March 20, 2008

Campylobacteriosis

Campylobacteriosis: Disease caused by Campylobacter jejuni, now the leading cause of bacterial food poisoning, most often spread by contact with raw or undercooked poultry. A single drop of juice from a contaminated chicken is enough to make someone sick with Campylobacteriosis.

Campylobacteriosis usually strikes only one person or a few people at a time. A common way to become infected is to cut poultry meat on a cutting board, and then use the unwashed cutting board or utensil to prepare vegetables or other raw or lightly cooked foods. The Campylobacter organisms from the raw meat can then spread to the other foods. The organism is not usually spread from person to person, but this can happen if the infected person is a small child or is producing a large volume of diarrhea.

Many chicken flocks are silently infected with Campylobacter; that is, the chickens are infected with the organism but show no signs of illness. When an infected bird is slaughtered, Campylobacter can be transferred from the intestines to the meat. More than half of the raw chicken in the US market has Campylobacter on it. Campylobacter is also present in the giblets, especially the liver.

Larger outbreaks of Campylobacteriosis are not usually associated with raw poultry but with drinking unpasteurized milk or contaminated water. Unpasteurized milk can become contaminated if the cow has an infection with Campylobacter in her udder or if the milk is contaminated with manure. Surface water and mountain streams can become contaminated from infected feces from cows or wild birds. This infection is common in the developing world, and travelers to foreign countries are also at risk for becoming infected with Campylobacter.

Animals can also be infected, and some people are known to have acquired their infection from contact with the infected stool of an ill dog or cat.

Symptoms tend to start 2 to 5 days after exposure and typically last a week. They resemble viral gastroenteritis �- diarrhea, fever, abdominal pain, cramping, nausea and vomiting �- but with campylobacter, fever is typical and the diarrhea is often bloody.

Most people get better within 2 to 5 days after the onset of symptoms without specific treatment, although sometimes recovery can take up to 10 days. People with immune deficiencies may benefit from two weeks of antibiotics such as erythromycin or a fluoroquinolone. And, as all types of diarrhea, one should maintain a high intake of fluids for as long as the diarrhea persists.

To prevent campylobacteriosis,

  • Cook all poultry products thoroughly. Make sure that the meat is cooked throughout (no longer pink), any juices run clear, and the inside is cooked to 170oF (77oC) for breast meat, and 180oF (82oC) for thigh meat.
  • If you are served undercooked poultry in a restaurant, send it back for further cooking.
  • Wash hands with soap before handling raw foods of animal origin. Wash hands with soap after handling raw foods of animal origin and before touching anything else.
  • Prevent cross-contamination in the kitchen:
    • Use separate cutting boards for foods of animal origin and other foods.
    • Carefully clean 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 having contact with pet feces.

Most people who have campylobacteriosis recover completely. However, some suffer long-term consequences. One is arthritis. Another is a condition called Guillain-Barr� syndrome. Both are thought to occur when a person's immune system is "triggered" by the Campylobacter to attack the person's own body. In arthritis, the attack is mounted against joints, while in Guillain-Barr� syndrome the attack is against nerves leading to ascending paralysis that typically lasts several weeks and usually requires intensive care. It is estimated that approximately one in every 1000 campylobacteriosis cases leads to Guillain-Barr� syndrome. As many as 40% of Guillain-Barr� syndrome cases may be triggered by campylobacteriosis.

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