Campylobacter infection

Campylobacter infection is a bacterial diarrheal disease with a high temperature and abdominal pain. The source of infection is generally contaminated food of animal origin. It can be prevented by complying with hygiene rules.

At a glance

  • Campylobacter infection is a form of bacterial food poisoning with a high temperature and diarrhea.
  • The infection is passed on via animal foods contaminated with gut bacteria.
  • Severe diarrhea may be life-threatening for babies, infants, older people and people with a immune deficiency.
  • Most of those affected make a complete recovery within a week.
  • Rare complications are arthritis and paralysis.
  • People can protect themselves by complying with hygiene rules.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

Campylobacter infection: man sitting on the toilet with his trousers down. Only his legs are visible. There is a roll of toilet paper by his feet.

What is campylobacter infection?

Campylobacter infection is an infectious diarrheal disease caused by contaminated food. In most cases the diarrhea clears up on its own after a few days. In babies, infants and older people, however, it can cause life-threatening loss of fluids and salts. Late complications occasionally arise such as arthritis or paralysis.

It is generally passed on from food of animal origin contaminated with gut bacteria. Frequent sources of infection are chicken and unpasteurized milk. It can be prevented by following strict hygiene rules.

What are the symptoms of campylobacter infection?

The first symptoms appear around 2 to 5 days after infection with the bacteria. General pathological symptoms such as a high temperature, headache and joint pain occasionally occur 12 to 24 hours before onset of diarrhea.

Typical symptoms are: 

  • abdominal pain and abdominal cramps
  • loose or watery, occasionally also bloody diarrhea
  • nausea and vomiting 
Characteristic symptoms of campylobacter infection are abdominal pain and abdominal cramps, diarrhea and nausea and vomiting.

The condition lasts around a week, sometimes even longer. Many people do not have any symptoms despite being infected.

What are the pathogens that cause campylobacter infection?

Campylobacter is a bacterium that is found throughout the world and is frequently the cause of diarrheal diseases. Campylobacter jejuni and Campylobacter coli are the most important forms. They live in animal gut. Although they cannot reproduce on food, they can survive and remain infectious for some time. They survive sub-zero temperatures, for example in a freezer.

Important: People with the disease continue to eliminate the bacteria in their stools for around 2 to 4 weeks even if they do not have any symptoms. During this period people may become infected from contact with the stool. Infants and people with an immune deficiency often excrete the germs over an even longer period.

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How is the campylobacter infection passed on?

The campylobacter infection is most often passed on from food contaminated with minute particles of feces. This frequently occurs when the animals are being slaughtered or milked. Chicken, other poultry meat, uncooked meat or meat that has not been cooked through, uncooked sausages, raw (unpasteurized) milk and unpasteurized dairy products are particularly affected. Pet feces, well water and water in swimming lakes may also be infectious. 

Important: Even small amounts of bacteria are sufficient to cause the condition. Transmission from person to person via contaminated hands is rare but may occur in infants.

How common is campylobacter infection?

There are around 60,000 to 70,000 cases of diarrheal disease due to campylobacter infection every year in Germany. Campylobacter bacteria are found throughout the world. In Germany and Europe, the condition is most prevalent in the warmer seasons. Children under 5 and young adults between 20 and 29 are particularly affected. 

What are the complications of campylobacter infection?

It can sometimes take longer than usual to eliminate the pathogens. In patients who have no pre-existing conditions, this generally happens without symptoms.

Possible complications of campylobacter infection are:  

Reactive arthritis 

Arthritis may occur a few days or weeks after a bacterial infection, with the body’s immune defenses attacking the cartilage and bones. It is not exactly clear why this happens. However, some people are predisposed to develop this type of arthritis. They generally recover after around 6 months after a course of anti-inflammatory drugs. 

Guillain-Barré syndrome

Paralysis and numbness can occur after an infection, starting in the hands and feet and spreading to the torso. This often also affects the respiratory muscles. This neural disorder appears to be caused by a faulty response from the body’s immune defenses.

Irritable bowel syndrome and chronic inflammatory disorders of the intestine

Doctors believe it is possible that irritable bowel syndrome or a chronic inflammatory disorder of the intestine can develop following a diarrheal disease with campylobacter infection.

How can campylobacter infection be prevented?

There are numerous precautions that people can take to protect themselves and others from food-related diarrheal disease: 

General hygiene

People should wash their hands thoroughly in soap and water and dry them off with a clean towel afterwards to avoid being infected by gut bacteria in the following situations:

  • after going to the toilet
  • before eating
  • before preparing meals 
  • immediately after working with uncooked food 
  • after changing diapers 
  • after disposing of pet feces 

Uncooked food of animal origin

This includes, for example, raw (unpasteurized) milk, unpasteurized dairy products, certain types of uncooked sausage such as meat paste and all types of uncooked meat or meat that has not been cooked through.

  • Babies, infants, pregnant women, older people and people with an immune deficiency should refrain from eating uncooked food of animal origin. 
  • Raw milk, milk labeled “direct from the farm” or “Vorzugsmilch” should be boiled before consumption. 
Prevent campylobacter infection by always washing food, ensuring meat is properly cooked through, disposing of melted ice from thawed meat, cleaning work surfaces, using separate utensils for raw and cooked food, regularly replacing brushes and sponges.

Hygiene in the kitchen

  • Food should always be washed before it is eaten or prepared.
  • Meat, particularly poultry, must always be fully cooked through.
  • Dispose of melted ice from thawed meat immediately and clean objects and work surfaces that have been in contact with it.
  • Do not wash poultry before cooking. This is to prevent germs being sprayed in and around the kitchen.
  • Clean work surfaces and equipment after each step in dishwashing liquid and warm water. 
  • Use separate kitchen utensils for uncooked and cooked food. 
  • Replace dishwashing brushes and sponges regularly. Wash wiping cloths and kitchen towels at a minimum temperature of 60 degrees.

The website of the German Federal Institute for Risk Assessment (BfR) provides answers to frequently asked questions on protection against food-related campylobacter infection.

Attending community facilities

Children under 6 suffering from an infectious diarrheal disease should not attend community facilities such as schools or nurseries. Their parents must inform the community facility of their illness. Once the children have been symptom-free for 48 hours they may resume attendance at the community facility after being assessed by a doctor. A written doctor’s certificate is not required. 

Working in the food or catering sector

People with an infectious diarrheal disease must temporarily cease working anywhere where they come into contact with food or meals. Infected people’s stools can remain infectious over a prolonged period. That means that, although they can return to work after the symptoms clear up, they must follow strict hand hygiene rules for 4 weeks.  

Treatment of contacts

No special measures are required for people who come into contact with infected persons, provided that they do not exhibit any symptoms such as diarrhea or vomiting. 

How is campylobacter infection diagnosed?

At the acute stage of a diarrheal disease, doctors can detect the bacterium directly from a fresh stool sample or cultivate it in a bacterial culture. They can also check what antibiotics the bacterium may be resistant to. The stool sample needs to reach the lab fairly quickly for the cultivation of the bacteria to be successful.

How is campylobacter infection treated?

Ensuring an adequate intake of fluids and salt as well as easily digestible food will normally be enough to treat even severe cases of diarrheal disease. Campylobacter infections generally clear up on their own after a few days. Hospital treatment may be necessary in very severe cases of diarrhea, lasting more than 2 to 3 days. Doctors will only prescribe antibiotics in exceptional cases. 

Important: Severe diarrhea may rapidly become life-threatening for babies, infants, older people and people with a immune deficiency. Doctors often have to replenish lost liquid and salt with an infusion at hospital.

Reviewed by the German Society for Gastroenterology, Digestive and Metabolic Diseases (Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten e.V.) (DGVS).

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