From January 9, 2019, through March 1, 2021, a total of 56 people infected with the outbreak strain of Campylobacter jejuni were reported from 17 states.9 people were hospitalized; no deaths were reported.

Epidemiologic and laboratory evidence showed that contact with puppies, especially those at pet stores, was the likely source of this outbreak.38 (93%) of 41 ill people reported contact with a puppy before getting sick.

21 (55%) of these 38 people reported contact with a puppy from a pet store.

13 (62%) of these 21 people had a link to Petland, a national pet store chain.

5 (38%) of these 13 people were Petland employees.

The outbreak strain was identified in samples collected from two puppies in the homes of ill people, one in in Iowa and one in Minnesota. Both puppies were purchased from pet stores.

Laboratory evidence showed that bacteria from ill people were closely related genetically to bacteria from ill people in the 2016–2018 outbreak of multidrug-resistant Campylobacter infections linked to pet store puppies.

Campylobacter is a genus of bacteria that is among the most common causes of bacterial diarrheal illness in humans worldwide. It is a gram-negative rod-shaped bacterium that grows best in a high temperature (42°C, or 107°F) and low oxygen environment.

Campylobacter infection is commonly associated with the consumption of raw (unpasteurized) milk, undercooked poultry, and contaminated water; however, most Campylobacter cases are sporadic and are never traced back to a specific food or beverage. Nonetheless, very large outbreaks (greater than 1,000 illnesses) have been documented, most often from consumption of contaminated milk or unchlorinated water supplies. Not all Campylobacter infections cause obvious illness. Symptomatic infection occurs almost exclusively in infants and young children, who can be infected repeatedly. The amount of time from infection to symptom onset—typically referred to as the incubation period—can vary to a significant degree.  It is relatively short, ranging from 1 to 7 days, with an average of 3 days. 

Although uncommon, Campylobacter infection can lead to disorders of the nervous system such as Guillain-Barré syndrome (GBS), as well as reactive arthritis, irritable bowel syndrome, and other functional gastrointestinal disorders (i.e., indigestion, constipation, and acid reflux). 

Five lab-positive campylobacteriosis cases have been identified in individuals who consumed Dungeness Valley Creamery raw milk. The raw milk was purchased in Clallam, Skagit, Kitsap, and Clark Counties.

Dungeness Valley Creamery has issued a voluntary recall of all raw milk product with a ‘Best By’ date of April 13, 2021, or earlier. These products may be contaminated with Campylobacter bacteria, which can cause serious illness. The recalled product is bottled in gallon, half-gallon, quart and pint containers. It was sold to customers in western Washington in the on-farm store, outside retail stores and drop-off locations. Health officials urge consumers not to drink any Dungeness Valley Creamery raw milk product with a ‘Best By’ date of April 13, 2021, or earlier, and to discard any leftover product, or return it to the place of purchase.

The Washington State Department of Health (DOH) is working with Washington State Department of Agriculture (WSDA) and local health investigators during this ongoing investigation.

“Unpasteurized raw milk can carry harmful bacteria and germs. Foodborne illnesses can be caused by many different foods; however, raw milk is one of the riskiest,” said Dr. Scott Lindquist, State Epidemiologist for Communicable Diseases.

Symptoms of Campylobacter infection include fever, diarrhea (often bloody), nausea, vomiting, malaise and abdominal pain. Most people with Campylobacterinfection recover on their own, but some need antibiotic treatment. In severe cases, complications may include reactive arthritis, irritable bowel syndrome and Guillain-Barré syndrome. Infants, young children, the elderly, pregnant women and those with a weakened immune system are at greatest risk for severe illness.

Data published by officials at Sante Publique France on Campylobacter in the country in 2019 shows a slight increase compared to the year before.

In France, epidemiological surveillance of Campylobacter infections is based on the National Reference Center for Campylobacter and Helicobacter and the mandatory declaration of outbreaks.

This national reference center reported 8,309 strains of Campylobacter and related bacteria with 7,712 strains identified as Campylobacter spp. In 2018, 7,491 strains were classed as Campylobacter.

Among the 7,712 strains in 2019, Campylobacter jejuni was most frequently identified at 6,526 times, followed by Campylobacter coli 1,061 times and Campylobacter Fetus 75 times.

A seasonal upsurge was observed during the summer period, with a peak in August. This summer pattern was also seen in previous years.

The age at infection ranged from zero to 100 years old. A higher number of cases was seen among children. The highest incidence was in the zero- to 9-year age group and the lowest was reported in the 40- to 59-year age group. Incidence was higher in males than females except in people aged 20 to 29 years.

Meat often linked to outbreaks
In 2019, 55 outbreaks from Campylobacter with biological confirmation were declared. There were 241 patients. Food types suspected as a source of contamination for 22 of the outbreaks were poultry products and in 12 it was meats other than poultry. The amount of outbreaks was similar to 2018 but the number of patients was lower.

The rate of resistance to ciprofloxacin remains high but stable at about 60 percent with about 7,700 isolates tested. The rates of resistance to tetracycline at 50 percent in 2019 and ampicillin at 31 percent are also steady.

Resistance rates of Campylobacter coli strains to erythromycin, tetracycline and ciprofloxacin were higher than those of Campylobacter. jejuni strains. The frequency of resistance was very low for gentamicin and zero for amoxicillin and clavulanic acid.

The number of Campylobacter strains reported by the national reference center has been increasing since 2013 when labs started directly entering their data online. The rise could reflect an increase in Campylobacter infections in France or developments in the surveillance system, according to public health officials.

California officials have recalled and quarantined raw milk from Valley Milk Simply Bottled because tests have shown it to be contaminated with Campylobacter jejuni.

State Veterinarian Dr. Annette Jones announced the recall and quarantine today in a public alert. She warned consumers about the dangers in the alert. There is concern that some people may have unused portions of the unpasteurized milk in their homes.

“Consumers are strongly urged to dispose of any product remaining in their refrigerators that were purchased or received on June 19 through June 30, or any product with a code date marked on the container of July 9 or earlier,” Jones said.

The affected raw milk is distributed in one-gallon plastic jugs under the labels “Valley Milk Simply Bottled Raw Milk” and “DESI MILK Raw Milk.”

The California Department of Food and Agriculture found the campylobacter bacteria in a routine sample of packaged products collected at the Valley Milk Simply Bottled production and packaging facility. No illnesses have been reported to date.

It is against federal law to engage in interstate sales of raw milk, but some states allow the sale of it within their borders. California allows the sale of unpasteurized, raw milk at retail stores, but warning signs must be posted.

Anyone who has consumed any of the recalled raw milk should monitor themselves for symptoms of Campylobacter infection. Children who were served the milk should also be monitored for illness.

Symptoms of campylobacteriosis include diarrhea, abdominal cramps, and fever. The illness usually occurs 2 to 5 days after exposure to campylobacter and lasts about a week. In some people with compromised immune systems, it can cause a serious, life-threatening infection.

A small percentage of people may have joint pain and swelling after infection. Also, a rare disease called Guillain-Barre syndrome that causes weakness and paralysis can occur several weeks after the initial illness.

The Oklahoma State Department of Agriculture, Food, and Forestry says raw milk produced by Swan Bros. Dairy, Inc. in Claremore is the subject of a statewide recall due to the confirmed detection of Campylobacter jejuni.

Anyone who has purchased or received their raw milk products between April 9 and June 22 is strongly urged to dispose of any remaining product.

The raw milk products were sold in plastic half-gallons, gallons, and pints directly from the Swan Bros. Dairy in Claremore and include raw whole milk, raw 2% milk, raw skim milk, and raw heavy cream sold in pints.

Symptoms of campylobacteriosis include diarrhea—often bloody, abdominal cramps, and fever. These symptoms could be paired with nausea and vomiting.

Most people with campylobacteriosis recover completely.

The illness usually occurs 2 to 5 days after exposure to campylobacter and lasts about a week. The illness is usually mild and some people with campylobacteriosis have no symptoms at all. However, in some persons with compromised immune systems or for those receiving chemotherapy, it can cause a serious, life-threatening infection.

ODAFF found the Campylobacter jejuni bacteria in a sample collected from Swans Bros. Dairy Inc.

To date, 10 people have tested positive for the bacterial infection from these products.

Most illnesses likely occur due to consuming raw/non-pasteurized milk and milk products and undercooked meat products. Pasteurization kills foodborne pathogens and harmful bacteria like Campylobacter jejuni. Raw milk cheeses are considered safe if aged at least 60 days.

Campylobacteriosis is not usually spread from person to person.

If you have consumed any raw milk from Swan Bros. Dairy, Inc., it is recommended to dispose of the remaining product and contact your medical provider if you experience any symptoms.

As of December 17, 2019, a total of 30 people infected with Campylobacter have been reported from 13 states. A list of the states and the number of confirmed cases in each state can be found on the Map of Reported Cases page.

Illnesses started on dates ranging from January 6, 2019, through November 10, 2019. Ill people range in age from 8 months to 70 years, with a median age of 34; 52% of ill people are female. Of 26 people with information available, 4 hospitalizations have been reported. No deaths have been reported.

Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported.

WGS analysis of 26 isolates from ill people predicted antibiotic resistance to tetracycline (26 isolates), ciprofloxacin (25), nalidixic acid (25), azithromycin (23), erythromycin (23), clindamycin (23), telithromycin (23), and gentamicin (18). Testing of one outbreak isolate using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these results.

Epidemiologic and laboratory evidence indicate that puppies purchased from pet stores are the likely source of this outbreak. Many of the cases had contact with puppies or were employees at pet stores, including Petland.

CDC included ill people in this outbreak if

  • their stool (poop) sample grew Campylobacter jejuni in the laboratory (called a culture-confirmed infection) and they also had a link to puppies, or
  • they had a culture-confirmed Campylobacter jejuni infection that was closely related genetically to a confirmed puppy-linked case by WGS.

In interviews, ill people answered questions about dog, puppy, and other exposures they had in the week before they became ill. Of 24 people interviewed, 21 (88%) reported contact with a puppy in the week before illness started, and 15 (71%) of those 21 people reported contact with a puppy from a pet store. When asked about the specific pet store, 12 (80%) of those 15 people reported either having contact with a puppy or working at a Petland store.

Investigators reported eight more ill people who had contact with a puppy at Petland and had a diagnostic test showing they were infected with Campylobacter bacteria. However, CDC did not include these people in the outbreak case count because no bacterial samples were available for WGS. Public health investigators use WGS to identify illnesses that are part of multistate outbreaks.

A single, common supplier of puppies has not been identified. This investigation is ongoing. CDC will provide updates if more information becomes available.

According to press reports, the Pennsylvania Department of Agriculture is warning consumers who bought raw whole milk distributed by Bad Farm in Kempton, Berks County, that they should immediately discard the milk, which was sold in plastic half-gallons, gallons and pints with sell-by date of Aug. 23.

Tests completed during routine sampling indicated that the product tested positive for Campylobacter bacteria, a news release stated.

The milk, labelled Bad Farm, was sold at Emmaus Farmers Market, Lehighton Farmers Market, Trexlertown Farmers Market, and in Bad Farm’s on-site store and Wannamakers General Store, both in Kempton.

The product was voluntarily recalled and pulled from shelves by the distributor.

Campylobacter can cause gastrointestinal illness including diarrhea, cramps, fever and pain.

People who consumed the milk should consult their physicians if they become ill.

The state Department of Health reported that one customer had a confirmed Campylobacter infection after drinking the milk.

Centers for Disease Control and Prevention (CDC), several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) investigated a multistate outbreak of drug-resistant Campylobacter infections. Epidemiologic and laboratory evidence indicated that contact with puppies sold through Petland stores was a likely source of this outbreak.

A total of 113 people with laboratory-confirmed infections or symptoms consistent with Campylobacter infection were linked to this outbreak. Illnesses were reported from 17 states. Illnesses started on dates ranging from January 12, 2016 to January 7, 2018. Ill people ranged in age from less than 1 year to 86, with a median age of 27. Sixty-three percent of ill people were female. Of 103 people with available information, 23 (22%) were hospitalized. No deaths were reported. Whole genome sequencing (WGS) showed that isolates from people infected with Campylobacter were closely related genetically, meaning that people in this outbreak were more likely to share a common source of infection.

In interviews, ill people answered questions about the foods they ate and any animal contact in the week before they became ill. Ninety-nine percent of people reported contact with a puppy in the week before illness started, and 87% reported they had contact with a puppy from Petland stores or had contact with a person who became sick after contact with a puppy from a Petland store. Twenty-five ill people worked at Petland stores.

During the investigation, officials collected samples from pet store puppies for laboratory testing and identified the outbreak strain of Campylobacter in the samplesWGS showed that the Campylobacter isolates from sick people in this outbreak and isolates from pet store puppies were closely related genetically, providing additional evidence that people got sick from contact with pet store puppies.

Campylobacter bacteria isolated from clinical samples from people sickened in this outbreak were resistant to commonly recommended, first-line antibiotics. The 12 isolates tested by standard methods were resistant to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline. In addition, 10 were resistant to gentamicin, and 2 were resistant to florfenicol.