1. Campylobacteriosis How safe is your chicken?
Adeola Sonaike, MPH Student
Walden University PH
Instructor: Dr. Stephen Arnold
Winter, 2009
Campylobacteriosis, How safe is your chicken?

2. Welcome
My key focus today is to educate the food handlers and consumers on the impact of foodborne illness, specifically campylobacteriosis.
Awareness and Education is the first step to Promoting Change
Hello, my name is Adeola Sonaike and I am a MPH student at Walden University. My key focus today is to educate you on the impact that foodborne illness has on our health, especially in the case of campylobacteriosis. Myself, as well my fellow public health professionals believe that awareness and education are the first step to promoting change and healthy habits of daily living.

3. An introduction to Foodborne Illness
In the United States there is a high incidence of foodborne illness.
The CDC estimates that in the United States alone there are on average 76 million cases on a yearly basis.
Although a majority of foodborne cases go unreported and undiagnosed, approximately 325,000 lead to hospitalizations diagnosed as food poisoning.
Foodborne illnesses have a high incidence in the United States with 76 million cases occurring on a yearly basis, although a majority of foodborne illnesses go unreported and undiagnosed, the hospital still sees about 325,000 patients who are diagnosed with food poisoning (CDC).

4. Campylobacteriosis The main focus here today, is Campylobacteriosis.
The Causative pathogen is Campylobacter jejuni.
The optimal host environment is the Gastrointestinal tract of poultry.
Campylobacteriosis is the main focus here today. This foodborne illness is caused by the pathogen Campylobacter jejuni and is a spiral-shaped disease causing bacteria in humans and animals. The optimal environment for the growth of C. jejuni is within the gastrointestinal tract of the bird.

5. Prevalence
13 cases are diagnosed as campylobacteriosis each year for each 100,000 persons in the population
Campylobacteriosis affects 2.4 million individuals each year (0.8% of the population)
Campylobacteriosis results in 124 deaths each year
Most Cases can be isolated to a small group of people who consumed undercooked chicken
Campylobacteriosis is a highly prevalent foodborne illness affecting approximately 2.4 million individuals each year, which is roughly 0.8% of the population (CDC). Although many cases go undiagnosed and unreported approximately 13 cases of campylobacteriosis are diagnosed each year per 100,000 persons in the population (CDC). Lack of diagnosis or treatment can lead to death and campylobacteriosis has been reported as the cause of approximately 124 deaths each year (CDC). Since the majority of cases are due to the consumption of undercooked chicken, many cases can be isolated to a small group of people.

6. Transmission
C. jejuni is transmitted from warm blood animals such as poultry and cattle to humans via the ingestion of undercooked meat products, contaminated milk and contaminated water
Highly infectious; only needs 500 organisms of C. jejuni to cause infection
Also transmitted via the feces of pets or other infected individuals.
A foodborne infection C. jejuni is transmitted from warm blooded domestic, production and wild animals to humans due to their prevalence in poultry, cattle, pigs, sheep, ostriches, shellfish, cats and dogs. Transmission is generally foodborne via the consumption of undercooked meats and meat products, raw or contaminated milk and contaminated water or ice (WHO). Only a few organisms are needed for infection therefore a small amount of bodily fluid from poultry that is infected will contaminate anything it comes in contact with. C. jejuni is also transmitted via the feces of pets or other infected individuals and ican therefore be highly contagious when adequate sanitation is unavailable.

7. Symptoms Fever Headache Myalgias Diarrhea Cramps Amebic Dysentry
Abdominal Pain
Symptoms do not usually develop until 1-2 days after infection. Symptoms include fever (40ºC), headache, myalgias, diarrhea, cramps, amebic dysentry and abdominal pain. These symptoms can persist for approximately 2-10 days.

8. Diagnosis Stool Cultures Gram staining techniques
The main form of diagnosis for Campylobacteriosis are stool samples. Gram staining techniques are used to test identify the presence C. jejuni organisms. These diagnostic tests are performed by laboratories.

9. Treatment Electrolyte Replacement Antibiotics IV fluids
Consumption of electrolytes
Antibiotics
Erythromycin
Tetracycline
Fluoroquinolone
Due to the excessive loss of fluids associated with Campylobacteriosis primary treatment is electrolyte replacement, depending on the severity of the case physicians can administer these fluids using IV methods or these fluids can be administered orally. Antibiotics can also be used. Erythromycin is the primary choice for children and Tetracycline is the primary choice for adults, fluoroquinolone can also be administered for treatment

10. High Risk Individuals Infants Young Adults Males
Immune compromised individuals
HIV/AIDS patients
Travelers
Often referred to as travelers diarrhea
Studies show that infants, young adults, males, immune compromised individuals and travelers are at a higher risk of infection and complications associated with campylobacteriosis. Patients with HIV/AIDS infections are much more numerous and lead to a longer duration of illness as infection can spread to the bloodstream, at times resistance to antibiotic treatment is also noted. Travelers are also more exposed to infectious bacteria and campylobacteriosis is often referred to as the travelers diarrhea.

11. Optimal Environment Intestine of poultry at 42˚C Summer Season
Moist Environment
Oxygen is toxic
The optimal environment for C. jejuni is the intestine of poultry 42˚C, C. jejuni has a symbiotic relationship with its host and can reside within the intestine of the bird without causing illness to the bird. Campylobacteriosis is much more prevalent during the summer seasons than the winter seasons and can be eliminated at freezing temperatures (CDC). C. jejuni prefers moist environments as they cannot tolerate drying and can be killed by oxygen (CDC).

12. Protection
It is your responsibility to ensure that the food you eat, especially chicken is properly handled in order to avoid any form of transmission from product to consumer.
As food handlers and consumers it is important to follow all safety guidelines in order to protect oneself from foodborne illness such as campylobacteriosis. One must always remember the personal responsibility as consumers to ensure that the food you eat is properly handled in order to avoid any form of transmission from meat product to consumer. The following slides contain recommendations necessary to protect yourself from foodborne illnesses such as campylobacteriosis.

13. Sanitize Often! When preparing food Wash hands thoroughly
Sanitize all surfaces
Keep food covered
It is very important to keep the kitchen area clean and sanitized at all times in order to limit the possibility for the growth of microorganisms; as a food preparer you should wash hands thoroughly, sanitize all surfaces, and keep food covered.

14. Avoid cross contamination
Do not mix raw food and cooked food
Use separate cooking tools for raw food and cooked food
Use separate storage containers for raw food and cooked food
C. Jejuni thrives in meat products, therefore it is important that when handling raw meat, other foods should not come in contact with it. For example the knives that are used to cut the uncooked chicken should not be used to cut the lettuce for ones salad. Also when storing food in the refrigerator it is important to use separate storage containers for raw food and cooked food. In general it advisable to have specific cooking utensils, pots, pans and containers reserved for raw food only, so to avoid any form of mishap. (WHO)

15. Well-done, is always better
Cook food thoroughly
Allow food to boil
Poultry should be cooked to an internal temperature of 165 ˚F
Ensure that the juices present are clear
Thoroughly reheat cooked food
People often prefer to eat medium rare food in order to enjoy the savory juices, however such food is not always advisable as this also means that many microorganisms may still be present. It is always advisable to consume well done meat products. There are many ways to ensure that food is cooked thoroughly, these include; allowing food to boil, cooking chicken to an internal temperature of at least 165˚F, ensuring that the juices present are no longer pink, and thoroughly reheating cooked food. (WHO)

16. Use of thermometers
Promptly refrigerate food at a temperature below 5ºC.
Food should not be stored in the refrigerator for a long time.
Frozen food should not be thawed at room temperature
Promptly serve food while hot at a temperature above 60ºC.
Reheat food thoroughly after refrigerating
There are specific temperatures at which many microorganisms cannot thrive; such as below 5ºC and above 60ºC. For this reason it is advisable to refrigerate cooked and perishable food promptly, within 2 hours and ensure food is hot when served. Food should not be stored in the refrigerator for extended periods of time and frozen food should not be thawed at room temperature as microorganisms multiply at room temperature. After refrigerating food it is important that food is thoroughly reheated before serving as some microorganisms can survive at temperatures below 5ºC. (WHO)

17. Be Aware Ensure the restaurant passes all sanitation laws
Ensure your food has been cooked thoroughly
Observe the hygiene of servers
If you can see the kitchen; take a peek
Check Restaurant Reviews
It is easy to control the sanitation of meat products when eating in your home, it is much harder however to control this when you eat out. Be aware of the sanitation status of places you eat. Ensure that they have passed recent sanitation inspection laws; usually documentation of this is available in a visible area of the restaurant. It is always important to be vigilant of your surroundings; observe the hygiene of servers and waitresses as this tends to be a clear indication of the hygiene status of the restaurant itself. When ordering out it is advisable to be aware of the sanitation status of their kitchen, society today is prone to ordering out for food, usually looking online for restaurant reviews is a good indication of the status of a restaurant.

18. Summary
It only takes fewer than 500 C. jejuni organisms to cause infection
Primary transmission is through
Poultry
Contaminated milk
Contaminated water
As mentioned early C. jejuni is highly infectious and only takes fewer than 500 organisms to cause infection. Primary transmission is through poultry, contaminated milk and contaminated water.

19. Prevention Summary Thoroughly cook chicken and other meat products
Sanitize all kitchen surface
Wash hands with soap and water constantly while cooking
Pasteurization of milk
Chlorination of water
There are multiple methods for prevention that are ideal in reducing the risk of exposure to C jejuni. These include thoroughly cooking chicken and other meat products to an internal temperature of 165˚F, sanitizing of all kitchen surfaces while handling raw products, washing of hands constantly while preparing food, pasteurization of milk which is known to destroy C. jejuni, and also ensuring that water is chlorinated as this also destroys C jejuni.

20. Regulation FoodNet U.S. Department of Agriculture
Surveillance of cases
U.S. Department of Agriculture
Preventing infection in poultry
Food and Drug Administration
Food Code for Restaurants
Public health professionals are working to decrease the incidence of Campylobacteriosis. FoodNet is responsible for surveillance of cases in order to identify possible looming outbreaks. The U.S department of Agriculture is conducting research on methods to prevent C. jejuni infection in poultry. The Food and Drug Administration developed the food code for restaurants in order to decrease incidence.

21. Take home message Clean Separate Cook Chill
The take home message for today, is that when handling food products such as meat in order to limit contamination from organisms such as C. jejuni it is important to Clean the area you are cooking thoroughly using disinfectants, Separate the poultry and meat products from vegetables and fruit to prevent cross contamination, Cook food thoroughly to the optimal temperature of 165 ˚F and lastly Chill food promptly after preparation (

22. So, Do You know how safe your chicken is?
Thank you for your time, and be aware of how you prepare your food!
For any further questions contact me at
Stay Safe!
Adeola Sonaike

23. References
Center for Disease Control. Foodborne Active Surveillance Network. Retrieved from
Colles,F.M., McCarthy,N.D., Howe,J.C., Devereux, C.L., Gosler,A.G.,Maiden, M.C.J. Dynamics of Campylobacter colonization of a natural host, Sturnus vulgaris (European Starling). Retrieved from,
Emerging Infectious Diseases. Campylobacter jejuni: An emerging foodborne pathogen (1999). Retrieved from,
World Health Organization. Campylobacter (2000). Retrieved from,
Center for Disease Control. Campylobacter jejuni-An Emerging foodborne pathogen (2008). Retrieved from,
United States Department of Agriculture. Analytical Utility of Campylobacter Methodologies (2006). Retrieved from,
U.S. Food and Drug Administration. Food Safety. Retrieved from,
Food Safety. Retrieved from,