Campylobacter Resources

Food Safety News reports that a vaccine to protect against Campylobacter jejuni was recently approved for human clinical trials by the U.S. Food and Drug Administration.

Campylobacter is a major cause of bacterial diarrhea worldwide — estimated to be the cause of 4-15 percent of cases. It’s a problem in both developed and developing countries and is associated with unpasteurized dairy products, contaminated water, poultry and produce.

In the U.S., the Centers for Disease Control and Prevention estimates that campylobacteriosis affects more than 1.3 million people every year.

Although Campylobacter infections are generally mild, complications can include reactive arthritis neurological disorders such as Guillain-Barré syndrome, a disorder in which the body’s immune system attacks part of the peripheral nervous system.

Campylobacter is the most common cause of food poisoning in the UK. It is considered to be responsible for about 460,000 cases of food poisoning, 22,000 hospitalizations and 110 deaths each year and a significant proportion of these cases come from poultry. An FSA survey of chicken on sale in the UK (2007/8) indicated that 65% of chicken on sale in shops was contaminated with campylobacter.

Reducing cases of campylobacter is the FSA’s top food safety priority but monitoring carried out by the FSA shows there is no evidence of change in the proportion of the most highly contaminated chickens since 2008.

The Board paper, which can be found at the link below, outlines how the FSA will:

  • Improve the amount and quality of information about campylobacter levels that is available at all stages of the supply chain, to support and incentivize more effective risk management
  • Address regulatory barriers to the adoption of safe and effective technological innovations for reducing campylobacter risks at all stages in the food supply chain
  • Work with local government partners and others to raise awareness of campylobacter and ensure that food businesses using chilled chicken are aware of the risks and managing them appropriately
  • Continue and increase our support to research programs into vaccination and other possible long term interventions to address the issue
  • Drive changes in behavior and approach, using tools including regulation if appropriate

The FSA expects industry to focus its actions to:

  • Continue to improve the effectiveness of biosecurity measures on farms to prevent flock colonization with campylobacter
  • Ensure that steps involved in slaughter and processing are effective in preventing contamination of carcasses
  • Continue to work on packaging and other initiatives that reduce cross contamination in the consumer and food service kitchen
  • Develop and implement new interventions that reduce contamination when applied at production scale

Catherine Brown, FSA Chief Executive, said: ‘what we have proposed in this paper is a shift in culture and a refocusing of effort by both government and the food industry to tackle this persistent and serious problem. While we remain committed to joint working with industry we want to encourage and see producers, processors and retailers treat campylobacter reduction not simply as a technical issue but as a core business priority – and I see some encouraging signs of that happening.

‘I feel that because this is a complex and difficult issue there has tended to be an acceptance that a high level of contamination will inevitably occur and that there’s little that can be done to prevent it. The FSA doesn’t believe this is the case and this paper sets out how together we can make progress towards reducing the number of people who get ill from campylobacter. I am hosting a round table discussion with industry leaders on Monday, 2 September where we will explore these ideas more fully.’

FSA monitoring results show there is no evidence of a change in the proportion of most highly contaminated birds since 2008. Samples for this monitoring are taken from chickens at the end of processing (post-chill) in UK slaughterhouses and tested to determine the level of campylobacter present on the skin. Results are classified into 3 bands of contamination, which correspond to less than 100 colony forming units/gram (cfu/g), between 100 and 1000cfu/g and more than 1000cfu/g.

A team of Iowa State University researchers has received a federal grant to study ways to reduce infections of Campylobacter a food-borne bacteria spread mostly through undercooked chicken.

The $2.5 million grant announced Friday is from the U.S. Department of Agriculture. It will help the researchers develop new methods to manage Campylobacter, a bacteria carried primarily by poultry. It’s difficult to track and contain the bacteria because infected chickens show no signs of illness.

Campylobacter is a leading cause of food-borne illness in the United States, causing an estimated 800,000 illnesses a year.

The research team aims to identify risk factors that affect infection among live birds and contamination of poultry carcasses. Their goal is to work on vaccines, management of litter on poultry farms and other methods to help reduce infections.

ScienceDaily reports in “Life-Saving in the Bacterial World: How Campylobacter Rely on Pseudomonas to Infect Humans” that the bacterium Campylobacter jejuni is a major cause of food poisoning in humans. It is normally transmitted from contaminated chicken meat, as it is frequently found in the intestines of chickens, where it apparently does not result in any symptoms. Campylobacter jejuni is well adapted to life in the intestines of animals — and humans — so it is surprising that it is able to survive on the surface of meat, which is generally stored in a much more oxygen-rich atmosphere.

Screen shot 2010-12-07 at 3.15.30 AM.pngResearchers at the University of Veterinary Medicine, Vienna have now solved the puzzle, showing that Campylobacter can survive ambient oxygen levels thanks to the presence of other bacteria, species of Pseudomonas. The interaction between the different species seems to be a mechanism for Campylobacter to remain viable on chicken meat and thus to infect humans. Campylobacter (yellow) and Pseudomonas (red).

Although Campylobacter infections are rarely life-threatening they are extremely debilitating and have been linked with the development of Guillain-Barré syndrome, one of the leading causes of non-trauma-induced paralysis worldwide.

Friederike Hilbert, Manuela Scherwitzel, Peter Paulsen and Michael P. Szostak. Survival of Campylobacter jejuni under Conditions of Atmospheric Oxygen Tension with the Support of Pseudomonas spp.. Applied and Environmental Microbiology, 2010; 76 (17): 5911 DOI: 10.1128/AEM.01532-10

Screen shot 2010-11-19 at 6.03.53 AM.pngPeople from Walkerton Canada who had gastroenteritis after drinking water contaminated with Escherichia coli O157:H7 have a higher long-term risk than other people of developing hypertension, renal impairment and cardiovascular disease, research has shown. “Long term risk for hypertension, renal impairment, and cardiovascular disease after gastroenteritis from drinking water contaminated with Escherichia coli O157:H7: a prospective cohort study.”

A prospective cohort study was set up in Walkerton, Ontario, Canada to investigate any long-term health problems following contamination of the town’s water supply in May 2000 with E. coli O157:H7 and Campylobacter.

Researchers recruited 1977 adult participants of whom almost all (99%) said they had drunk the contaminated water. Of these, 1067 (54%) had had acute gastroenteritis, and 378 sought medical attention.

Participants were followed up annually, with physical examination and laboratory assessment. This included height, weight, blood pressure, serum creatinine concentration, random (spot) urine analysis for albumin: creatinine ratio; in some years fasting serum glucose measurement, oral glucose tolerance testing and 24-hour urine collection were also done.

People who had had acute gastroenteritis during the E. coli outbreak were 1.3 times more likely to develop hypertension, 3.4 times more likely to develop renal impairment and 2.1 times more likely to have a cardiovascular event such as a heart attack or stroke, compared with people who had not been ill or only mildly ill. We have certainlly seen these risks for people who develop Hemolytic Uremic Syndrome (HUS), but not for more mild illnesses.

“Our findings underline the need for following up individual cases of food or water poisoning by E. coli O157:H7 to prevent or reduce silent progressive vascular injury.” They suggest that annual monitoring of blood pressure and periodic monitoring of renal function may be warranted. They add: “These long term consequences emphasize the importance of ensuring safe food and water supply as a cornerstone of public health.”

Journal Journal of Pediatric Infectious Diseases, Publisher IOS Press, ISSN 1305-7707 (Print), 1305-7693 (Online), Issue Volume 5, Number 2 / 2010, DOI 10.3233/JPI-2010-0234, Pages 199-201

Authors

Arnon Broides1, Raffi Lev-Tzion1, Eugene Leibovitz2

1Department of Pediatric Emergency Medicine, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
2Pediatric Infectious Disease Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Abstract

We present a case of a child with generalized convulsions and dysentery caused by Campylobacter jejunii and review the pediatric literature published on this topic. Our case, as well as previous reports, suggests that in a child with convulsions and dysentery, the differential diagnosis should include shigellosis and also Campylobacter spp. infection. Because azithromycin provides appropriate coverage for both etiologies and in light of the present case, we suggest that it be considered in addition to parenteral ceftriaxone in severe cases of dysentery with or without convulsions.

Guillain-Barre syndrome is a condition in which the body’s immune systems attack its nerves, often after infection with a respiratory bug or stomach flu.

Although acute cases are an emergency, most people recover completely, according to the Mayo Clinic.

Q: What are its symptoms?

A: While its first symptoms are usually weakness and numbness in the extremities, it can eventually paralyze the entire body, according to the Merck Manual of Medical Information. Symptoms are often worst in the first two or three weeks.

In 5% to 10% of cases, the muscles that control breathing become so weak that patients need to be put on a ventilator. In another 10% of cases, muscles that control swallowing are so weakened that patients need to be fed through a tube into the stomach.

Q: How is it treated?

A: Doctors may cleanse the blood, removing harmful antibodies, or give patients a treatment called immune globulin, with protective antibodies with donors, according to the Mayo Clinic.

Q: Do people recover?

A: Most patients improve slowly over several months, even without treatment, according to the Merck Manual. Early treatment can speed up recovery, allowing patients to improve within days or weeks. Although there’s no known cure, treatment can ease recovery, according to the Mayo Clinic.

About 30% of adults still suffer from some muscle weakness three years later, however. Fewer than 5% of patients die in the early stages of the disease.

Q: How common is it?

A: Guillain-Barre affects one or two out of every 100,000 people.

Q: What causes it?

A: Doctors don’t know the exact cause of Guillain-Barre, and some cases appear without any clear trigger, according to the Mayo Clinic. One of the most common triggers is campylobacter, a type of bacteria often found in undercooked chicken or other food. Guillain-Barre has also been triggered by surgery; the Epstein-Barr virus; Hodgkin’s disease; mononucleosis; HIV, the virus that causes AIDS; and rabies.

In an infamous outbreak in 1976, hundreds of people who received a swine flu vaccine developed Guillain-Barre, although scientists question whether the shots were really the cause. The Centers for Disease Control and Prevention has not seen any increase in Guillain-Barre related to vaccination against the H1N1 virus.

Q: How is the immune system involved?

A: The disease occurs when the immune system — which typically protects the body from illness by attacking viruses and other foreign invaders — instead attacks the myelin sheath, a coating that protects the nerves. Damage to this critical coating, which acts like insulation, interferes with the way that nerves send signals between the body and brain, according to the Mayo Clinic.

Contrary to popular belief, some disease causing bacteria may actually survive the composting process. Researchers from Agriculture and Agri-Food Canada report in the February 2010 issue of the journal Applied and Environmental Microbiology that campylobacter bacteria in cattle manure can survive composting and persist for long periods in the final product.

Campylobacter bacteria are the most common cause of gastroenteritis in the developed world. They are frequently shed by beef cattle in manure and although the impact on human health is undetermined there appears to be a link in areas such as Alberta, Canada where cases of human campylobacteriosis are extremely common and the cattle density is high.

Composting is described as a process in which organic matter in manure is stabilized through water loss, nutrient transmission, alteration of physical structure, elimination of weed seeds, and the inactivation of coliform bacteria, protozoan cysts and oocysts and viruses. Government agencies in both the United States and Canada recommend composting to reduce pathogen levels in manure.

In the study researchers examined the persistence of naturally occurring campylobacter bacteria in compost derived from manure of beef cattle that were administered antibiotics (AS700) and a control group that were not. Bacterial populations were the same in both groups, however, the temperature of the AS700 compost was more viable and not as high as that of the control group. Water content, total carbon, total nitrogen and electrical conductivity varied significantly between groups. Results showed that no reductions in the quantities of Campylobacter jejuni DNA were observed throughout the 10-month composting period. Further testing suggests that Campylobacter DNA examined from compost was extracted from viable cells.

“The findings of this study indicate that campylobacteria excreted in cattle feces persist for long periods in compost and call into question the common belief that these bacteria do not persist in manure,” say the researchers.

What would a Thanksgiving turkey be without its stuffing, and what better place for that stuffing than inside the turkey?

Despite the tradition involved, a food-safety specialist in Penn State’s College of Agricultural Sciences says some practices are worth reconsidering, especially since Mom may not have fully appreciated the risk of foodborne illness.

“Cooking a stuffed turkey is riskier than cooking an unstuffed one, because it takes longer for the stuffing to reach the proper internal temperature of 165 degrees F when it is placed into the cavity of the bird,” said Martin Bucknavage, food safety specialist in the department of food science. “While people concern themselves about cooking the bird to 165 degrees F, they must ensure that stuffing also achieves that temperature.”

Bucknavage noted that often the turkey ends up overcooked in getting the stuffing to the proper temperature, or the stuffing ends up undercooked because the turkey is removed from the oven when the bird is at the right temperature, but the stuffing is not.

“It is the undercooked stuffing that poses the real risk,” he said. “Bacterial pathogens such as Salmonella may be present in the cavity of the bird and can contaminate the stuffing. If the stuffing is not cooked thoroughly, Salmonella can survive and may infect those who consume it.”

If you want a properly cooked, stuffed bird with less chance of foodborne illness, Bucknavage said, just cook your stuffing separately. To preserve a family tradition, stuff your fully cooked bird with the cooked stuffing before serving. If you simply must stuff your bird before cooking, take extra care to ensure the internal temperature of both the bird and the stuffing exceeds 165 degrees F before serving.

Another common practice that Bucknavage discourages is washing the outside surface of your store-purchased bird.

“The problem with this practice is that pathogenic bacteria often are embedded in the surface of the skin,” he said. “When faucet water hits bacterial pathogens, they become aerosolized and land all over your kitchen counter, the faucet and you.

“The U.S. Food and Drug Administration says Campylobacter is one of the most common causes of diarrheal illness in the country, and undoubtedly, many of these cases are a result of cross-contamination in the kitchen. So there is no need to wash the outside of your bird — the cooking process easily will kill these bacteria. But you still need to clean and sanitize your counter and any kitchen equipment that touches the raw bird.”

Lastly, although Mom may have thawed that frozen bird on the counter overnight, this method has been shown to help increase the amount of pathogenic bacteria that might be present on the raw turkey. Rather, you can use one of three methods:

–Thaw in the refrigerator. “You should allow about 24 hours for every five pounds of turkey in a refrigerator set at 40 degrees F or below,” he said. “Be sure to place the frozen turkey, breast side down, in the original wrapper in a container to prevent raw fluids from dripping on other foods. A 16-pound turkey will require three and a half days of refrigerated thaw time.”

–Thaw under cold water. Submerge the wrapped turkey in cold tap water in a leak-proof plastic bag to prevent cross-contamination and to prevent excess pick-up of moisture. Allow 30 minutes per pound, and change the water every 30 minutes until the turkey is thawed.

–Thaw in your microwave. “You can do this if your microwave is large enough,” Bucknavage said. “Follow the manufacturer’s instructions, and be sure to cook the bird immediately once you’ve thawed it this way.

“Mother won’t mind if you change a thing or two if it means keeping this generation’s food safe,” Bucknavage said.

A USDA survey indicates that cold water immersion and other antimicrobial interventions in poultry processing substantially improve the microbiological profile of raw chickens. The survey found that 5% of the raw chickens in the survey had salmonella after chilling and 11% had campylobacter, down from 41% and 71%, respectively, prior to evisceration. Additionally, the actual number of bacteria on each raw chicken was greatly reduced, by about 99% on average with respect to campylobacter and 66% on average for salmonella.

According to Steve Pretanik, director of science and technology for the National Chicken Council, the USDA survey shows that the industry is doing an excellent job of reducing the presence of potentially disease-causing bacteria on raw chicken. Pretanik emphasized that the investments made by the industry in improved technology and bacteria-fighting interventions have paid off in terms of a safer product for consumers. He noted that any remaining bacteria are destroyed by the heat of normal cooking.

USDA conducted the study from July 2007 to June 2008 at 182 broiler slaughter plants. The agency collected a total of 6,550 samples, divided equally between samples taken at the re-hang station and after the chiller. Raw chickens were processed under the available antimicrobial measures of each plant, which typically include the use of chlorinated water in processing and in the chiller.