What is Campylobacter?
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Campylobacter jejuni (pronounced “camp-e-low-back-ter j-june-eye") is a bacterium that was first recognized as a cause of human gastrointestinal illness in 1975. Since that time, the bacterium has been identified as the most common cause of bacterial foodborne illness in the U.S., ahead of Salmonella – the second most common cause (MMWR Weekly, 2000, March 17; Tauxe, 1992).
Over 10,000 cases are reported to the Centers for Disease Control and Prevention (CDC) each year; however, many more cases go undiagnosed or unreported and estimates are that Campylobacter causes 2 to 4 million cases per year in the United States. Active surveillance for cases indicates that over 20 cases for each 100,000 persons in the population are diagnosed yearly, and 124 deaths are attributed to C. jejuni annually (CDC, 2005, October 6). Current estimates are that each case of campylobacteriosis costs $920 on average due to medical and productivity (lost wages) expenses with an annual total cost of approximately $1 billion (CAST, 1994).
The CDC reported that the incidence of Campylobacter infection decreased by 30 percent in the ten-year period between 1996 and 2006 (MMWR, 2007, April 13).
Campylobacter jejuni is a gram-negative, microaerophilic, thermophilic rod that grows best at 42°C (107°F) and low oxygen concentrations. These characteristics are adaptations for growth in its normal habitat – the intestines of warm-blooded birds and mammals. Several closely related species with similar characteristics, C. coli, C. fetus, and C. upsalienis, may also cause disease in man but are responsible for less than one percent of human infections annually (CDC, 2005, October 6).
Food is the most common vehicle for the spread of Campylobacter, and chicken is the most common food implicated. Contamination occurs during animal slaughter and processing when it comes into contact with animal feces. Ingestion of as few as 500 organisms – an amount that can be found in one drop of chicken juice – has been proven to cause human illness (FSIS, 1996; Tauxe, 1992). Despite this low infectious dose and the prevalence of Campylobacter jejuni in the environment, most cases of Campylobacter infection occur as isolated, sporadic events, and are not usually a part of large outbreaks. But, very large outbreaks (>1,000 illnesses) of campylobacteriosis have been documented, most often from consumption of contaminated milk or unchlorinated water supplies.
A 1998 Consumer Reports study identified Campylobacter in 63% of more than 1000 chickens obtained in grocery stores (Consumers Union, 1998), and other studies have documented Campylobacter contamination on up to 88 percent of chicken carcasses (FSIS, 1996; Tauxe, 1992). Any raw poultry – chicken, turkey, duck, goose, game fowl – meat and its juices may contain Campylobacter, including organic and “free range” products. Other identified food vehicles include unpasteurized milk, undercooked meats such as beef, pork, lamb, and livestock offal, and occasionally shellfish, fresh produce, and eggs.