Also known as: Campylobacter enteritis, Vibrinonic enteritis
Hospital: Report by IDSS, facsimile, mail or phone
Lab: Report by IDSS, facsimile, mail or phone
Physician: Report by IDSS, facsimile, mail or phone
Local Public Health Agency (LPHA): No follow-up required, except in outbreak situations
Iowa Department of Public Health
Disease Reporting Hotline: (800) 362-2736
Secure Fax: (515) 281-5698
Bacteria of the genus Campylobacter are responsible for campylobacteriosis. Campylobacter jejuni (C. jejuni) a species of Campylobacter is responsible for about 99% of campylobacteriosis in humans, with the remainder of cases caused by other species.
B. Clinical Description
Symptoms: of campylobacteriosis are diarrhea (sometimes bloody), abdominal pain, malaise, fever, nausea, and sometimes vomiting. Infection can cause a spectrum of disease ranging from mild, uncomplicated gastroenteritis to severe disease similar to acute appendicitis. Asymptomatic infections also occur. The illness is usually over within a week but may be prolonged in some individuals and can sometimes relapse.
Long-term complications: include reactive arthritis and Guillain-Barré syndrome, a rare disease that affects the nerves of the body beginning several weeks after the diarrheal illness. This complication results in paralysis that lasts several weeks and usually requires intensive care. It is estimated that approximately 1 in every 1000 reported campylobacteriosis cases leads to Guillain-Barré syndrome and as many as 40% of Guillain-Barré syndrome cases in this country are triggered by campylobacteriosis.
Campylobacteriosis can cause life-threatening sepsis in persons with compromised immune systems.
Campylobacter bacteria are present in animals, most frequently cattle and poultry, although swine, sheep, and even pets such as birds, kittens and puppies may be sources of human infection. A large percentage of raw poultry is contaminated with C. jejuni.
D. Modes of Transmission
Campylobacter is transmitted via food. The most common mode of transmission is ingestion of food or water that has been contaminated with animal or human feces. This includes raw and undercooked poultry or pork, inadequately treated drinking water, and raw milk and raw milk products. However, any food contaminated with the bacteria can be a source of infection. In addition, farm animals and pets, such as puppies with diarrhea, can be sources of infection. Person-to-person spread can also occasionally occur, especially among household contacts, pre-school children in child care, the elderly and developmentally disabled persons living in residential facilities. Transmission can also occur through certain types of sexual contact (e.g., oral-anal contact). A low dose of organisms is all that is needed to cause infection, but the infectious dose may be lower for certain susceptible groups such as children, the elderly and the immunocompromised.
E. Incubation Period
The incubation period can vary from 1 - 10 days but is usually about 2 - 5 days; incubation period may vary based on number of bacteria ingested.
F. Period of Communicability or Infectious Period
The disease is communicable for as long as the infected person excretes Campylobacter bacteria in their stool. This can occur from days to several weeks. People who are not given antibiotics have been known to shed these bacteria for as long as 7 weeks.
Campylobacter is the most common bacterial cause of diarrheal illness in the United States. It is estimated that 1.3 million cases occur annually with almost all cases occurring as isolated, sporadic events. Although common source outbreaks due to this organism have occurred, larger outbreaks due to Campylobacter are not usually associated with undercooked, pork, poultry and cattle but are typically related to consuming unpasteurized milk, cheese or contaminated water. Outbreaks due to Campylobacter are uncommon. Children and young adults have the highest incidence of infection. Campylobacter doesn’t commonly cause death, however there are an estimated 76 persons with Campylobacter infections that die each year.
H. Bioterrorism Potential
I. Additional Information
The Council of State and Territorial Epidemiologists (CSTE) surveillance case definitions for Campylobacteriosis can be found at: www.cdc.gov/osels/ph_surveillance/nndss/phs/infdis.htm#top
CSTE case definitions should not affect the investigation or reporting of a case that fulfills the criteria in this chapter. (CSTE case definitions are used by the state health department and the CDC to maintain uniform standards for national reporting.)
American Academy of Pediatrics. 2000 Red Book: Report of the Committee on Infectious Diseases. Illinois, Academy of Pediatrics, 2000.
CDC. Case Definitions for Infectious Conditions under Public Health Surveillance, 1990: www.cdc.gov/osels/ph_surveillance/nndss/casedef/case_definitions.htm
CDC Website. Campylobacter Infections. www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/
Heymann, D.L., ed. Control of Communicable Diseases Manual, 20th Edition. Washington, DC, American Public Health Association, 2015.