Conditions 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. In rare cases, there may be late complications 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.

Typical symptoms are:

• abdominal pain and abdominal cramps
• loose or watery, occasionally also bloody diarrhea
• fever
• nausea and vomiting 

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 the intestines of animals. 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.

The campylobacter infection is most often passed on from food contaminated with minute particles of feces. This contamination of foodstuffs can occur when 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.

In Germany, campylobacter infection is the most common cause of bacterial diarrhea. However, these infections have reduced in frequency since 2020. There are currently around 50,000 to 60,000 cases of diarrhea due to campylobacter infection every year. 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.

Many campylobacter infections go unnoticed and cause no symptoms. If a person becomes ill, the symptoms normally begin 2 to 5 days after contracting the infection. Often, the initial symptoms are a high temperature, headache and limb pain. Diarrhea and abdominal pain usually only begin 12 to 24 hours later. The symptoms subside after about a week.

However, people with a weakened immune system may be ill for longer. 

What are the potential complications of campylobacter infection?

In some people, reactive arthritis may occur a few days or weeks after a bacterial infection, as the body’s immune defenses may attack the cartilage and bones. Joint inflammations of this kind generally recover after around 6 months after a course of anti-inflammatory drugs. 

In addition, Guillain-Barré syndrome can occur in rare cases following an infection. This presents as paralysis and numbness that starts in the hands and feet and spreads to the torso. It often also affects the respiratory muscles.

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

People are most likely to ingest Campylobacter bacteria with 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.

The following measures can be taken to reduce the risk:

• 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. 

Kitchen hygiene, 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 Celsius.

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 who are suffering or suspected to be suffering from an infectious diarrheal disease should not attend community facilities such as schools or kindergartens. 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.

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.

In most cases, it is not necessary to detect the pathogen responsible for causing diarrhea. Diagnostic testing is, however, carried out in certain cases. This applies in particular to people who become seriously ill with bloody diarrhea, those with persistent diarrhea, people with pre-existing conditions, or individuals who work in community facilities or food establishments.  

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 determine the antibiotics to which the bacterium may be resistant (insensitive). 

All detected cases of campylobacter infection must be reported to the local health authority. 

Ensuring an adequate intake of fluids and salt as well as easily digestible food will normally be enough to treat most cases of diarrheal disease. Electrolyte solutions, available from pharmacies, can also help compensate for the loss of salt and fluids that occurs with severe diarrhea. 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.