Questions and Answers
- What is Campylobacter infection?
- What are the symptoms of Campylobacter?
- How does food and water get contaminated with Campylobacter?
- How do people get infected with Campylobacter bacteria?
- How is Campylobacter infection diagnosed and treated?
- Is Campylobacter infection serious?
- What are public health agencies doing to control Campylobacter and prevent infections?
Campylobacter infection, or campylobacteriosis, is caused by Campylobacter bacteria. It is the most common bacterial cause of diarrheal illness in the United States. The Foodborne Diseases Active Surveillance Network (FoodNet) indicates that about 20 cases are diagnosed each year for every 100,000 people. Many more cases go undiagnosed or unreported. CDC estimates Campylobacter infection affects 1.5 million U.S. residents every year. Most cases are not part of recognized outbreaks, and more cases occur in summer than in winter.
People with Campylobacter infection usually have diarrhea (often bloody), fever, and stomach cramps. Nausea and vomiting may accompany the diarrhea. Symptoms usually start two to five days after infection and last about one week. Some people experience complications, such as irritable bowel syndrome, temporary paralysis, and arthritis. In people with weakened immune systems, such as those with a blood disorder, with AIDS, or receiving chemotherapy, Campylobacter occasionally spreads to the bloodstream and causes a life-threatening infection.
Campylobacter can contaminate food and water in several ways.
Many chickens, turkeys, cows, and other animals that show no signs of illness carry Campylobacter. Campylobacter can be carried in the intestines, liver, and other organs of animals and can be transferred to other edible parts when an animal is slaughtered. In 2015, National Antimicrobial Resistance Monitoring System (NARMS) testing found Campylobacter on 24% of raw chicken bought from retailers.
Milk can become contaminated when a cow has a Campylobacter infection in her udder or when milk is contaminated with manure. Pasteurization makes milk safe to drink.
Fruits and vegetables can be contaminated through contact with soil or water containing feces (poop) from cows, birds, or other animals. Animal feces can contaminate lakes and streams. Washing or scrubbing fruits and vegetables and disinfecting untreated drinking water helps prevent illness.
It takes very few Campylobacter bacteria to make someone sick. A single drop of juice from raw chicken can contain enough bacteria to infect someone.
Most Campylobacter infections are probably acquired by eating raw or undercooked poultry or eating something that touched it. Campylobacter are also transmitted by other foods, including seafood, meat, and produce; by contact with animals; and by drinking untreated water.
People can get infected when a cutting board that has been used to cut and prepare raw chicken isn’t washed before it is used to prepare foods that are served raw or lightly cooked, such as salad or fruit. People can also get infected through contact with dog or cat feces. Very rarely, people have become infected through a transfusion of contaminated blood.
Campylobacter does not usually spread from one person to another.
Outbreaks have been associated with poultry, raw (unpasteurized) dairy products, seafood, untreated water, produce, and puppies.
Campylobacter infection is common in low-resource countries, and people who travel abroad have a greater chance of becoming infected. About one in five Campylobacter infections reported to FoodNet are associated with international travel.
Campylobacter infection is diagnosed when a laboratory test detects Campylobacter bacteria in stool (poop), body tissue, or fluids. The test could be a culture that isolates the bacteria or a rapid diagnostic test that detects genetic material of the bacteria.
Most people recover from Campylobacter infection without antibiotic treatment. Patients should drink extra fluids as long as diarrhea lasts.
Some people with, or at risk for, severe illness might need antibiotic treatment. These people include those who are 65 years or older, pregnant women, and people with weakened immune systems, such as those with a blood disorder, with AIDS, or receiving chemotherapy.
Most people with a Campylobacter infection recover completely within a week, although some shed (get rid of) Campylobacter bacteria in their stool for weeks after recovery. Campylobacter infection rarely results in long-term health problems. Some studies have estimated that 5–20% of people with Campylobacter infection develop irritable bowel syndrome for a limited time and 1–5% develop arthritis.
About one in every 1,000 reported Campylobacter illnesses leads to Guillain-Barré syndrome (GBS). GBS happens when a person’s immune system is triggered by an infection. People with GBS can have muscle weakness or sometimes paralysis that can last for weeks and often require intensive medical care. Most people recover fully, but some have permanent nerve damage. Estimates indicate that as many as 40% of GBS cases in the United States might be triggered by Campylobacter infection.
State health departments report human Campylobacter infections to CDC. Through the surveillance systems listed below, CDC monitors cases, tracks antibiotic resistance, estimates the total number of people infected each year, identifies prevention measures to meet food safety goals, and provides data and analyses that inform food safety action and policy.
- PulseNet, a national laboratory network that detects foodborne disease outbreaks, compares the DNA fingerprints of Campylobacter from patients to find groups of infections that may indicate an outbreak.
- FoodNet, a collaboration among CDC, 10 state health departments, the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), and the U.S. Food and Drug Administration (FDA), collects data on human infections caused by Campylobacter.
- National Antimicrobial Resistance Monitoring System (NARMS), a collaboration among state and local public health departments, CDC, FDA, and USDA, tracks changes in antibiotic resistance among Campylobacter bacteria isolated from humans, meat sold at retail, and food animals.
- National Outbreak Reporting System (NORS) collects data from state health departments about Campylobacter
- Laboratory Enteric Disease Surveillance (LEDS) collects data on laboratory-confirmed Campylobacter infections from state public health laboratories.
USDA-FSIS regulates meat, poultry, and processed eggs. In 2011, the agency established performance standards to limit Campylobacter contamination of whole broiler chickens, requiring contamination rates to be no more than 10.4% of samples in processing plants. In 2016, USDA-FSIS implemented further measures, requiring Campylobacter contamination rates to be no more than 1.9% in ground chicken and turkey products and 7.7% in raw chicken parts in processing plants. USDA-FSIS also posts contamination testing results online.
FDA regulates all foods other than those regulated by USDA-FSIS. FDA publishes the Food Code, a model for regulating retail and food service establishments, including restaurants, grocery stores, and institutions such as nursing homes. The FDA Food Safety Modernization Act, passed in 2011, aims to ensure the U.S. food supply is safe by shifting the focus to preventing contamination.