Campylobacteriosis

What is it?

Campylobacteriosis is an infection by one of several species of Campylobacter bacteria, particularly Campylobacter jejuni (C. jejuni). This infection typically causes diarrhea. The infection also can cause fever and abdominal cramps.

Humans usually become infected with Campylobacter after eating poorly prepared meat, especially undercooked chicken. Campylobacter is one of the most common bacterial causes of foodborne illness.

Infants have an especially high rate of campylobacteriosis because of their immature immune defenses. Young adults also are at higher risk of infection, possibly because they have less experience cooking and handling raw meats. So, they may be exposed more often to potentially contaminated foods.

Most healthy people probably develop some degree of immunity against Campylobacter as they mature. This may account for the lower number of cases of Campylobacter infection in middle-aged and older adults.

Besides being transmitted to humans in tainted, undercooked meat, Campylobacter also can contaminate unpasteurized milk and untreated water. In addition, Campylobacter bacteria sometimes infect humans who have handled raw meat (especially poultry), touched a sick pet that has diarrhea, or traveled to undeveloped countries where sanitation is poor. Although it is possible to develop campylobacteriosis after direct contact with an infected person, this is not common.

People with weakened immune systems are more likely to become infected with Campylobacter. They also tend to have symptoms that are more severe.

Symptoms

Some people who have a Campylobacter infection have mild symptoms, such as a few loose stools per day. These people probably would not seek medical attention, since the symptoms would resolve on their own.

When full-blown symptoms occur, they usually begin two to seven days after exposure to Campylobacter. At first, you may have a 12- to 48-hour period of fever, headache, muscle aches, and malaise (a general feeling of sickness). These early symptoms are followed by crampy abdominal pain and diarrhea, sometimes with nausea and vomiting. There may be up to 10 loose stools watery stools per day. You may notice some blood in the stool.

Diagnosis

Your doctor may suspect that you have some sort of food-related illness based on your history and symptoms. If your symptoms are very typical and not severe, the treatment for most food-related illnesses is the same. The only way to confirm that you definitely have been infected with Campylobacter is to collect a stool sample for examination in a laboratory (called a stool culture). However, a stool culture is often not needed.

Some patients have symptoms that are not typical. In those cases, the doctor would send the stool culture and also recommend additional tests such as CT scan.

Expected duration

In adults who have normal immune defenses, Campylobacter infection is usually a self-limited illness that goes away on its own within seven to 10 days. With antibiotic treatment, symptoms often stop sooner, usually in about five days.

Prevention

Uncooked commercial chicken, raw veal, and raw ground beef are frequent sources of Campylobacter. To help prevent infection:

• Cook poultry and meat thoroughly.
• Wash your hands after handling raw poultry and meat.
• Wash kitchen countertops and utensils thoroughly after they have been used to prepare poultry and meat.
• You also can reduce your risk by never drinking unpasteurized milk or untreated water.

If your pet becomes sick with diarrhea, wash your hands thoroughly after you have cared for it. Keep sick pets away from infants, elderly family members, and family members with weakened immune systems.

Treatment

The first goal in treating Campylobacter-related diarrhea is to replace lost body fluids and electrolytes (chemical substances involved in many body processes). If you have severe diarrhea, you may be at risk of developing dehydration. To treat your dehydration, your doctor will prescribe oral or intravenous (IV) fluids.

Because Campylobacter infections are usually self-limited, your doctor may not treat you with an antibiotic if you are otherwise healthy. However, antibiotic treatment is usually necessary in the following situations:

• You have severe symptoms, including high fever, bloody diarrhea, and more than eight stools per day.
• Your symptoms persist or worsen after seven days.
• You have an underlying illness that weakens the immune system.
• Laboratory cultures have identified Campylobacter bacteria in your blood.

When an antibiotic is needed to treat C.jejuni infections, azithromycin (Zithromax) should be the first choice. Although most strains will respond to fluoroquinolones, such as levofloxacin (Levaquin) or ciprofloxacin (Cipro), antibiotic resistance and side effects are more common with these types of antibiotics.

To slow down the diarrhea, your doctor may recommend loperamide (Imodium, generic versions) or another anti-diarrheal drug.

When to call a professional

Call your doctor promptly if you develop severe diarrhea, bloody diarrhea, or severe abdominal pain. Your doctor will consider Campylobacter infection as one of several reasons for your symptoms. Infants, elderly adults, and people with a weakened immune system need urgent medical evaluation if they develop symptoms of Campylobacter infection.

Prognosis

Most otherwise healthy adults recover from Campylobacter infection within several days. Occasionally diarrhea may persist for up to 10 days. Complications other than dehydration are very uncommon. One rare complication is Guillain-Barr' syndrome. In this condition, Campylobacter jejuni somehow triggers the immune system to attack nerves, causing weakness and sometimes paralysis.

In patients with reactive arthritis, a Campylobacter infection can trigger an arthritis flare in one or more joints, usually within seven to 10 days after the diarrhea begins.

Additional info

Centers for Disease Control and Prevention
https://www.cdc.gov/