Campylobacter in the Food Chain: Contamination Sources, Prevention Strategies, and Risk Assessment

Campylobacter, often known as a food-poisoning bacteria, is one of the leading causes of diarrheal diseases worldwide. Due to its high incidence, prolonged duration, and potential complications, Campylobacter-induced diarrhea has significant socio-economic implications. In developing countries, young children under two are particularly susceptible to Campylobacter infections, which can sometimes be fatal.

Campylobacter bacteria typically have a spiral, "S"-shaped, or curved rod-like structure. The Campylobacter genus consists of 17 species and six subspecies, with the most commonly reported ones causing human diseases being C. jejuni (subspecies jejuni) and C. coli. Although other species like C. lari and C. upsaliensis have been isolated from patients with diarrheal illness, they are less frequently reported.

Prevalence and Spread

Campylobacteriosis is a zoonotic disease, meaning it can be transmitted to humans from animals or animal products. Campylobacter species are widely prevalent in warm-blooded animals, including food animals like poultry, cattle, pigs, sheep, ostriches, and pets like cats and dogs. It may also be found in shellfish. 

The primary mode of transmission is believed to be through contaminated food, especially undercooked meat and meat products, as well as raw or contaminated milk. Water or ice contaminated with Campylobacter can also serve as a source of infection. 

Clinical Features and Symptoms 

The disease caused by Campylobacter infection usually appears 2 to 5 days after exposure, but the onset can range from 1 to 10 days. It causes food poisoning symptoms, with typical manifestations being:

 Diarrhea (often bloody)

 Abdominal pain

 Fever

 Headache

 Nausea, and vomiting

Typically, the symptoms persist for 3 to 6 days. While death from Campylobacteriosis is rare, it is more likely to occur in very young children, elderly individuals, or those with underlying severe illnesses like AIDS. Complications such as bacteremia, hepatitis, pancreatitis, miscarriage, reactive arthritis, and neurological disorders such as Guillain-Barré syndrome may occur, although their frequency varies.

Treatment and Control Measures

Most cases of Campylobacteriosis are self-limiting and do not require specific treatment. However, for severe or prolonged cases, fluid and electrolyte replacement therapy may be necessary to manage dehydration. In certain situations, antimicrobial therapy may be prescribed, especially for immunocompromised individuals or patients with severe symptoms. 

Preventive measures include:

Thorough handwashing.

Keeping raw poultry separate from other foods.

Ensuring proper cooking temperatures.

Consuming pasteurized milk.

Avoiding untreated water.

Additionally, maintaining good hygiene practices with pets is advised.

Implementing control measures, practicing good hygiene during slaughtering, and employing bactericidal treatments are crucial steps in reducing the prevalence of Campylobacter. The World Health Organization (WHO) emphasizes the significance of food safety and collaborates with other organizations to strengthen global food safety systems, establish standards, enhance disease surveillance, educate consumers, and train food handlers.

Here are some of the recommendations for the public and travelers:

To prevent food infection, ensure food is cooked thoroughly and served hot.

Refrain from consuming raw or undercooked meats, including poultry, seafood, beef, and pork.

Avoid consuming raw milk and products made from raw milk. Opt for pasteurized or boiled milk.

Exercise caution when consuming ice, ensuring it is made from safe water.

When unsure about the safety of drinking water, either boil it or use a reliable, slow-release disinfectant agent to disinfect it (usually available at pharmacies).

Practice thorough and frequent handwashing with soap, especially after contact with pets, farm animals, or using the toilet.

Carefully wash fruits and vegetables, particularly if consumed raw. If possible, peel them before consumption.

Ensure that your children wash their hands before eating.

Recommendations for Food Handlers:

Both professional and domestic food handlers should prioritize food safety and follow hygienic food preparation practices.

Professional food handlers who experience fever, diarrhea, vomiting, or visible infected skin lesions should refrain from cooking food for others.

Handle raw chicken, beef, and pork cautiously, assuming they are potentially contaminated with Campylobacter.

Use a plastic bag to wrap chicken and meat, preventing juices and blood from contacting other foods.

After purchasing, promptly refrigerate chicken and meats.

Immediately wash cutting boards, countertops, and utensils used for preparing raw chicken or meat to avoid contaminating other foods.

Keep raw chicken or meat separate from cooked chicken or meat to prevent cross-contamination.

Ensure that chicken or meat is cooked to the appropriate internal temperature until the middle is no longer pink. For example, medium red meat should reach 160°F (72°C), breast meat or well-done red meat should reach 170°F (77°C), and thigh meat should reach 180°F (82°C).

After handling raw chicken or meat, wash your hands with soap and water.

Avoid consuming raw or undercooked eggs.

Wash your hands before and after preparing meals.

The WHO recommends Five Keys to Safer Food service: a. Keep clean. b. Separate raw and cooked foods. c. Cook food thoroughly. d. Keep food at safe temperatures. e. Use safe water and raw materials.

The bottom line

Campylobacteriosis is a significant public health concern worldwide due to its high prevalence and associated morbidity. Enhanced awareness of Campylobacter, adherence to food safety practices, and appropriate surveillance measures are essential for preventing and controlling the transmission of this pathogen. 

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