Campylobacter enteritis

Epidemiology of Infectious Diseases: Campylobacter enteritis

Causal Agent
Campylobacter jejuni. Other Campylobacter organisms include C. coli, C. fetus and C. lari.

The majority of human illness is caused by Campylobacter jejuni.

Common Clinical Features

  • Mild to severe diarrhoea (frequently with bloody stools).
  • Abdominal pain, cramping, fever, headache, nausea and/or vomiting.
  • Infection with campylobacter can cause serious illness among the immuno-compromised.
  • Illness typically lasts about 1 week in healthy persons.
  • Most infections are self limiting and are not treated with antibiotics. However, treatment with erythromycin reduces the length of time that infected individuals shed the bacteria in their faeces.

Geographical Distribution

  • Campylobacter is a major cause of diarrhoeal disease in humans.
  • Infection with campylobacter is the most common cause of bacterial infectious intestinal disease in England and Wales, with approximately 50,000 cases reported each year.
  • However, estimates suggest that for each reported case, 8 more cases are thought to go unreported1.
  • In temperate zones, including England and Wales infection with Campylobacter occurs more frequently during the early spring and summer.
  • Laboratory confirmed cases in England and Wales have been shown to be high among children 2.
  • Campylobacter is a common cause of traveller's diarrhoea and is hyper-endemic in developing countries.

Reservoir

Animals; Poultry, cattle, pigs, sheep and shellfish. Most raw poultry meat is contaminated with C. jejuni.

Mode of Transmission:

  • Ingestion of infected undercooked meats and meat products, especially poultry.
  • Ingestion of unpasteurized or contaminated milk, contaminated ice and water.
  • While person to person spread occurs, most cases are thought to be single,-sporadic cases.
  • In the UK approximately 5% of cases are thought to occur through contact with infected pets2.

Incubation Period
Commonly 2-5 days with a range of 1-10 days.

Period of Communicability
Throughout period of infection, usually several days to weeks.

Prevention and Control

  • Notify - In the UK Campylobacter infection is notifiable as 'suspected food poisoning', of which it is the most commonly reported cause2.
  • Follow correct food hygiene practices for food preparation and cooking in domestic and commercial kitchens as described by the WHO five keys to safer food3.
  • Prevent cross contamination of raw and cooked food by washing hands before, during and after food preparation.
  • Wash and sanitize all equipment, surfaces and utensils used for food preparation.
  • Separate raw and cooked food, and use separate equipment and utensils for handling raw food.
  • Cook food thoroughly (until centre of food reaches at least 70oC), especially poultry, meat, eggs and seafood.
  • Reheat cooked food thoroughly, and store cooked and raw food at a safe temperature.
  • Use safe water and raw materials, e.g. pasteurized milk and water.
  • Wash fruit and vegetables.

References

  1. Gillespie IA, O'Brien SJ, Frost JA, Adak GK, Horby P, Swan AV, et al. A case-case comparison of Campylobacter coli and Campylobacter jejuni infection: a tool for generating hypotheses. Emerg Infect Dis [serial online] 2002 Sep [date cited];8. Available from: www.cdc.gov/ncidod/EID/vol8no9/01-0187.htm
  2. Hawker J, Begg N, Blair I, Reintjes R, Weinberg J. Communicable Disease Control Handbook, Blackwell, 2005.
  3. World Health Organization: 5 Keys to Safer Food. Available at http://www.who.int/foodsafety/publications/consumer/5keys/en/

© CM Kirwan 2006