of campylobacteriosis is school playgrounds. Many playgrounds constitute the habitat of a variety of birds, and bacteria can spread through bird faeces. Children may put their hands in their mouths and ingest these germs.7,10
However, the main risk factor for getting campylobacter infection is eating or handling raw or undercooked meat.26
How common is Campylobacter infection?
Campylobacter infection is a significant public health concern worldwide. In the United States population, it was reported that the annual incidence of Campylobacter infection was 14.3 in 100,000 population.27 A UK one-year study reported that back in 2009, C was the most common bacterial pathogen to cause infection.29 Generally, in the UK and Europe, campylobacteriosis is even more common than salmonellosis.2,29
When should I see a doctor?
Most campylobacteriosis cases can be treated at home with rest and hydration without medical supervision. Nevertheless, in situations when symptoms are prolonged (more than a week) and severe (bloody diarrhoea), it is important to seek medical care. If you become severely dehydrated or have a persistent fever, it is necessary to see a doctor.25
Campylobacter infection is a common foodborne bacterial infection that can cause both mild and severe symptoms. The most common symptom is diarrhoea, and others include fever, abdominal pain, and nausea. The infection results from consuming contaminated food, particularly poultry, but can be spread through various other ways, including contact with faeces. Most cases of Campylobacter infection are treated at home with rest and rehydration, but people with weakened immune systems are at risk for developing more serious symptoms. These people should seek medical attention. Overall, understanding the signs and symptoms of Campylobacter infection, as well as appropriate prevention and treatment, can help reduce the risk of this illness.
- O’Brien SJ. The consequences of campylobacter infection. Curr Opin Gastroenterol; 2017. 33(1): 14-20.
- Facciola A, Riso R, Avventuroso E, Visalli G, Delia SA, Lagana P. Campylobacter: from microbiology to prevention. J Prev Med Hyg; 2017. 58(2): E79-E92.
- Ternhag A, Torner A, Svensson A, Giesecke J, Ekdahl K. Mortality following campylobacter infection: a registry-based linkage study. BMC Infect Dis; 2005. 5: 70.
- Newell DG, Fearnley C. Sources of campylobacter colonization in broiler chickens. Appl Environ Microbiol; 2003. 69(8): 4343-4351.
- Mullner P, Spencer SEF, Wilson DJ, Jones G, Noble AD, Midwinter AC, Collins-Emerson JM, Carter P, Hathaway S, French NP. Assigning the source of human campylobacteriosis in New Zealand: a comparative genetic and epidemiological approach. Infect Genet Evol; 2009. 9(6): 1311-1319.
- Keener KM, Bashor MP, Curtis PA, Sheldon BW, Katharine S. Comprehensive review of campylobacter and poultry processing. Compr Rev Food Sci Food Saf; 2004. 3(2): 105-116.
- French NP, Midwinter A, Holland B, Collins-Emerson J, Pattison R, Colles F, Carter P. Molecular epidemiology of campylobacter jejuni isolates from wild-bird faecal material in children’s playgrounds. Appl Environ Microbiol; 2009. 75(3): 779-783.
- Tulve NS, Suggs JC, McCurdy T, Hubal EAC, Moya J. Frequency of mouthing behaviour in young children. J Expo Anal Environ Epidemiol; 2002. 12(4): 259-264.
- Guerin MT, Sir C, Sargeant JM, Waddell L, O’Connor AM, Wills RW, Bailey RH, Byrd JA. The change in prevalence of campylobacter on chicken carcasses during processing: a systematic review. Poult Sci; 2010. 89(5): 1070-1084.
- Hayama Y, Yamamoto T, Kasuga F, Tsutsui T. Simulation model for campylobacter cross-contamination during poultry processing at slaughterhouses. Zoonoses Public Health; 2011. 58(6): 399-406.
- Young CR, Harvey R, Anderson R, Nisbet D, Stanker LH. Enteric colonisation following natural exposure to campylobacter in pigs. Res Vet Sci; 2000. 68(1): 75-78.
- Graham C, Simmons NL. Functional organization of the bovine rumen epithelium. Am J Physiol Regul Integr Comp Physiol; 2005. 288(1): R173-R181.
- Hunter PR. The microbiology of bottled natural mineral waters. J Appl Bacteriol; 1993. 74(4): 345-352.
- Barrell RA, Hunter PR, Nichols G. Microbiological standards for water and their relationship to health risk. Commun Dis Public Health; 2000. 3(1): 8-13.
- Butzler JP, Oosterom J. Campylobacter: pathogenicity and significance in foods. Int J Food Microbiol; 1991. 12(1): 1-8.
- Taylor PR, Weinstein WM, Bryner WM. Campylobacter fetus infection in human subjects: association with raw milk. Am J Med; 1979. 66(5): 779-783.
- Evans MR, Roberts RJ, Ribeiro CD, Gardner D, Kembrey D. A milk-borne campylobacter outbreak following an educational farm visit. Epidemiol Infect; 1996. 117(3): 457-462.
- Lejeune JT, Rajala-Schultz PJ. Food safety: unpasteurized milk: a continued public health threat. Clin Infect Dis; 2009. 48(1): 93-100.
- Stehr-Green JK. Schantz PM. The impact of zoonotic diseases transmitted by pets on human health and the economy. Vet Clin North Am Small Anim Pract; 1987. 17(1): 1-15.
- Scott Weese J, Rousseau J, Arroyo L. Bacteriological evaluation of commercial canine and feline raw diets. Can Vet J; 2005. 46(6): 513-516.
- Nichols GL. Fly transmission of campylobacter. Emerg Infect Dis; 2005. 11(3): 361-364.
- Pebody RG, Ryan MJ, Wall PG. Outbreaks of campylobacter infection: rare events for a common pathogen. Commun Dis Rep CDR Rev; 1997. 7(3): R33-R37.
- Centers of Disease Control and Prevention (CDC). 2023. Campylobacter (Campylobacteriosis). https://www.cdc.gov/campylobacter/symptoms.html
- World Health Organization (WHO). 2023. Campylobacter. https://www.who.int/news-room/fact-sheets/detail/campylobacter
- Cleveland Clinic. 2023. Campylobacter Infection. https://my.clevelandclinic.org/health/diseases/15251-campylobacter-infection
- Gras LM, Smid JH, Wagenaar JA, de Boer AG, Havelaar AH, Friesema IHM, French NP, Busani L, van Pelt W. Risk factors for campylobacteriosis of chicken, ruminant, and environmental origin: a combined case-control and source attribution analysis. PloS One; 2012. 7(8): e42599.
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- Tam CC, Rodrigues LC, Viviani L, Dodds JP, Evans MR, Hunter PR, Gray JJ, Letley LH, Rait G, Tompkins DS, O’Brien SJ. Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice. Gut; 2012. 61(1): 69-77.
- Gov.uk. 2023. Zoonoses: UK annual reports. https://www.gov.uk/government/publications/zoonoses-uk-annual-reports