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Campylobacter and Food Poisoning
Learn the Sources, Signs, Symptoms, Treatment, and Means to Prevent One of The Most Common Food Poisoning Microorganisms
Campylobacter (and more specifically Campylobacter jejuni ) is a pathogenic (disease causing) bacteria (single cell microorganism) that is a common cause of foodborne illness or food poisoning. It was first identified in 1963.(1)
The most common means of transmitting or contracting this bacterial pathogen include fecal-oral, ingestion of contaminated food or water, and the consumption of raw chicken, seafoods and meats.
In the United States Campylobacter is generally the second most common identified source of food borne illness. Salmonella is number one. On a larger scale though, Campylobacter is the most commonly identified bacterial cause of diarrheal illness or bacterial gastroenteritis in the world. (1,2)
Sources of Campylobacter
The US Centers for Disease states the following regarding Campylobacter:
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"These bacteria live in the intestines of healthy birds, and most raw poultry meat has Campylobacter on it. Eating undercooked chicken, or other food that has been contaminated with juices dripping from raw chicken is the most frequent source of this infection." (3) The one assertion "most raw poultry meat has Campylobacter on it" should definitely alert if not alarm everyone. Since you, as a consumer, can not distinguish a contaminated chicken from a safe, uncontaminated chicken, it is best therefore to assume that all raw chicken could be contaminated and to handle raw chicken accordingly. Also, the fact that this bacteria lives in the intestines of "healthy birds" means that the chickens do not display any symptoms when they are alive, or diseased characteristics after killed and processed. This also means that the slaughtering and processing methods of chickens allows for intestinal waste to contaminate the chicken. |
Other sources of Campylobacter include raw milk, meat, raw beef liver, raw clams, mushrooms, unpasteurized milk and dairy products. Notice a common characteristic of most of these foods --- raw or uncooked. Thorough cooking kills this microorganism.
Like Salmonella, there are 2 main routes foods take to become contaminated with the Campylobacter pathogen:
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Cross-Contamination - Juices from raw product (poultry, meats, seafoods) come in contact with ready-to-eat foods, such as salads, or already cooked foods ready to serve. This happens by using the same utensils, cutting boards, plates, platters or hands for the raw product without thorough washing and/or sanitizing in-between uses.
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Consuming raw or partially cooked naturally hazardous foods. This includes beef (raw or rare hamburgers), poultry, egg or egg based dishes ( see a list of raw egg based dishes by clicking here), seafoods (shellfish and finfish), unpasteurized dairy products (including cheese products from unknown sources, i.e. someone's home or garage).
Signs & Symptoms
The time between the consumption of Campylobacter contaminated food or drink and the first sign of symptoms is usually 2 - 4 days, but can be as long as 10 days. This longer period can make it more difficult to pinpoint the source food or meal. Symptoms can last as long as a week.
The prominent symptoms include:
Abdominal pain Cramping, which can become severe Less prominent, but other possible symptoms:
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Because the symptoms and food sources for Campylobacter infection are so close to Salmonella infection, it can be difficult to distinguish between the two without a laboratory examination of a stool sample.
There are 2 slight differences between Campylobacter and Salmonella that can help to determine the more likely pathogen causing your illness:
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Campylobacter generally has a longer incubation time (2 - 4 days versus 8-12 hours for Salmonella) and therefore if you are able to pinpoint or estimate the most likely meal source (remember the most common food sources noted above), then calculate the incubation period - the time between consumption and first sign of symptoms.
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Because of the longer incubation period, the usual symptoms for Campylobacter will focus more on diarrhea (possibly bloody) and less on vomiting, where as the usual symptoms for Salmonella focus more on vomiting, nausea etc.
If you, or someone you are caring for, has these symptoms for more than a day or two, or is a higher risk person such as a child, elderly person or someone with a chronic illness or compromised immune system, do not hesitate to get them to a doctor or at least call the doctor for assistance. Campylobacteriosis (the resulting symptoms and infection from Campylobacter) complications can include infecting the blood (bacteremia), severe dehydration, Guillian-Barre syndrome, Reiter's syndrome and more.
Treatment
Although the symptoms can last a week, they normally subside without drug treatment or other special measures.
The most important measure to take to avoid dehydration is by drinking electrolyte solutions (not just water). You can purchase these at most drug stores and major grocery stores. If you or someone you are caring for is unable to take in fluids, the only option may be intravenous fluids.
Be exceptionally careful with contaminated clothing or other surfaces that are exposed to the diarrhea. Thoroughly clean, sanitize surfaces and of course meticulously wash your hands. This bacterium can very easily be picked up by others especially children through hand to mouth contact.
Prevention - Steering Clear
At Home
There are 3 basic measures to take at home (and to a different degree away from home) to minimize your chances of contracting this illness:
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Thorough cooking of those high risk foods i.e. chicken, seafoods and meats to a temperature of not less than 165° Fahrenheit in order to kill any cells present. Get yourself a good instant-read, digital probe thermometer that is sensitive at the tip.
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Minimize temperature abuse. This means watching closely the amount of time the food spends in what is known as the food temperature danger zone-between 41° and 135° Fahrenheit (no more than 2 hours is the best rule). This also means getting a good air temperature thermometer for your refrigerator and setting or adjusting the refrigeration temperature at or just below 40° Fahrenheit. Place it in the warmest part, usually front and center, to get the most accurate reading.
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Careful handling of these high risk foods to avoid cross contamination. This means washing and sanitizing (hot, soapy water and scrubbing) all surfaces, utensils and hands that have come in contact with these foods.
Away From Home
This applies to a restaurant, deli, outdoor event, picnic, or party. Since you are most likely not directly involved in the preparation of the foods, you need to use other techniques and strategies to avoid Campylobacteriosis. These include:
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Avoid consuming raw or partially cooked high risk foods (poultry, seafood and red meats). I know how difficult this can be for the raw seafood lovers but if you ever speak to someone who has endured a foodborne illness related to, or caused by some higher risk raw food they consumed, they more often than not will tell you they are a former raw seafood devotee!
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Look for these foods to be steamy hot or obviously cold. A good rule to follow is that if your food is supposed to be hot, it should be hot to the touch and possibly steaming, and if cold, you must be able to feel or sense cold at your first bite. If anywhere between, or it feels just warm or room temperature, send it back and order something else altogether.
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Avoiding cross contamination is the most difficult strategy to carry out under these circumstances. You're not likely to be able to observe every step of the food preparation process, but I suggest where you can observe, do take note. Many restaurants have views into the kitchen, especially many fast food chicken focused restaurants. You can look out for kitchen staff using the same utensils, cutting boards, plates, platters or hands to handle raw chickens and then turn around and handle cooked ready-to-eat and serve foods without washing or exchanging for a clean utensil. I have witnessed this as both a customer, and as an inspector many more countless times.
To get more information on avoiding food poisoning hazards while dining out click on Signs of a Safe Restaurant, Restaurant Personal Hygiene, Good Ordering Practices, and Restaurant Food.
REFERENCES
1. Nachmankin I; Szymanski CM; Blaser J (editors) (2008). Campylobacter (3rd ed.). ASM Press. pp. 3-25. ISBN 9781555814373
2. United States Centers for Disease Control “Preliminary FoodNet Data on the Incidence of Foodborne Illnesses --- Selected Sites, United States, 2001” http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5115a3.htm
3. United States Centers for Disease Control “Foodborne Illness Frequently Asked Questions” http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#mostcommon
About the Author
Michael Doom worked as a Registered Environmental Health Specialist (REHS) for Los Angeles County for more than 21 years. For most of these years he worked as a field inspector and Supervising Senior REHS in the retail food inspection programs. His experience within Los Angeles County has taken him to some of the smallest “mom and pop” restaurants and markets in the poorest areas of south Los Angeles, as well as to the largest facilities and affluent areas on the west side. He has literally conducted thousands of inspections of numerous types of restaurants, food markets, warehouses, events, and more; educated hundreds, if not more than a thousand, food facility owners, managers and employees on food sanitation and food safety, and how to prevent food poisoning hazards; has supervised more than 50 field inspectors that were responsible for an inventory of food facilities larger than many U.S. states.
Mr. Doom has a B.S. in Biology from Loyola Marymount University, an REHS with the state of California, holds a Project Management Professional (PMP®) credential from the Project Management Institute, and a Masters Certificate in Project Management from George Washington University. Mr. Doom continuously works to expand his knowledge and experience in the subject of food safety, sanitation and food poisoning prevention.
He can be reached at Mike@foodpoisoningprevention.com