Campylobacter infection is a very common cause of diarrhea worldwide. Campylobacter is one of the most frequent causes of food poisoning. It affects several million people each year predominantly babies under one year of age, adolescents and young adults. Campylobacter affects especially people who live in poor sanitary conditions. Malnutrition is an important factor in the frequency and severity of this infection.
Campylobacter is a bacterial genus that can cause various types of infections. The most frequent are fetal infections in some animals, such as cows or sheep and intestinal infections that cause diarrhea in men. There are many species of Campylobacter, but most of them will not affect the human being.There are three types of campylobacter which affect human being and their names are Campylobacter jejuni, Campylobacter coli and Campylobacter fetus.
Campylobacter bacteria are found in the intestines of many animals – they’re going to be eliminated through the stool– used for consumption as poultry, pigs, cows or sheep and companion animals such as dogs and cats. The majority of human infections are acquired through ingestion of contaminated food or water. There may also be transmission between humans.
Campylobacter Infection Symptoms
Symptoms of Campylobacter infection begin in two to five days after contact with the bacteria. The diseases caused by this bacillus can be grouped into two types: Enteric and Extraintestinal.
Enteric diseases: These diseases are caused by mainly Campylobacter jejuni and by Campylobacter coli. They are more frequent than extraintestinal ones. Most Enteritis which are produced by Campylobacter resolve spontaneously in 3-10 days. However, it is important to maintain an expectant attitude to ensure that the evolution is favorable. Typical symptoms are:
- Diarrhea: It is the main symptom of Campylobacter infection which may be greater or lesser severity due to its condition. This bacteria causes an inflammation of the intestine, cause diarrhea with presence in the feces of mucus, blood or pus.The main complication of diarrhea is dehydration (signs of dehydration are the presence of dry skin and mucous membranes, drowsiness, decreased urination …). The intestinal inflammation can be accompanied in exceptional cases of serious complications such as toxic megacolon, which consists in a dilatation of the colon at least 6-7 inches
- Campylobacter diarrheas that occur with bacteremia (passage of bacteria into the bloodstream) are very rare in immunocompetent people whose immune system functions properly. if it happens, it is usually a transient phenomenon that has a good prognosis. When it occurs in patients in whom the immune system does not function properly,it becomes serious and has a high mortality. The species that most often result in invasion of the bloodstream are Campylobacter fetus and Campylobacter jejuni.
- Fever (body temperature greater than 38 ° C)
- Abdominal pain: usually colic type and lasts approximately 2-3 days, although in some cases can last up to a week or even longer
- Nausea and vomiting
- General discomfort
Extraintestinal diseases:These diseases are caused mainly by Campylobacter fetus, although Campylobacter jejuni can also cause them. They are less frequent than enteric. Symptoms such as the following may occur:
In those caused by Campylobacter fetus:
- Affection of the heart and blood vessels: thrombophlebitis, endocarditis (inflammation of the inner layer that covers the heart), pericartidis (inflammation of the pericardium)
- Guillain Barré syndrome (an exceptionally rare neurological disorder)
- Others: arthritis, peritonitis, urinary tract infections
In those caused by Campylobacter jejuni:
- Arthritis (inflammation of the joints)
- Pancreatitis (inflammation of the pancreas)
- Cholecystitis (inflammation of the gallbladder)
Diagnosis of Campylobacter Infection
The anamnesis (clinical interview made by the physician on the patient’s symptoms) and the presence of symptoms compatible with a Campylobacter infection are necessary requirements for a first diagnostic approach to the disease.
Physical examination is usually not very useful, since it varies greatly from one patient to another and there are usually no characteristic signs that make it possible to suspect Campylobacter infection.
Alterations in the blood test may help to suspect Campylobacter infection (increased white blood cells, altered ions or blood pH if there is too much dehydration).
Microscopic examination of feces may reveal red blood cells and white blood cells. The definitive diagnosis of Campylobacter infection is performed with the co-culture (culture of the stool of the infected patient which demonstrates the growth of the microorganism).
If bacteremia is suspected (passage of bacteria into the blood) it is necessary to order blood cultures to try to demonstrate the presence of these in the bloodstream.
Treatment of Campylobacter Infection
In the treatment of infection by campylobacter, it is essential to ensure adequate hydration during the acute phase of the disease as in all diarrheas.It requires replacement of fluids and electrolytes to compensate for the losses of diarrhea. Hydration by mouth is always preferable by oral rehydration sera or beverages with salts, but in cases where there is a great affectation of the general condition, the replacement of liquids and ions will be carried out intravenously.
In regards to the food, once you perform less than 3-4 bowel movements a day, you should be taken gradually to a solid diet, in small amounts to verify that there is a good tolerance to the same. They should consume foods astringents such as rice, potatoes, toast, cooked poultry or grilled and cooked fish or some soups. You should avoid other types of food such as milk or its derivatives (even though we can tolerate yogurt and natural cheeses fresh as it produces improvement), sweets, fruits and some raw vegetables, some nuts, or refreshing drinks. Also, avoid consuming those foods that contain a lot of fats or other products such as spices or the spicy.
The antibiotic treatment of Campylobacter can be avoided in most patients, although it is true that it can lessen the symptoms and shorten the period of fecal excretion of micro-organisms. Most used antimicrobials in our environment are erythromycin and azithromycin. It is advisable to treat with antibiotics those patients very symptomatic (high fever, bloody diarrhea, those who make more than 6-8 bowel movements a day).
The prognosis of the infection by Campylobacter is very good for the majority of patients who recover in a period that ranges between five and 10 days. Although in patients at risk (young children, elderly and immunocompromised) may be a greater number of complications. In fact, Campylobacter infection can cause even death in these patients.
How to Prevent Campylobacter Infection
In order to prevent Campylobacter infections, it is essential to practice basic hygiene practices.It is very important to be clean in our Daily life and must be carefull when we make our Daily meal.
Some preventive measures will help aganist Campylobacter Infection are:
- Wash your hands thoroughly several times a day, especially before handling and preparing food, before meals or after going to work. Proper handwashing with soap is one of the most effective prevention measures in all age groups.
- Disinfect objects that may be contaminated by infected feces (this includes disinfecting lavatories after they have been used by people infected with Campylobacter).
- Control the management of excretions rigorously. The diapers of infected children should be thrown away in a sealed bag, and the area where the diapering was done should be properly cleaned with disinfectant products.
- In addition, when a school-age child is infected, it is important to promote a series of hygienic-sanitary measures in the nursery to avoid contagion to other children.
- Watch the different stages of the food chain (production, processing and preparation of food).
- Cook or pasteurize the contaminated food, since heat destroys the bacteria (bactericidal action).
- Try to manage in the best way possible to the wastewater (in the least-developed countries), to prevent its use for irrigation of crop fields or for consumption.
- Do not drink water from rivers or other areas close to areas of grass, because there is more risk that it is contaminated.
- Avoid consumption of raw milk and dairy products