Campylobacter Jejuni: An emerging food borne pathogen Rhoda Odivbri PUBH-8165-3 Environmental Health Walden University January 24th, 2010

Target Audience Population in United States Center for Foodborne Illness. (2009). Foodborne illness. Retrieved January 22, 2010 from http://www.foodborneillness.org/Foodillnesslongterm.htm Food borne pathogen is a serious public health issue in United States. According to CDC, about 5000 die from food borne infections, 325,000 are hospitalized, and about 76 million are sick each year. The medical cost of just five food borne pathogen is about $6.9 billion. This result into low productivity, premature death and long-term secondary health outcomes. According to CIDRAP News in May 19, 2002, United States is increasing vulnerable to food bioterrorists attack since their food supply has been more centralized, public health need to strengthen up their programs.

Brief History of Food borne pathogen Over 200 known diseases are transmitted through food. The causative organism are viruses, bacteria, parasites. Food borne diseases cause about 5000 death each year in United States. Salmonella, Listera, and Toxoplasma are responsible for 1, 500 death. Many of the pathogen of concern today were not recognized as a cause of food pathogen until 20 years. CDC. (1999). Food-Related Illness and death in United States. Retrieved January 22, 2010 from http://www.cdc.gov/ncidod/eid/vol5no5/mead.htm According to CDC, more than 200 known disease has been recognized caused by variety of viruses, bacteria, and parasites. Some cause food poisoning through toxins and chemicals. The most common form of food pathogens are caused bacteria, for example Campylobacter, Salmonella, E.coli. From 1951 through 1960, the National Office of Vital Statistic review report of outbreaks of foodborne illness, which are annually published in Public Health Report. However, this annual publishing was stopped in during 196-1965. Food borne-Disease Outbreak Surveillance System was established in 1973, during 1993-1997, a total of 2,751 of foodborne outbreaks were reported. This report has been on the increase till date.

Why Campylobacter Jejuni Campylobacter jejuni is the most commonly reported bacterial caused of foodborne disease in United States. Campylobacter causes a chronic complication that is adding to human and economic cost. Resistant to anti-microbial treatment. Prevalance Its emergence CDC. (1999). Campylobacter jejuni-An emerging Foodborne pathogen. Retrieved January 22, 2010 from http://www.cdc.gov/ncidod/eid/vol5no1/altekruse.htm For more than one century, the awareness of campylobacter jejuni has been evolving. In 1970s, selective growth media was established which permitted more laboratories to test for campylobacter that established campylobacter as the most common human pathogen. In 1966, 46% of the laboratory-confirmed cases of gastroenteritis reported in CD Surveillance Network System were caused by campylobacter species. Additionally, chronic complication that has added to human and economic cost; the so-called Guillain Barre syndrome (GBS) is a de-myelinating disorder resulting into acute neuromuscular paralysis, 20% of the patients with GBS are left with permanent disabilities, while 5% die from respiratory complications. Resistant to anti-microbial therapy is on the increase, it was notable that US troops from developing are more resistant to these anti-microbial. This has also led to the emerging of campylobacter species.

What is Campylobacter Jejuni A spiral-shaped bacteria Causes disease in humans and animal Grow best at the body temperature of a bird. Very fragile bacteria Can not survive in a drying environment Can be killed by oxygen Causes an infectious disease called campylobacteriosis Most common cause of diarrheal disease in United States. CDC. (2008). Campylobacter. Retrieved January 22, 2010 from http://www.cdc.gov/nczved/dfbmd/disease_listing/campylobacter_gi.html Campylobacter jejuni is a spiral shaped bacteria, that causes disease in humans and animal. The most common form of foodborne disease, it can grow best in bird’s temperature, it seems to be well adapted by birds without becoming sick. They grow only in environment with less oxygen. These bacteria are fragile. They cannot tolerate drying and can be killed by oxygen. They grow only in places with less oxygen than the amount in the atmosphere. Freezing reduces the number of Campylobacter bacteria on raw meat.

Transmission of Campylobacter Jejuni Raw or undercooked poultry products Unpasteurized milk Contaminated water Cross-contamination of food items CDC. (2008). Campylobacter. Retrieved January 22, 2010 from http://www.cdc.gov/nczved/dfbmd/disease_listing/campylobacter_gi.html Campylobacter was initially isolated in 1909, and the first known human infection was reported in 1947. Within the past 10-20 years, the organism has emerged as a widespread gastrointestinal pathogen. Campylobacter jejuni cause an infectious disease-campylobacteriosis. Most people infected with campylobacter have diarrhea, cramping, abdominal pain, and fever within 2-5 days after exposure. Campylobacteriosis has been estimated to affect approximately 2.4 million person in United States, 0.8% of the population. This disease is common in the summer than the winter. Most common outbreak of campylobacteriosis is associated with eating raw or undercooked poultry products, unpasteurized milk, or contaminated water or cross-contamination of food items. Infants may get contaminated by poultry packages in shopping carts. Some people have been infected from contact with infected animal stool like dog or cat. In 2005, Campylobacter was present on 47% of raw chicken breasts tested through the FDA-NARMS Retail Food program. Campylobacter is also present in the giblets, especially the liver.

Prevention Cooking of all poultry product thoroughly Thorough hand washing before food preparation. Thorough washing of hand after handling raw poultry products. Prevent cross-contamination in the kitchen. Avoid consuming unpasteurized milk products. Use of National Surveillance Network program. CDC. (2008). Campylobacter. Retrieved January 22, 2010 from http://www.cdc.gov/nczved/dfbmd/disease_listing/campylobacter_gi.html Make sure all meat product are cooked through out with no juices run clear. Thorough washing of hands after handling raw poultry product before touch any food items. Children should wash hand with soap after any diarrhea episode. Hands should also be washed after contact with pets feces. To avoid cross-contamination in kitchen; use separate cutting boards for each animal products, and cutting boards should be thoroughly wash and cleaned before use. Additionally, untreated surface water should be avoided. In 1982, CDC started a National surveillance program to monitor its spread.

Treatment Self-recovery Drink extra fluid Anti-biotic CDC. (2008). Campylobacter. Retrieved January 22, 2010 from http://www.cdc.gov/nczved/dfbmd/disease_listing/campylobacter_gi.html Most people recover within two to five days after illness, while some may take longer about 10 days without any specific treatment. Patients are expected to take extra fluids while the diarrhea lasts. In severe cases, use of antibiotics will be needed. The most common type of antibiotic used is erythromycin or any fluoroquinolones, this help to reduce the disease process. However, there has been an increased of antibiotic resistant in some cases.

Critical areas and why New Zealand- with highest cases in 2004. United States-an estimate of 2.1-2.4 million cases occur each year. Europe- over 200,000 cases in 2005. Sobel, j, et al (2002). US is vulnerable to foodborne bioterrorism, CDC report says. Retrieved January 22, 2010 from http://www.cidrap.umn.edu/cidrap/content/biosecurity/food-biosec/news/foodattack.html CDC. (1999). Campylobacter jejuni-An emerging Foodborne pathogen. Retrieved January 22, 2010 from http://www.cdc.gov/ncidod/eid/vol5no1/altekruse.htm In 2004, New Zealand was reported to have the highest cases of campylobacter, while in 2005, EU reported 200,000 cases. The majority of these are thought to be foodborne. A similar situation exists in North America and other countries. In the United States, an estimated 2.1 to 2.4 million cases of human campylobacteriosis occur each year . Some of these cases were linked to immigration, increase import of food materials from other countries, resistance to antibiotics, and increase vulnerable to bioterrorist attacks on its food supply. Nation food production system is becoming more centralizes, serving as a vehicle for bioterrorist attack. For example, In 1984, members of a religious cult contaminated salad bars in The Dallas, Oregon, with Salmonellaenteritidis serotype typhimurium, causing 751 people to get sick. And in 1996, a laboratory worker used food contaminated with Shigella dysenteriae to infect colleagues. In addition, US troop from Thailand were reported to be resistant to ciprofloxacin, and nearly one third of isolates from U.S. troops located in Hat Yai were resistant to azithromycin.

References: CDC. (1999). Campylobacter jejuni-An emerging Foodborne pathogen. Retrieved January 22, 2010 from http://www.cdc.gov/ncidod/eid/vol5no1/altekruse.htm CDC. (2008). Campylobacter. Retrieved January 22, 2010 from http://www.cdc.gov/nczved/dfbmd/disease_listing/campylobacter_gi.html CDC. (1999). Food-Related Illness and death in United States. Retrieved January 22, 2010 from http://www.cdc.gov/ncidod/eid/vol5no5/mead.htm. Center for Foodborne Illness. (2009). Foodborne illness. Retrieved January 22, 2010 from http://www.foodborneillness.org/Foodillnesslongterm.htm. Sobel, j, et al (2002). US is vulnerable to foodborne bioterrorism, CDC report says. Retrieved January 22, 2010 from http://www.cidrap.umn.edu/cidrap/content/biosecurity/food-biosec/news/foodattack.html

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