IN HUMANS
PREVALENCE AND RISK FACTORS • Campylobacteriosis is mainly considered food-borne, with an estimated 77% of cases transmitted through food consumption in Australia. 2 Most outbreaks are linked to poultry as the primary source, with infection seasonal in temperate climates. 11 • The two most common species causing human disease are C. jejuni and C. coli. Other Campylobacter species, including C. lari, C. upsaliensis, and C. fetus , may cause infection in humans, although these are more sporadic. • PCR can detect a broader range of Campylobacter as some species are difficult to culture under routine conditions. 11 However this depends on the assay, as the targets included in PCR assays vary. Because of the limitations of culture diagnosis, PCR-positive, culture-negative results may be seen in 10-30% of cases. 12
40,000
30,000
20,000
10,000
0
2015
2016 2017 2018 2019 2020
Campylobacteriosis notifications by year in Australia (2015 to 2020) from National Notifiable Diseases Surveillance System. Data accessed April 2021.
infection may be asymptomatic or result in acute, self- limiting illness associated with diarrhoea, fever, and abdominal pain. More severe and persistent disease is seen in immunocompromised patients. • Extraintestinal infection may occur through ascending infection (cholecystitis, pancreatitis) or bacteraemia (meningitis, pneumonia). Extraintestinal infection is more common in the very young or aged, or patients with primarily T-cell related immune deficiencies. 13 • Post-infection campylobacteriosis complications may include irritable bowel syndrome, reactive arthritis and Guillain- Barre syndrome, a neurological disorder primarily affecting peripheral nerves. These are estimated to occur in 8.8%, 7%, and 0.03% of cases respectively. 14 Additionally, cardiovascular complications (myocarditis) and reproductive complications due to intrauterine infection have been reported. 15 • Campylobacter infection in humans is notifiable in all states and territories of Australia. • Campylobacter enteritis is usually a self-limiting condition and generally does not require antimicrobial therapy. Antibiotics may be indicated in severe or prolonged cases, in the third trimester of pregnancy, in infants, the immunocompromised and some elderly patients. • Most infections acquired in Australia remain susceptible to macrolide and fluoroquinolone antibiotics, however quinolone resistance is frequently demonstrated in Campylobacter isolates acquired during travel.
Gram stain of Campylobacter from blood culture
• In addition to direct contact with pets or indirect contact with a contaminated environment, other risk factors for human infection include consumption of contaminated meat, milk or water and international travel. • The incidence of notified campylobacteriosis cases in Australia is 124.6/100,000 (2020 data – National Notifiable Diseases Surveillance System), with an estimated 10 cases for every notified case within the community. 1 CLINICAL DISEASE • The incubation period in humans is reported to be 2-5 days, with a longer incubation period in children, and a shorter incubation period associated with higher challenge doses. • Gastrointestinal infection with Campylobacter can occur in any age group. In healthy immunocompetent individuals,
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26 Companion Animal Zoonoses Guidelines
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