Campylobacter Infection Causes, Symptoms, Distribution

Campylobacter infection, mainly caused by Campylobacter jejuni and C. coli, is a leading cause of bacterial gastroenteritis worldwide. Poultry, cattle, sheep, pigs, dogs, and cats are important reservoirs, with poultry being the primary source. Transmission occurs via the fecal–oral route through undercooked meat, unpasteurized milk, contaminated water, or direct contact with infected animals. After an incubation of 2–5 days, symptoms appear, including diarrhea (sometimes bloody), severe abdominal pain, fever, and nausea. The illness usually lasts about one week but can lead to complications like Guillain-Barré syndrome, reactive arthritis, or irritable bowel syndrome. In animals, young calves, dogs, and poultry may develop diarrhea, while adults often remain carriers. The infection is globally distributed, more common in summer and in developing regions, and prevention depends on food safety, clean water, and good hygiene.

Campylobacteriosis is an infection caused by bacteria you can get from contaminated food and water. It causes diarrhea. You might also hear it called campylobacter, campylobacter infection, or campylobacteriosis gastroenteritis.

What is campylobacter:

• Campylobacter infection causes human gastroenteritis and vibriosis affecting people worldwide.
• It is a common bacterial disease that usually occurs in both developed and developing countries.
• The disease is endemic in North America, Europe, Australia, Africa, Asia, and the Middle East especially during the summer and early autumn.
• Campylobacteriosis is a food-borne disease that affects children, elders and weakened immune patients mainly in low-income countries however, adults are rarely infected which may be due to their acquired immunity with increasing age.
• Campylobacter not only causes diarrhea but also causes extragastrointestinal infections such as lung infections, bacteremia, meningitis and long-term autoimmune diseases such as Guillain-Barre syndrome (GBS), Miller-Fisher syndrome (MFS), inflammatory bowel syndrome (IBS) and reactive arthritis (ReA).

Among them, C. jejuni is associated with 95% of the outbreaks and sporadic illnesses.

The prevalence of Campylobacter disease is globally therefore; its biocontrol methods, transmission route and prevention are of high concern.

Campylobacter have:

Gram-negative

Non-spore-forming Curved, spiral helical or S-shaped rod Mostly microaerophilic requires oxygen (3 to 5%) and carbon dioxide (3 to 10%)Motility in a corkscrew-like motion

Grows in temperature 37 to 42°C pH 5.5 to 8 Utilize amino acids for energy sensitive to heat and desiccation (cannot grow above 48°C)

• Sources of transmission of Campylobacter:
• The main reservoir of Campylobacter is animals especially poultry, birds, cattle, pigs and domestic pets.
• They are also found in untreated water, lakes, rivers and ponds.
• Infection also occurs due to consumption of undercooked foods, raw or unpasteurized milk and milk products and raw shellfish (mainly oysters)

• Sources of transmission of Campylobacter:
• The main reservoir of Campylobacter is animals especially poultry, birds, cattle, pigs and domestic pets.
• They are also found in untreated water, lakes, rivers and ponds.
• Cross-contamination occurs while handling raw meat to cooked meat and other food products and in kitchen utensils.
• Infection also occurs due to consumption of undercooked foods, raw or unpasteurized milk and milk products and raw shellfish (mainly oysters)
• Disease and Complications of Campylobacteriosis:
• The major cause of campylobacteriosis is gastroenteritis followed by diarrhea, inflammatory bowel disease (IBD), Barrett’s esophagus and colorectal cancer.
• The infectious dose of C. jejuni is 105cfu/ml which is capable of causing diarrhea in healthy humans.
• The signs start to appear after 1 to 3 days of ingestion with common symptoms such as watery diarrhea, malaise, fever and abdominal cramp.

Epidemiology (causes) of Campylobacter Infection:

• C. jejuni is the most pathogenic strain that is mostly isolated from patients suffering from diarrhea and gastrointestinal diseases.
• Campylobacteriosis cases are high in summer which might be due to the increased consumption of poultry and undercooked meat.
• The United States and England are highly affected countries during this season.
• In the US, about 8,45,000 cases of Campylobacter and 76 deaths are reported each year.
• From 2004 to 2009, the major cause of traveler’s diarrhea was associated with the Campylobacter species.
• Campylobacter has also affected the European countries with 2,14,000 cases in the year 2012 reported in the European Food Safety Authority (EFSA).
• A surveillance study was done in a multinational population with 9000 children of Bangladesh, Pakistan and India.
• The children younger than 60 months had severe diarrhea and later was detected as C. jejuni.
• C. jejuni and C. coli are more common in children and elder patients.
• People who travel abroad frequently are at high risk of C. coli infection than with C. jejuni.

• Pathogenic Mechanism of Campylobacter:
• Campylobacter should survive the stomach acid (pH 2.3) to cause infection however, the organism cannot survive at low pH but the infection occurs from contaminated meat, water and milk.
• The virulence factor and colonization of the bacteria are involved in escaping the stomach passage and reaches the gastrointestinal tract.
• Then the bacteria invade the epithelial cells of the distal ileum and colon, due to an unfavorable environment, the bacteria secrets protein that damages cells and causes inflammation of the intestinal epithelium.
• These secreted proteins are called Campylobacter virulence-associated factors which include chemotaxis, motility, flagella, cytolethal distending toxin (CDT), adhesion and invasion factors.
• The corkscrew motility of the bacteria helps in colonization and its polar flagella and chemoreceptors help to move within the mucous lining.

• Diagnostic Methods of Campylobacteriosis:
• 1. Culture method:
• Two selective media, one blood-containing media and other charcoal-containing media are required to isolate and identify the pathogen.
• Molecular typing:
• PCR is a widely used technique to detect the genes of most pathogens and is a highly sensitive technique but is not species-specific.
• It can detect the pathogen present in people showing no symptoms but sheds the bacteria from person to person.
• Other molecular-based typing method includes MALDI-TOF MS, multiplex PCR, Ribotyping, RFLP and AFLP.
• Serotyping
• Heat-labile and heat-stable serotyping methods are currently used to detect Campylobacter pathogens.
• C. jejuni, C. coli and C. lari are detected by heat-labile method in which the targeted proteins are uncharacterized bacterial surface or flagella antigens.
• Treatment and Control of Campylobacteriosis:
• Campylobacteriosis is a self-limiting disease and the use of antibiotics is not required unless the patients have severe and bloody diarrhea.
• Erythromycin, azithromycin, gentamicin, carbapenems and chloramphenicol are the antibiotics used in C. jejuni and C. coli infections.
• In the case of gastroenteritis, erythromycin or azithromycin is used in antibiotic therapy.
• Rehydration and electrolyte therapy helps in the treatment of enteritis.
• Campylobacter infection is caused by bacteria commonly found in warm-blooded animals, especially poultry, and is spread by consuming contaminated food or water, or contact with infected animals. Symptoms, which begin 2–5 days after exposure, typically include watery or bloody diarrhea, abdominal pain, and fever, lasting for about a week. While most cases are self-limiting, potential complications include reactive arthritis and, rarely, Guillain-Barré syndrome.

Distribution

Campylobacter bacteria, particularly C. jejuni, are widely distributed in various warm-blooded animals, with a strong presence in food animals like poultry, cattle, and swine. They are also found in household pets like cats and dogs. Transmission to humans is primarily through contaminated food, especially undercooked poultry and meat, as well as raw or contaminated milk. 
Foodborne Transmission:

• Undercooked Meat and Poultry 
• This is the most common route of transmission. 
• Raw Milk: Contaminated raw milk can also spread the bacteria. 
• Other Foods: Meat, dairy products, and even some produce can be contaminated. 

Environmental Contamination

Manure: Animal manure can be a source of contamination. 

Untreated Water: Surface water can be contaminated with fecal matter, leading to C. jejuni presence.

• C. jejuni is a major cause of diarrhea worldwide and is often associated with foodborne illnesses, especially those linked to poultry. 
• The bacteria can survive for a time in food, even after cooking, if not done thoroughly. 
• Some studies suggest that cattle may also be a primary reservoir of C. jejuni, with transmission to humans potentially occurring through contaminated poultry and the fecal-oral route. 

Campylobacter Infection – FAQs

1. What causes Campylobacter infection?
It’s caused by Campylobacter bacteria, mainly C. jejuni and C. coli, often from contaminated food or water.

2. How is it transmitted?
Through raw/undercooked meat (especially poultry), unpasteurized milk, or contact with infected animals.

3. What are the main symptoms?
Diarrhea (sometimes bloody), fever, abdominal cramps, nausea, and vomiting.

4. Who can get infected?
Humans, dogs, cats, cattle, poultry, sheep, and goats. It’s zoonotic—can spread between animals and people.

5. Where is it commonly found?
Worldwide, especially in areas with poor food handling or hygiene.

6. How is it diagnosed?
Through fecal culture or PCR testing in labs.

7. Is it treatable?
Yes, mild cases are self-limiting. Severe cases may require antibiotics like erythromycin or azithromycin.

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