Campylobacter Jejuni ( Kim Mihalek )

What Is Campylobacter jejuni?

Bacteria

Slender, Rod Shaped*

Flagellate

Motile

Gram negative

Microaerophilic

Thermophilic

What is known about the Genome of C. jejuni?

First published 2/10/2000 in Nature by Parkhill, et al.

Unusual points

Almost complete lack of repetitive DNA sequences.

No functional inserted sequences or phage-related sequences.

Little organization of genes into operons or clusters.

Broad set of regulatory systems to adapt to varying environmental conditions

What is Campylobacteriosis?

Infectious disease caused by bacteria of genus Campylobacter.

99% C. jejuni, 1% other.

Affects the small intestine.

Not recognized as cause of human food borne illness prior to 1975.

Most common bacterial cause of diarrheal illness in the United States -More cases than Shigella and Salmonella combined.

How Prevalent Is This Disease In the United States?

Most common cause of food borne illness in the United States.

15 cases diagnosed/100,000 people annually.

Approximately 100 people die each year..

Most cases go unreported or undiagnosed

Estimated 1-4 million cases in U.S. yearly.

How Prevalent Is This Disease Worldwide?

Leading cause of food borne illness worldwide.

Many countries do not have national survey programs for Campylobacteriosis; worldwide incidence numbers do not exist.

Prevalent in developing countries.

Study by University of Lagos, Nigeria showedthat in developing countries, 40-60% of children under 5 with diarrhea were positive for Campylobacter spp.

Worldwide, gastroenteritis is second only to respiratory infections in causing deaths.

Who is affected?

All warm-blooded animals can become affected. Some animals carry the disease without exhibiting symptoms.

Any person can become infected.

Children under 5 and young adults ages 15-29 are most often affected.

Most deaths occur among the elderly and the immune-suppressed.

What Are the Symptoms?

Diarrhea

Usually watery and sticky

Can contain blood and fecal leucocytes

Fever

Abdominal pain

Nausea and vomiting

Headache

Muscle pain

Are There Long-Term Effects?

Guillain-Barre Syndrome

Immune system attacks own nerves

40% caused by C. jejuni infection

Arthritis, Reiter’s Syndrome

Hemolytic Uremic Syndrome

Septicemia

Leading to infection of nearly any organ, including appendix, abdominal cavity, heart, nervous system, etc.

How Does Campylobacter affect individual cells in the intestines?

Produces a toxin called Cytolethal Distending Toxin (CDT).

CDT activity requires activation of three genes: cdtA, cdtB, and cdtC.

CdtB is nuclease that damages DNA and causes cell cycle arrest.

Causes cell death.

How Does Campylobacter Affect Individual Cells In the Intestines?

What Is the Incubation Period and How Long Does the Illness Last?

Onset of symptoms 2-10 days after ingestion.

Duration of illness 2-21 days, typically 5-7 days.

Relapses occur in 25% of cases.

What are the Diagnostic Tests?

Present in feces of infected individuals

Cultured sample of stool from ill person

Isolation requirements:

Special antibiotic containing media

Microaerophilic atmosphere

5% oxygen

2-10 % carbon dioxide

How is the Illness Treated?

– Most cases

Most infections are usually self-limited.

> 95% of infections clear up on their own.

Affected persons should drink plenty of fluids to avoid dehydration.

Antidiarrheal medications such as loperamide may help symptoms.

How is the Illness Treated?

– Severe cases

Antibiotics used in severe cases of gastroenteritis.

Macrolide antibiotics including Erythromycin are effective and may shorten course of illness.

Resistance developing to Fluoroquinolone antibiotics due to use in poultry feed.

How do people get infected?

Single, sporadic cases

Eating raw or undercooked poultry meat

Fact: Even one single drop of juice from raw chicken meat can infect a person.

Handling raw poultry

Contact with infected fecal matter

How do people get infected?

Outbreaks

Unpasteurized or under-pasteurized milk

Children on class trip drinking unpasteurized milk

Dairy under-processed surplus raw milk for schools.

Cow-leasing program in Wisconsin.

Contaminated water source

Bennington, VT using non-chlorinated water.

How does food or water become contaminated?

Poultry

63-88% of all chickens carry latent infection.

Spread through flock through drinking water and feces.

Spread to meat from intestines during slaughter.

Present in giblets, especially liver.

Milk

Infected udder.

Contact with manure.

Surface water

Infected manure from cows or wild birds.

Enters streams through runoff.

What can be done to prevent Campylobacter infections?

Food Industry

Provide chickens with chlorinated water.

Avoid fecal contamination of udders or milk.

Strictly adhere to pasteurization time and temperature requirements.

Avoid fecal and/or intestinal contamination in meat processing.

What can be done to prevent Campylobacter infections?

Individuals

Avoid drinking unpasteurized milk or untreated surface water.

WASH HANDS!!!

after having contact with pet feces.

after using the restroom or changing a diaper.

What can be done to prevent Campylobacter infections?

Individuals

Use safe food handling practices

Cook all poultry products thoroughly

Wash hands before handling foods.

Wash hands after handling raw foods of animal origin.

Prevent cross-contamination in the kitchen.

What are the latest morbidity and mortality reports?

CDC Morbidity and Mortality Weekly

Published April 30, 2004

“Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food — Selected Sites, United States, 2003 “

Published June 28, 2002

“Outbreak of Campylobacter jejuni infections associated with drinking unpasteurized milk procured through a cow-leasing program.” Wisconsin, Nov 10 – Dec 18, 2001.

What is the latest research?

CDC Emerging Infectious Diseases

Published March 2002

“Human Campylobacteriosis in Developing Countries.” Akitoye O. Coker, et al. University of Lagos.

Infection and Immunity

Published July 2001

“CdtA, cdtb, and cdtC form a tripartite complex that is required for Cytolethal Distending Toxin activity.” Maria Lara-Tejero and Jorge Galan. Yale School of Medicine.

What were my sources?

Bad Bug Book: U.S. Food & Drug Administration Center for Food Safety & Applied Nutrition Food borne Pathogenic Microorganisms and Natural Toxins Handbook; vm.cfsan.fda.gov/~mow/chap4.html.

CDC Division of Bacterial and Mycotic Diseases, Disease Information; Campylobacter infections; www.cdc.gov/ncidod/dbmd/diseaseinfo/campylobacter_g.htm.

Campylobacter Facts and Information;
www.foodborneillness.com/ecoli1/campylobacter-overview.htm.

Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly
Through Food — Selected Sites, United States, 2003;
www.cdc.gov/mmwr/preview/mmwrhtml/mm5316a2.htm.

Outbreak of Campylobacter jejuni Infections Associated with Drinking Unpasteurized Milk
Procured through a Cow-Leasing Program, Wisconsin, 2001;
www.cdc.gov/mmwr/preview/mmwrhtml/mm5125a2.htm.

Nature 403, 665 – 668 (10 February 2000); The genome sequence of the food-borne pathogen
Campylobacter jejuni reveals hypervariable sequences; J. PARKHILL, et al.;
www.nature.com/cgitaf/DynaPage.taf?file=/nature/journal/v403/n6770/full/403665a0_fs.html;


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