Campylobacter Information

According to Poultry World, levels of campylobacter in chicken sold by the UK’s major retailers continue to fall, according to statistics released by the Food Standards Agency on Wednesday 18 October.

Just 5.9% of chickens had high levels of campylobacter in the survey – which sampled 1,437 birds between April and July – down from 20.1% for the same period in 2014.

The FSA announced last month that it was changing its annual campylobacter retail survey with the top 9 retailers publishing their own results. Instead, the Agency would concentrate on smaller retailers, independent traders and markets stalls where levels of campylobacter have been stubbornly high.

Full results from the third annual retail survey, running from August 2016 to July 2017, showed:

  • The figure for high-level campylobacter prevalence (more than 1,000 cfu/g) among the top nine retailers (based on market share) was 5.6%
  • The ‘Others’ group, consisting of smaller retailers and butchers, had a significantly higher prevalence at 17.1%
  • The retailers with significantly lower prevalence than the average among all retailers were Morrisons (2.9%), Tesco (4.2%) and Waitrose (2.7%)
  • There was a significant fall in the percentage of chickens positive for campylobacter at any level – down from 73.2% in 2014/5 to 54% in 2016/7.

According to the CDC, at least 39 people across seven states have confirmed or suspected cases of Campylobacter bacteria, which can cause diarrhea, abdominal pain and fever. While the investigation is ongoing, federal officials have linked it to contact with puppies sold by Petland, a chain of pet stores based in Ohio.

Twelve of the confirmed cases are in Petland employees, and 27 other people who fell ill either visited a Petland, recently purchased a puppy there, or visited or live in a home with a Petland puppy. According to the CDC’s announcement, nine people have been hospitalized and there are no reported deaths.

The State Department of Agriculture and Markets announced Monday that milk from Martin Yoder Farm, 2594 Murdock Rd., was contaminated by Campylobacter jejuni, a bacteria that is a common cause of food poisoning, in samples conducted last week.

Ag & Markets Commissioner Richard A. Ball warned consumers in Orleans County and the surrounding area not to consume unpasteurized raw milk from the farm, but noted that no illnesses have been associated with the product.

“The Department recommends that any consumers who purchased raw milk from the Martin Yoder Farm immediately dispose of it,” the department said in a statement.

According to Ag & Markets, symptoms from Campylobacter jejuni exposure typically develop within two to five days after exposure and include abdominal pain, diarrhea, fever and malaise. These symptoms generally last about seven days but Campylobacter jejuni has been linked to incidents of Guillain-Barre syndrome, which may occur weeks after exposure.

Inspectors discovered the bacteria in a preliminary test completed on Sept. 13, and the farm immediately voluntarily suspended sales of the product. Further laboratory testing, completed on Friday, confirmed the presence of Campylobacter jejuni in the raw milk sample.

The farm, founded by the late Martin Yoder, is part of an Amish community that came to northwestern Orleans County from families in Ohio. Yoder’s farm, as of 2013, had 45-head of grazing cows on a fully-organic operation.

Consumers were able to purchase raw milk directly from the farm, but those sales have been prohibited until additional sampling is completed that confirms the product is bacteria-free.

Unpasteurized raw milk is supported by some consumers as a healthier and less industrial product, but skipping the heating process does not eliminate the possibility for bacteria. Consumers who may have purchased this product and have questions may call the Department at (518) 457-1772.

Raw milk can harbor dangerous bacteria, even when routine testing results show it to be uncontaminated, says a report from Utah on a 2014 outbreak of confirmed or suspected campylobacteriosis in 99 individuals. The report appears in today’s issue of Morbidity Mortality Weekly Report (MMWR).

The outbreak began in May 2014 with three patients who tested positive on pulsed field gel electrophoresis for Campylobacter jejuni. They had all consumed raw milk from an unnamed dairy in Weber County in northern Utah. The dairy’s routine testing, which is required monthly of dairies selling raw milk in Utah and consists of somatic cell and coliform counts, had yielded results within acceptable levels (<400,000 somatic cells/mL and <10 coliform colony forming units/mL).

Enhanced testing after the illnesses were identified showed C jejuni in the dairy’s milk.

Officials suspended the dairy’s permit in August and then reinstated it Oct 1 after follow-up cultures were negative. However, seven more C jejuni cases occurred by Nov 4, and the permit was permanently revoked Dec 1.

It total, 99 people in Utah, 85 (86%) of them from northern counties, were identified through lab testing and patient interviews as having confirmed (59) or probable (40) cases of campylobacteriosis from May 9 to Nov 6, 2014. Patients ranged in age from 1 to 74 years; 10 were hospitalized, and 1 died.

Of the 98 patients for whom exposure history was available, 53 reported drinking raw milk, 52 of them milk from the Weber Country dairy; 4 drank raw milk but could not name the dairy where it was purchased, and 14 bought raw milk at the dairy but did not report drinking it.

The authors point out that “Current raw milk testing standards do not readily detect contamination.” They recommend more education of consumers about the dangers associated with consuming unpasteurized milk, and they conclude, “The safest alternative is to consume pasteurized milk.”

Orange County has confirmed three cases of campylobacteriosis infection associated with consumption of raw goat milk distributed by Claravale Farm of San Benito County, California.  All three patients are young children less than 5 years of age.  One patient was hospitalized, and all of them are expected to recover.

The raw goat milk was distributed throughout the state, and the California Department of Public Health (CDPH) is leading an investigation to determine if there are additional cases.  While the CDPH investigation is ongoing the Health Care Agency advises against consuming Claravale Farm raw goat milk.

There is always a risk of illness associated with consumption of raw, or unpasteurized, milk products.  The risk of getting sick from drinking raw milk is greatest for infants and young children, the elderly, pregnant women, and people with weakened immune systems, such as people with cancer or HIV/AIDS. But, it is important to remember that healthy people of any age can get very sick if they drink raw milk contaminated with harmful germs.

Campylobacteriosis is an infectious disease caused by the Campylobacter bacteria. Outbreaks of Campylobacter disease have most often been associated with unpasteurized dairy products, contaminated water, poultry, and produce. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism.

The Food Standards Agency’s (FSA) released its “Name and Shame” Report this morning.  The idea of testing retail chicken and publishing the results had been the focus of much discussion over the last few months.  Some UK retailers were not very happy that the public would actually know how tainted the chicken really is.

If this had been the US equivalent, FSIS, we would be wondering why would the report be released on Thanksgiving Day.  My guess is that in the UK Thanksgiving does not have the same meaning as it does over here.

Retailers had tried to block the study’s release.

Well, back to the study; Campylobacter was found in 70 per cent of chicken tested up from 59 per cent of chickens in August.  Almost a fifth of all chickens (18 per cent) tested positive for Campylobacter above the highest level of contamination, while six per cent of packaging tested positive – a rise of four per cent since August.

The FSA also revealed that Asda sold the highest percentage of chickens contaminated with the bug.  Campylobacter was present in 78 per cent of chickens from the supermarket, with 28 per cent above the highest level of contamination.

Packaging testing showed 12 per cent was contaminated.  Don’t forget the recent “chicken juice” report.

Almost three-quarters of chickens (73 per cent) sold by the Co-operative tested positive, followed by Morrisons, Sainsbury’s and Waitrose (69 per cent), Marks & Spencer (67 per cent) and Tesco (64 per cent).

Perhaps it is time to redo our 2011 testing of contamination levels in chicken purchased in Seattle.  Here were some of the results:

The study showed that up to 80% of Seattle area raw chicken could be contaminated with some form of potentially harmful bacteria.

Testing done by IEH Laboratories in Lake Forest Park, Washington showed that 80 of 100 raw chickens purchased at various Seattle area grocery stores contained at least one potentially harmful pathogen.

The test was comprised of 18 brands of chicken purchased at 18 different Seattle area stores including chain grocery stores, Safeway (3 locations), Albertsons (2), QFC (4), Fred Meyer (2), Thriftway (1); warehouse clubs Costco (2) and Sam’s Club (1); natural foods stores Whole Foods (1) and PCC (1), and one small market, Ken’s Market (1).

In the study local and organic chicken did not prove to be safer than other samples. In terms of origination, 59 chicken samples originated from Washington, while 13 samples came from other states and 28 were of unknown origin. Regardless of place, chicken from every state tested was confirmed to contain potentially harmful bacteria.  Of the 14 samples of organic chicken 12 contained harmful bacteria.

The study tested for five pathogens.  While some findings were typical, other results were more surprising.  Previous studies have found on average that 33 to 53% of chicken is contaminated with Campylobacter.  In Seattle 65% of the chicken tested positive for Campylobacter.  Salmonella was isolated in 19% of the chicken purchased at retail stores in the Seattle area, slightly higher than the expected average of 16%.  Staphylococcus aureus was found in 42% of the chicken sampled; 10 of these samples were Methicillan-resistant, commonly known as MRSA.  One sample cultured positive for Listeria monocytogenes and one sample cultured positive for E. coli O26, a bacteria often found in beef.

Campylobacter:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Campylobacter outbreaks. The Campylobacter lawyers of Marler Clark have represented thousands of victims of Campylobacter and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Campylobacter lawyers have litigated Campylobacter cases stemming from outbreaks traced to a variety of sources, such as raw milk and municipal water.

Food safety experts plan to “superfreeze” chickens to halt the rise of campylobacter food poisoning. The Food Standards Agency is currently looking into a procedure which involves exposing the surface of slaughtered chickens to extreme cold, known as rapid surface chilling.

The radical process is currently being considered to help curb the rampant levels of the food poisoning bacteria commonly found in uncooked poultry products.

Around two-thirds of fresh, raw chicken sold by retailers is believed to be contaminated with campylobacter, which can cause sever stomach upsets.

The FSA aims to reduce the proportion of birds in the highest category of contamination at UK poultry houses from 27 per cent to 10 per cent by 2015.

Read full article: “Chickens to be ‘superfrozen’ to kill food bug.”

New Zealand Health officials are warning liver lovers to cook their offal properly, after more than two dozen cases of food poisoning in Wellington.  They are also working with restaurants and cafes, where use of organs and other cheap cuts of meat have had a resurgence, to ensure would-be chefs are cooking their grandmother’s lamb’s fry recipes to today’s food safety standards.

Campylobacter, a bacterium that causes stomach bugs, was found in undercooked poultry and lamb’s liver, Margot McLean of Regional Public Health said. Symptoms included diarrhoea, abdominal pain, fever, headache and vomiting.

Like chicken meat, lamb liver needs to be cooked long enough to kill any bacteria.

Most campylobacter victims are fine after a week, but some develop arthritis and on rare occasions people can develop the rare disease Guillain-Barre syndrome, which involves the immune system attacking the body’s nerves, resulting in paralysis that can last several weeks.

Researchers at the Institute of Food Research have discovered why the micronutrient selenium is important to the survival of Campylobacter bacteria, which are responsible for an estimated half a million cases of food poisoning annually in the UK alone. Knowing how and why Campylobacter uses selenium could help develop ways of controlling it, benefitting public health and the food industry.

Converting nutrients into energy is essential to all forms of life, and without this process, known as respiration, life would not exist in harsh and hostile conditions. This holds true for the foodborne bacterial pathogen Campylobacter, which colonises the intestines of poultry. In this environment it uses organic acids produced by other bacteria to respire and thrive. Campylobacter needs selenium to make the formate dehydrogenase enzyme required for this respiration, but it is not known how selenium is acquired or metabolised by Campylobacter or many other bacteria.

New research from the group of Dr Arnoud van Vliet at the Institute of Food Research, strategically funded by the Biotechnology and Biological Sciences Research Council, has resulted in the identification of two Campylobacter genes which are required for the formation of the formate dehydrogenase enzyme. Inactivation of these two genes blocked the formation of the formate dehydrogenase enzyme, but when the bacteria were supplemented with extra selenium, they were able to synthesize the enzyme again, suggesting that the two Campylobacter genes are involved in selenium metabolism. As it was previously shown that the lack of formate dehydrogenase affects the ability of Campylobacter to colonise the chicken gut, this may open up possibilities to target this pathway for antimicrobial purposes. In addition, as these selenium metabolism genes and the formate dehydrogenase enzyme are also present in other important foodborne pathogens like Salmonella and E. coli, it may be possible to extend such investigations to other areas of food safety.

“Selenium metabolism is still poorly understood in bacteria, and its role in important foodborne pathogens like Campylobacter is not yet appreciated fully”, said Dr van Vliet. “With the identification of these two genes essential for formate respiration, we now hope to have a tool to generate knowledge that helps us get a better understanding of what makes Campylobacter so good in colonising the chicken gut and cause disease in humans. Such knowledge is essential if we want to achieve the ultimate goal of reducing the impact of Campylobacter in the food industry.”

ThePoultrySite News Desk

Bad Bug Book – Foodborne Pathogenic Microorganisms and Natural Toxins – Second Edition

Campylobacter1.jpg1. Organism

Campylobacter jejuni is a non-sporeforming, Gram-negative rod with a curved- to S- shaped morphology. Many strains display motility, which is associated with the presence of a flagellum at one or both of the polar ends of this bacterium.

Members of the Campylobacter genus are microaerophilic; i.e., they grow at lower-than- atmospheric oxygen concentrations. Most grow optimally at oxygen concentrations from 3% to 5%. Thus, these bacteria generally are fairly fragile in the ambient environment and somewhat difficult to culture in the laboratory. Additional conditions to which C. jejuni are susceptible include drying, heating, freezing, disinfectants, and acidic conditions.

Other Campylobacter species, such as C. coli and C. fetus, also cause foodborne diseases in humans; however, more than 80% of Campylobacter infections are caused by C. jejuni. C. coli and C. jejuni cause similar disease symptoms. C. fetus infections often are associated with animal contact or consumption of contaminated foods and beverages and are especially problematic for fetuses and neonates, in whom the mortality rate may be up to 70%.

Campylobacter genomes are relatively
unstable; several mechanisms that may lead
to this genetic instability have been proposed,
including bacteriophage activity, DNA recombination and transformation. There are several typing methods, such as pulsed-field gel electrophoresis, PCR-based typing, ribotyping and genomotyping, for assessing the genetic diversity of C. jejuni. A list of Campylobacter genomes that have been sequenced is available under the National Center for Biotechnology Information web link.

2. Disease

• Mortality: Approximately 99 deaths in the United States, per year, are estimated to be due to campylobacteriosis.

• Infective dose: In general, the minimum number of ingested Campylobacter cells that can cause infection is thought to be about 10,000. However, in trials, as few as 500 ingested Campylobacter cells led to disease in volunteers. Differences in infectious dose likely can be attributed to several factors, such as the type of contaminated food consumed and the general health of the exposed person.

• Onset: The incubation period, from time of exposure to onset of symptoms, generally is 2 to 5 days.

• Disease / complications: The disease caused by C. jejuni infections is called campylobacteriosis. The most common manifestation of campylobacteriosis is self- limiting gastroenteritis, termed “Campylobacter enteritis,” without need for antimicrobial therapy. When antimicrobial therapy is indicated, erythromycin or ciprofloxacin are most commonly prescribed. 
A small percentage of patients develop complications that may be severe. These include bacteremia and infection of various organ systems, such as meningitis, hepatitis, cholecystitis, and pancreatitis. An estimated 1.5 cases of bacteremia occur for every 1,000 case of gastroenteritis. Infections also may lead, although rarely, to miscarriage or neonatal sepsis. 
Autoimmune disorders are another potential long-term complication associated with campylobacteriosis; for example, Guillain-Barré syndrome (GBS). One case of GBS is estimated to develop per 2,000 C. jejuni infections, typically 2 to 3 weeks post infection. Not all cases of GBS appear to be associated with campylobacteriosis, but it is the factor most commonly identified prior to development of GBS. Various studies have shown that up to 40% of GBS patients first had Campylobacter infection. It is believed that antigens present on C. jejuni are similar to those in certain nervous tissues in humans, leading to the autoimmune reaction. Reactive arthritis is another potential long-term autoimmune complication. It can be triggered by various kinds of infections and occurs in about 2% of C. jejuni gastroenteritis cases. 
Hemolytic uremic syndrome and recurrent colitis following C. jejuni infection also have been documented.

• Symptoms: Fever, diarrhea, abdominal cramps, and vomiting are the major symptoms. The stool may be watery or sticky and may contain blood (sometimes occult – not discernible to the naked eye) and fecal leukocytes (white cells). Other symptoms often present include abdominal pain, nausea, headache, and muscle pain.

• Duration: Most cases of campylobacteriosis are self-limiting. The disease typically lasts from 2 to 10 days.

• Route of entry: Oral.

• Pathway: The mechanisms of pathogenesis by C. jejuni are not well understood and usually vary based on the virulence genes present in a particular strain. In general, C. jejuni cause infections by invading and colonizing the human gastrointestinal tract.

Motility appears to be an important factor in C. jejuni pathogenesis, enabling the bacterium to invade the human intestinal mucosa. The mechanisms by which cellular invasion by C. jejuni cause the observed symptoms remain a mystery. In genome- sequencing studies, researchers were not able to identify the presence of toxin genes that likely contribute to diarrhea and other common symptoms.

3. Frequency

Campylobacter species are believed to be the third leading cause of domestically acquired bacterial foodborne illness in the United States, with an estimated 845,024 cases occurring annually, according to the Centers for Disease Control and Prevention (CDC). According to data from FoodNet, the incidence of cases of campylobacteriosis reported to the CDC in 2008 was 12.68 per 100,000 individuals, which is a decrease of 32% over the last decade. For each reported case of campylobacteriosis, it is estimated that 30 cases are unreported.

4. Sources

Major food sources linked to C. jejuni infections include improperly handled or undercooked poultry products, unpasteurized (“raw”) milk and cheeses made from unpasteurized milk, and contaminated water. Campylobacter infection in humans has been linked to handling and eating raw or undercooked meat and poultry, whether fresh or frozen. Avoiding cross contamination of uncooked items from raw meat and poultry products, thorough cooking, pasteurization of milk and dairy products, and water disinfection are effective ways to limit food- and water-borne exposure to Campylobacter. Reduction of risk from contaminated poultry products can be achieved through good hygienic practices by manufacturers and consumers.

Campylobacter is part of the natural gut microflora of most food-producing animals, such as chickens, turkeys, swine, cattle, and sheep. Typically, each contaminated poultry carcass can carry 100 to 100,000 Campylobacter cells. Given the fact that up to 500 Campylobacter cells can cause infection, poultry products pose a significant risk for consumers who mishandle fresh or processed poultry during preparation or who undercook it.

C. jejuni has been found in a variety of other foods, such as vegetables and seafood, and in non- food animal species. C. jejuni also occurs in nonchlorinated water, such as that found in ponds and streams.

5. Diagnosis

Special incubation conditions are required for isolation and growth of C. jejuni cells, since the organism is microaerophilic. Samples from stool or rectal swabs are inoculated directly onto selective media, or they can be enriched to increase recovery. To limit growth of competing organisms, media used for cultivation usually are supplemented with blood and antimicrobial agents. The cultures are incubated at 42oC, under microaerophilic conditions (5% oxygen and 5% to 10% carbon dioxide), for optimal recovery.

6. Target Populations

Children younger than 5 years old and young adults 15 to 29 years old are the populations in whom C. jejuni gastroenteritis most commonly is detected. The highest incidence of infection is among infants 6 to 12 months old. C. jejuni bacteremia may also affect pregnant women, leading to infection of the fetus, which can lead to miscarriage or stillbirth. The incidence of infection is estimated to be 40-fold greater in people with HIV/AIDS, compared with others in the same age group.

7. Food Analysis

Isolation of C. jejuni from food is difficult, because the bacteria are usually present in very low numbers. For isolation from most food products, samples are rinsed and the rinsate is collected and subjected to pre-enrichment and enrichment steps, followed by isolation of C. jejuni from the agar medium. For more information about isolation of Campylobacter from food and water, see FDA’s Bacteriological Analytical Manual.

8. Examples of Outbreaks

For an update on recent outbreaks related to Campylobacter, please visit the CDC’s Morbidity and Mortality Weekly Report and enter Campylobacter in the search field.

The following reports are available on the surveillance of foodborne outbreaks in the U.S.: CDC annual report, CDC report #1, CDC report #2, and FoodNet report.

9. Other Resources

The following web links provide more information about Campylobacter and its prevention and control:

• U.S. Department of Agriculture – Q&A from Food Safety and Inspection Services

• CDC – Disease Listing

• CDC – Emerging Infectious Diseases review

• Several federal surveillance and monitoring programs in the U.S. report the incidences of Campylobacter infections and their resistance to antimicrobial drugs; for example, FoodNet, PulseNet, and National Antimicrobial Resistance Monitoring System. 
Additional resources include:

  • National Center for Biotechnology Information (taxonomy)
  • World Health Organization
  • FDA report on risk assessment

Continue Reading Bad Bug Book – Foodborne Pathogenic Microorganisms and Natural Toxins – Second Edition – Campylobacter jejuni