NAME: Campylobacter jejuni
SYNONYM OR CROSS REFERENCE: Campylobacter jejuni subsp. jejuni, C. jejuni subsp. doylei Footnote 1. Formerly known as Campylobacter fetus subsp. jejuni Footnote 2. Disease known as Campylobacteriosis or Campylobacter enteritis.
CHARACTERISTICS: Campylobacter jejuni is a microaerobic, non-spore forming, gram-negative bacteria of the Campylobacteraceae family. They form motile, spiral shaped rods that are 0.2-0.9 μm wide and 0.5-5 μm long, and moves by a corkscrew-like motion Footnote 3. One unsheathed polar flagella is present at the end (or both ends) of the cell, which gives the bacterium a slender “S” shape, and this spiral appearance is its most distinguishable feature. C. jejuni grows slowly in culture and have an optimum growing temperature of 42°C Footnote 4. Old cultures or ones exposed to air for extended periods tend to become spherical or coccoid Footnote 1.
PATHOGENICITY: Campylobacter jejuni cause gastroenteritis, with the most common symptom being diarrhea (sometimes bloody) that lasts 2-10 days, as well as mild to severe abdominal pain, fever, malaise, nausea and vomiting Footnote 5. Symptoms last for about a week but relapses occur in 5-10% of untreated cases Footnote 1, Footnote 4. Although a large number of campylobacter infections are asymptomatic and mild Footnote 4, many complications have been reported in young children and immunocompromised patients, including bacteremia, hepatitis, cholecystitis, pancreatitis, abortion, myocarditis and meningitis Footnote 1. C. jejuni has been associated with post-infection sequelae, most commonly Guillain-Barré syndrome and reactive arthritis Footnote 1, Footnote 4. All strains of C. jejuni possess a gene coding for cytolethal distending toxin, however not all strains produce it. The role of these toxins in disease is not known Footnote 6. Motility is required for full virulence, and some effectors associated with virulence are secreted through the flagellum.
EPIDEMIOLOGY: Infections occur worldwide, and are common in both developed and developing countries Footnote 1, Footnote 4. In developed countries, Campylobacter is the leading cause of bacteria gastroenteritis with the majority of these cases cause by C. jejuni Footnote 7. Infections show seasonal trends, with most cases occurring in late summer/early fall in developed countries, although the reason for this pattern is not fully understood Footnote 8. Infection is primarily associated with handling and consumption of raw meat. The prevalence of campylobacter on chicken carcasses is very high and cross contamination can easily occur during food preparation. The majority of cases are sporadic with outbreaks accounting for only a small number of cases Footnote 1, Footnote 4, Footnote 9. However, there have been outbreaks caused by the distribution of water or milk, which have infected 3000 people at a time Footnote 6. In developing countries, infections are endemic with the majority of symptomatic cases occurring in young children. Asymptomatic cases in adults and children are common Footnote 4, Footnote 9.
HOST RANGE: C. jejuni subsp. jejuni: humans, cattle, wild birds, poultry, pigs, sheep, dogs, cats, water, mink, rabbits, and insects Footnote 1, Footnote 9. C. jejuni subsp doylei can be found in humans Footnote 1, Footnote 9.
MODE OF TRANSMISSION: Oral ingestion of bacteria from faecally contaminated food (primarily chicken) or drinking water is the main mode of transmission Footnote 4, Footnote 11. Contact with animals and their feces is also a source of infection Footnote 11.
INCUBATION PERIOD: 1 to 10 days Footnote 9.
COMMUNICABILITY: Low, person-to-person transmission is unusual Footnote 4.
RESERVOIR: C. jejuni subsp. jejuni: humans, cattle, wild birds, poultry, pigs, sheep, dogs, cats, water, mink, rabbits, and insects Footnote 1, Footnote 9. C. jejuni subsp doylei can be found in humans Footnote 1, Footnote 9.
ZOONOSIS: Yes – Transmitted from a variety of animals (birds and mammals) Footnote 11.
VECTORS: Flies have been suggested as a possible vector Footnote 12.
DRUG RESISTANCE: Antibiotic resistance strains are emerging particularly to fluoroquinolones, macrolides, trimethoprim, beta lactam antibiotics, including penicillin and most cephalosporins, as well as to tetracycline, quinolone and kanamycin Footnote 6, Footnote 13, Footnote 14.
SUSCEPTIBILITY TO DISINFECTANTS: C. jejuni is susceptible to 10 mg/L iodophor, 1:50 000 quaternary ammonium compound, 0.15% phenolic compound, 70% ethyl alcohol or 0.125% glutaraldehyde all with a contact time of 1 minute or 5mg/L of hypochlorite with a contact time of 5 minutes Footnote 15.
SURVIVAL OUTSIDE HOST: Campylobacter cells can enter a viable but nonculturable state (VBNC) when subject to stress. This is thought to improve their survival in the environment, as it has been observed to survive freezing for several months in frozen poultry, minced meat, and other cold food products Footnote 5, Footnote 18. Campylobacter can survive for many weeks in water at 4°C, but only a few days in water above 15°C Footnote 19.
SURVEILLANCE: Campylobacter infection can be confirmed by culturing and identification of bacteria from stool Footnote 20. Recent Campylobacter infections can be identified using serologic tests Footnote 20.
Note: All diagnostic methods are not necessarily available in all countries.
FIRST AID/TREATMENT: Treatment is primarily supportive as most infections are self-limiting Footnote 1, Footnote 21. However, antibiotic therapy may be required in more serious cases particularly in young, elderly or immunocompromised patients Footnote 22. Erythromycin is the drug of choice for treating Campylobacter gastroenteritis Footnote 20.
PROPHYLAXIS: No drugs are available. Reducing faecal contamination of the carcass after slaughter can control the spread of the bacteria Footnote 5.
LABORATORY-ACQUIRED INFECTIONS: Yes, several cases have been reported for Campylobacter spp. Footnote 23.
SOURCES/SPECIMENS: Fecal samples, blood and specimens from animals Footnote 1.
SPECIAL HAZARDS: May have adverse effects on the fetus if contracted during pregnancy Footnote 25.
RISK GROUP CLASSIFICATION: Risk Group 2 Footnote 26.
CONTAINMENT REQUIREMENTS: Containment Level 2 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, or cultures.
PROTECTIVE CLOTHING: Lab coat. Gloves when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk of exposure to splashes Footnote 27.
OTHER PRECAUTIONS: All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activities Footnote 27.
SPILLS: Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply an appropriate disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up Footnote 27.
DISPOSAL: Decontaminate all wastes that contain or have come in contact with the infectious organism by autoclave, chemical disinfection, gamma irradiation, or incineration before disposing Footnote 27.
STORAGE: The infectious agent should be stored in leak-proof containers that are appropriately labeled Footnote 27.
UPDATED: December 2011
PREPARED BY: Pathogen Regulation Directorate, Public Health Agency of Canada.
Although the information, opinions and recommendations contained in this Pathogen Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Public Health Agency of Canada, 2011