Campylobacter - Questions & Answers

The Bacteria

What is Campylobacter?

• Campylobacter [pronounced "kamp-e-lo-back-ter"] bacteria are commonly found in the intestinal tracts of cats, dogs, poultry, cattle, swine, rodents, monkeys, wild birds, and some humans. The bacteria pass through feces to cycle through the environment and are also in untreated water. Campylobacter jejuni, the strain associated with most reported human infections, may be present in the body without causing illness.

Why are we hearing more about Campylobacter?

• During the 1980's, public health authorities began to learn more about the prevalence of the bacteria in the environment, the illness it can cause, and laboratory techniques for identifying the bacteria. As individual states within the United States increase their reporting of illnesses to CDC, research continues on the organism and the disease.

How is Campylobacter destroyed?

• The bacteria are extremely fragile and are easily destroyed by thorough cooking. They are also destroyed through typical water treatment systems. Freezing cannot be relied on to destroy the bacteria. Thorough cooking is what will make the product safe.

The Illness

What harm can Campylobacter bacteria cause?

• The bacteria can exist in the intestinal tracts of people and animals without causing any symptoms or illness. However, if people consume live bacteria in raw milk, contaminated water, or undercooked meat or poultry, they may acquire a Campylobacter infection (also called campylobacteriosis). Studies show that consuming as little as 500 Campylobacter cells can cause the illness.
  
  Symptoms of Campylobacter infection, which usually occur within 2 to 10 days after the bacteria are ingested, include fever, headache, and muscle pain, followed by diarrhea, stomach pain, and nausea. In some cases physicians prescribe antibiotics when diarrhea is severe.
  
  Complications can include meningitis, urinary tract infections, and possibly reactive arthritis (rare and almost always short-term), and rarely, Guillain-Barre syndrome, an unusual type of paralysis.

Are more people becoming ill from campylobacteriosis?

• Reports of illness are going up as more states recognize that Campylobacter infections are a public health concern, and as laboratory techniques for culturing and identifying the bacteria continue to be refined. Campylobacter is the most frequently isolated bacterium from persons with diarrhea (45%), Salmonella is second (30%), Shigella is third (17%), E. coli O157:H7 is fourth (5%).

Do people actually die from Campylobacter infections?

• Yes, Campylobacter infections can be fatal. CDC recorded 2 deaths from outbreaks over a 9-year period. The estimated death rate per 100,000 cases has actually fallen as more data have been gathered.
  
  Study of epidemiological data from actual illnesses helps the public health community understand and solve public health problems; however, the data are estimates and must be interpreted with caution.

Who is most susceptible?

• Anyone may become ill from a Campylobacter infection. However, persons with underdeveloped or weakened immune systems such as newborns or the elderly, or immune systems weakened by chronic illness such as AIDS, or medical treatment, e.g., cancer patients on immunosuppressive therapy, are more susceptible to health complications from Campylobacter. The elderly could also be more susceptible because of weakened immune systems.

What causes humans to get this disease?

• Contaminated water, raw milk, and raw or undercooked meat or poultry can all be the "vehicles" that carry Campylobacter and other bacteria into the human intestinal system. Fecal matter on an animal's coat might be transmitted to human hands through petting. Also, failure to properly wash hands after bathroom use may also continue the cycle of Campylobacter infection.

Campylobacter Control

What is the best way to prevent Campylobacter infections?

• The best prevention is to follow sensible public health precautions. A recent CDC report* states, "Universal pasteurization of milk and proper treatment of all drinking water might prevent 80 percent of the U.S. outbreaks due to Campylobacter." The report also noted that improved chicken handling practices in kitchens would reduce the number of illnesses. Campylobacter and other bacteria are destroyed when meat or poultry is cooked to an internal temperature of 160 °F, although most people prefer chicken cooked to 180 °F. Compartments of home freezers generally are not cold enough to destroy bacteria. (See last section for more tips.)
  
  To minimize the risk of illness from Campylobacter infections or other bacterial illnesses:
  
  Do follow the principles of safe food handling, including prompt refrigeration or freezing, thorough cooking and rapid, even cooling. Avoid cross-contamination of other foods by thoroughly washing cutting boards (preferably plastic, not wooden) and hands after contact with raw meat and poultry.
  
  Don't drink untreated water from mountain streams or lakes.
  
  Don't drink unpasteurized raw milk from farms or other sources.
  
  * "Campylobacter isolates in the United States, 1982-1986," Centers for Disease Control and Prevention, "Morbidity and Mortality Weekly Report," U.S. Department of Health and Human Services, Vol. 37, No. SS-22.

Why can't Campylobacter be stopped at the source?

• Campylobacter can be stopped at a number of different points in the food production and marketing chain.
  
  On the farm: Good sanitary practices on farms, as recommended by USDA, minimize the opportunity for the bacteria to spread among animals and birds. Pasteurization of milk and treatment of municipal water supplies eliminate another route of transmission for Campylobacter and other bacteria.
  
  In the plant: Raw foods are not sterile, and there are no requirements that they be sterile. Thorough cooking destroys bacteria. Food processing companies are accountable for following good, up-to-date manufacturing practices that minimize the opportunity for spread of Campylobacter and other bacteria.
  
  At retail: USDA enforces a recall policy on any ready-to-eat meat and poultry products that are found to be contaminated with bacteria that cause illness. USDA also enforces this recall policy on any ground, raw meat or poultry that is contaminated with E. coli O157:H7.
  
  FSIS published the Pathogen Reduction Hazard Analysis and Critical Control Point (HACCP) Final Rule on July 25, 1996. It requires that all federally-inspected meat and poultry plants adopt a HACCP system to ensure that they use science-based process controls to prevent and reduce significant food safety hazards. HACCP, which is being implemented in phases, with the largest plants having to implement HACCP by January 26, 1998, will clarify the responsibilities of industry and FSIS in the production of safe meat and poultry products. The role of FSIS is to set appropriate food safety standards and maintain vigorous inspection oversight to ensure that those standards are met.

What is USDA doing to prevent Campylobacter infections?

• In its commitment to ensure that the public has a safe, wholesome food supply, USDA's FSIS is constantly working to improve the level of safety and reduce contaminants in the meat and poultry supply. USDA enforces a recall policy on contaminated ready-to-eat products and ground, raw meat or poultry that are found to be contaminated with E. coli O157:H7.
  
  As part of the Federal government's campaign to improve the safety of the nation's food supply, the Sentinel Site Study (FoodNet) was begun to collect more precise information on the incidence of foodborne disease in the United States. One of the objectives of FoodNet is to measure if preventive measures are effective in reducing the incidence of foodborne illness attributable to consumption of meat, poultry, and other foods.
  
  With the implementation of HACCP starting in January 1998, FSIS expects a combination of HACCP-based process control, microbial testing, pathogen reduction performance standards, and sanitation standard operating procedures to significantly reduce contamination of meat and poultry with harmful bacteria and reduce the risk of foodborne illness.
  
  USDA is supporting research to learn more about Campylobacter in food and how to control it.

Safe Food Tips to Destroy Campylobacter and Prevent Illness

• Most foodborne illness from bacteria on raw meat or poultry can be prevented by proper food handling in home and institutional kitchens.
  
  To keep food safe at home, refrigerate promptly and properly. Freeze raw meat and poultry you will not use within 1 or 2 days. Freezers should register 0 °F and refrigerators 40 °F.
  
  Thaw foods in the refrigerator. Food should not be thawed at room temperature. Cross-contamination of bacteria to other foods from raw meat and poultry can be prevented by thorough washing of hands, countertops, and utensils. Campylobacter are very fragile bacteria that are easily destroyed by thorough cooking. Freezing cannot be relied on to destroy the bacteria. Thorough cooking is what will make the product safe.

For safe microwaved meat or poultry: First, microwave the food in a covered dish or under a plastic wrap. Under cover, steam helps kill bacteria and ensures uniform heating.

Second, rotate the dish or stir the food during microwaving. This is necessary for even cooking.

Third, check the internal temperature in several places with a temperature probe or meat/poultry thermometer. If the internal temperature is at least 160 °F for meat and 180 °F in the inner thigh for poultry, Campylobacter and other bacteria will be destroyed.

Fourth, be sure to observe the "standing" time recommended in the microwave recipe. This step is necessary to complete the microwave cooking process

For safe grilled chicken or meat: Cook the meat to an internal temperature of 160 °F and poultry to an internal temperature of 180 °F; verify by using a meat thermometer.

If you plan to use marinade for dipping or basting on the grill, reserve some in the refrigerator before use on raw meat or poultry. Do not reuse marinades from the raw meat or poultry since they may contain bacteria.

Transfer cooked meat or poultry to a clean platter -- never to the dish that held the raw meat or poultry.

For safe precooked meat and poultry: Use a meat thermometer to verify that precooked meat and poultry has reached a safe internal temperature -- 160 °F for meat and 180 °F for poultry.

Cool the cooked food rapidly and evenly. Large roasts and whole poultry should be cut into smaller portions, then wrapped separately. Casserole-type dishes should be cooled in shallow, covered pans rather than deep pots.

Refrigerate promptly and use leftovers within 3-4 days or freeze.

Reheat leftovers to 165 °F or eat cold from the refrigerator.

For safe meat and poultry in restaurants: Eat only in restaurants that are clean and practice safe food handling. Restaurants that do not follow these rules should be reported to local public health officials. Send back food that is undercooked