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Food Focus May 2006

Campylobacter: PREVENTION IS BETTER THAN CURE

Every year, one in every 30 New Zealanders gets sick because of Campylobacter. Campylobacteriosis – a notifiable disease – occurs when the bacterial cells lodge in the walls of the intestine, irritate the lining and cause it to swell. Cases are reported by doctors to public health units, allowing investigation of the source and, hopefully, control of the outbreak.

Reporting also allows researchers to investigate any outbreak and identify ways to prevent future outbreaks and cases.

Two species of Campylobacter commonly affect people: Campylobacter jejuni and C. coli are normally found in the gut of large farm animals, pets and birds. Illness strikes within 2-5 days but can take up to 10. Symptoms include general muscle pain, stomach cramps, nausea, headache or fever followed by sudden watery diarrhoea that may contain blood.

Most people feel ill for about a week while their immune system fights the infection. During the illness, and for up to a fortnight afterwards, bacteria are shed from the gut. They can survive on hands and moist surfaces for up to an hour, so not washing your hands properly after using the toilet can help the bacteria to quickly spread to food, utensils, taps, etc.

Poultry is often implicated in outbreaks and appears to be associated with cross-contamination or under-cooking. Notable outbreaks have stemmed from undercooked chicken in stir-fries, undercooked chicken liver in paté, barbequed sausages and cross-contamination in tuna salad and cucumber.

Campylobacter can also be picked up from animals and from environmental contact, recreational swimming and from drinking untreated water and raw (unpasteurised) milk.

Reports of the disease are highest among young men under 20 and infants less than a year old whose immune systems may be compromised. The latter may be as a result of parental concern being focused on babies, whereas adults may be more likely to ‘ride it out’. In general more men than women are reported with the illness, and 25% of victims have relapses.

Hospital treatment

Most cases are recorded in spring and summer and some patients require hospital treatment, especially if they’re dehydrated, have low immunity and the attack is severe. Longer-term complications may develop including arthritis (eg Reiter’s syndrome or Guillain-Barré Syndrome – see Food Focus February 2006) which can cause temporary or permanent paralysis, and sometimes even death.

If you think you may have a Campylobacter infection, or any kind of gastroenteritis, you should visit your doctor who may ask you to provide a sample for testing to establish a proper diagnosis. You may be able to return to work when symptoms disappear but if you have a job that involves food handling or interacting with vulnerable people you may require more time off work and further testing until you’re clear of the bacteria.